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058-200-072
n � 58-20-72 3889-89E IFED t FDiFEDE; Rosario & Lo uise 4520,Big Bend Rd, Orovill 058-200-072 05-2245 4520 BIC, . W ` � r NOTES l �- C 2�3�0'� l v •' o ✓V t --aa -2, -6 Cry 1 �1 Pell Jocke r { 3 PERMIT NO. RESIDENTIAL 058-200-0721 OS -2245 HEIMBECHER, WALTER 4520 BIGBEND RD, OROVILLE Cont: GREENE ROOFING M/H PERM FND (NEW) 1, OFFICE COPY ddress y�z� 81 ai'AW . Rio ���Q"*;� Deo lie-, GAS I i'L•01 Meter By �An� Date ELECTRICG'AA� Meter By Date SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -ST ARD HOUSING LETTER i� Cn-, be_- (d W CJS J JOB FINALED (Date) SignatureyJ2/� pom i1�1�aUr AL d S 0 (2 3y HJOh - 01140 1-176°lyl JOB FINALED (Date) SignatureyJ2/� = OK -Not OK = NotReady eaficabie = Not RMOBILE HOMES Date MOB! E'HOME UTILITIES (Plans) OK except #'s Zoning Requirements -Setbacks -Easements 2. Sols; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Water, Location -Test -Easement Needed (Sketch) 5. , Location-Clearances-Gmd-/ /Amp -Concrete Q f Gas; Location -Test -Wrap;-/ /" L'fL - PNat or/ /"LW PLPG ✓ -� 1. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s r1 /toning Requirements -Setbacks -Easements 2. gs; Siz ting -Marriage e MHT Demand -Valve nnector ricity, MH Test -Crossovers -Breakers -Clearances 5/'Drain; MH Test -Fall -Flex Connector 6. Wa r, MH Test -Regulator -Connector' 7. Katz and Sewer Connected -C/O to Grade -HD Approval and Electricity Tagged Tie Downs -Type -Installation Cert Exits; Insp.-Sketch 11. Cert of Occupancy Date', {�D{" Cana B-1 , Date Card B-1 Date'l Cana B-1 Date Card B-1 W. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 uate Gard 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 Cana 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 -GA 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Sec.: 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 Cana B-1 Date Card B-1 = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) late UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth 3. Ftg., Garage; Sols-Steel-Elec. Gmd. / /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth S. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Felting -Test -2 Way C/0 -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping-, Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill HL & 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-Nairing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor -Ducts -Meth. 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. KrL Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at M. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Dud in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector- P.R.V. in Garage; Above Floor -Meth. Protection 78. Plb.; Bec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FFI.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes 83. Following InslldJDrive O Yes 0 No/Walks O Yes O No/Plarders O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 1B. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated Neutral O Yes D No 32. Service -Riser Conductors & Ground Main Disconnect `. 33. Equip. Clearances Panels -Motors -Meeh. Equip.. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill HL & 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-Nairing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor -Ducts -Meth. 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. KrL Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at M. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Dud in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector- P.R.V. in Garage; Above Floor -Meth. Protection 78. Plb.; Bec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FFI.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes 83. Following InslldJDrive O Yes 0 No/Walks O Yes O No/Plarders O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELRMENT SERVICES BUILDING PERMIT BP052245 24 HOUR'INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and Issued Date: 09/15/2005 APN: 058-200-072-000 effect. 'License Class : License Number. Site Address: 4520 BIG BEND RD CON Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: MH PERM FND NEW(2142) 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: HEIMBECHER WALTER J & SARA S 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 1454 NIGHTHAWK W K PL 7000) of Division 3 of the Business and Professions Code) or that he or is therefrom SANTA ROTA, CA she exempt and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the 95409-4366 applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as'owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: HEIMBECHER WALTER J & SARA S 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 ' 1454 NIGHTHAWK PL year of completion, the owner -builder will have, the burden of SANTA ROTA, CA proving that he or she did not build or improve for the purpose of sale.). 95409-4366 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' Stale License Law.). Contractor: RED LINE INSTALLATIONS INC ❑ I am Exempt under Article 3 of the eusi assfessions Codde Date: Q/�oS Owner: _ 13407 GARNER LANE CHICO, CA 95973 WORKERS' COMPENSATION DECLARATION (530) 895-5543 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 License #: 848025 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: the work for which this permit is issued. My workers' compensation 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: 2142 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: $139,230.00 and agree that if I should become subject to the workers Census Code: compensation provisions of Section 3700 of the Labor Code,1 shall forthwith comply with those provisions. 5� Date: Applican WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred' thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. �r CONSTRUCTION LENDING AGENCY This permit is her issued and the. applic Ie ovisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutions to work indi at above or is e s have been paid. q-1 F—.0 Name: By: Date: 1 PERMIT Address: 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 ow r. I agree to comply with all county and state laws relating to building construction. 1 acknowledge it is unlawful to alter the substance of any official form or document of a County. I hereby 'authorize representatives of ButteCo my to enter upon the above mentioned property for inspection purposes. Print Name: l�/A-L7 y��l i✓% %3�l'�� - Signatu Date:a¢ ,❑ Owner ❑ Contractor 0 Agent for Owner 0 Agent for Contractor COUNTY OF BUTTE -DEPARTMENT OF- DEVELOPMENT- SERVICES BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 fax f530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: e/ s7yj bea hop- ASSESSOR PARCEL NUMBER 0,aF-, 56-� (J / 2 Proposed Building Use: {%% 4. IQG /J% �� Permit Technician: / Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. • 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. O 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 faxesl ❑ 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:j(A) Installation manual, including marriage line info,, fit, Floor Plan,,-) Tie down or fnd -lans all in duplicate. ❑ . 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form fo 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Re 'ning items needed to issue the permit. (May require additional plan rciview upon receipt of the following items.) 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chicooville, as applicable 16. Fire Sprinklers............................................................................................ (j 17. Agricultural Buffer clr.and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... Erosion Control Plan Required........................................................................ Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 1. City of Chico Plumbing permit........................................................................ ❑ _ 22. Site plan and business license approval from the City of Biggs .............................. / 23. California Department of Forest Ian approval 42 aid. Sent by: GS 24. Planning approval for (A) Use: �- B)Parking: (C) Parcel Check:. ! .... 25. Contact Land Development about _ Improvements, _ Drainage ........................ 26. NPDES Form.............................................................................................. Cq=N 27. Encroachment Permit for driveway from the Public Works Dept........ a1=105. 6- 0 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... J2- - 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone /,%7 =?e3)�i/�.�-l7 73'/�o�nPi and hold for pickup. I have been informed of the above items and regdirements for obtaining a buildjng permit. Applicant. Date: A -Z z- c`% " 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items re Contractor, designe owner as advised of the above data by V p n , 'L"J mail, ❑ counter, by K. 01 Date: - �J Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed b.. Date: ructural approved by: Date: Note transfer by: Date: _ Yellow: Building Division ao� ^COUI�T,Y OF$UTTE J 6 DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE (530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER` A.P. # PROP OSED BUILDING USE DATE' RECEIPT # DATE REC. 1. BUILDING PERMIT FEES S-�s -- Balance Due ..................... $� �. I t05_69 I per/ --- FEMA Flood elevation review ... $ --- Additional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES 11 Y o Ontati ue'1) S /30/CJ (paid at School District Office) (form avail le after Plan Check) 3. � -0 SHERIFF FEES (paid at Building Division) Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg.'il RECREATION DISTRICT FEES /(% %(� ISP, ✓(LSC _ -��'� (paid at Recreation District Office) (form available after Plan Check) q� RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per dwelling) Zoning SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) � 7. WATER TENDER FEES BATTALION # $200.00 (paid at Buildingg Division) 8. SMEP�t' ; q2, ( 26��7 9. DRAINAGE FEE 10. OTHER 11. OTHER At time of permit application, I was advised the above fee are required to be paid i r to issuance of the permit. These fees ss. may be changed during the plan checking proce DATE ig -ZZ -O<' Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 7/05) El 4. t *W ." C BUTTE COUNTY SCHOOLS lbPi1 FEE CERTIFICATION FORM One form per,fl3ullding) 4 rl1 Trc"4�. f. School District � n V,f%i y � 1 tl y'T' //(0eulleing Department No. A.P. Number 4f - r% �Jurisdictlon: Q Clty County Property Owner ( %/% 1����l•Ji'I (,�t� _ -� Ai l �� Xs--�22&s- Property. Location/Address �� �7 .L tom) 15 r��/J/�%�/i /l l PA . Subdivision Lot No. ......................_........._............................:_._....__-................._..., Residential Development 0 0� 0 Q Sq. Footage No of Living Mobile Home ': Addition/ 'Supplemental to (Group R) Units Installation _ Conversion' ` " Permit # e -(No foundation inspection) .............. _........ .........................................._....._......._...._.... ....... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) 'r Commercial/Industrial 0 Q Sq. Footage New Addition (Including Exterior 1-7 67 % �O'� Roofed Areas) I, or? ..;.- Build'ingl5epartment Representative + = Date District Identification No. 06 o lhL School District certifies that (Street Addiess) has complier with the requirements of Resolution No. representing square feet. r: Representative Paid by Check # Remarks: (Applicant) ' (Phone Number) %_,4 , ,-vlr.jiU*1.fes... r v r , . . (State) / (Z(Zip Code)/ S = u Q �l b a of U Li . �p2 Y'Yment S , i 2926 $ FULL MRIGATION $ Date 41 Notfoe: You may protest the Imposition of the fess identified above by submitting a written protest to the DWUK In compliance wMh Govemment Code section 66020(a), wltirin 90 days from the date fees are paid. Failure to submit a timely written protest wlll'prohlbit you from challenging tit Imposition of the fees In any court action. , if, subsequent to the school District Representative signing this Butte County—S Impact Fee Grtllkaflon Form, the School District Is rroU by fit applicable Local Planning Agency #0 this project Is being`.' 1\ wxW the California E rivlronmarW Quality Act (CEQ4 thio proleet may be sublect to additional school tees to fully midgets Its impaet.on the school distriel'a schools. Yellow (building department), Pink (school district) teeform.xls (10/03)dmm •�M BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM ❑ FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) ❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD) B-16ARADISE RECREATION AND PARK DISTRICT (PRPD) 0 DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s)Building Permit Number Property Owner (s Project Location /Address Subdivision Name Assessable Sq. Ftge Type of Residential Development (check one) New Development Single Family -Detached Single Family -Attached /Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling !/ Mobile home Mobile home replacement verified by Assessor Department Demo Permit (date issued ) verified by Building Department hT � �0� Comments: /./lJ d�P/� /J �YYI � //I/I /1' /l //�✓� ❑ FRRPD ❑ CARD VRPD ❑ DRPD certifies that: (,J 3- F29`� Applicant Name Phone Number L( S 2a «� Mailing Address City State Zip Has complied with requirements of the Butte County Board of Supervisors Resolution No. 0 by Payment of: Dwelling Units @ $ per unit for a total of $ 02 t{ Z Square Feet @ $ Ll i per sq foot for a total of $ Remarks: Paid by Check No: Paid by Cash: e _ .. .. .... ...... ....... ....... .... . --�--'--.1 A-, L? L/,2- L( FL Receipt No: 7 l / g - Fo.5- Date 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 Phone (530) 538-7157 Ext. 2016 Permit Number 066 District �'6 APPLICATION I / WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the County roads and highways, all in accordance with County ordinances and general laws. All information except signature must be typed or legibly rinted. 1. Applicant's Name: , / LT f�Ei M E la. Company Name: 2. Address: O• fl 4/ Z ,T 3. Phone:4. 3 b 403 SZ S61 Assessor's Parcel Number: os CXD 5. Location of Work o be Done S /moo WoLllaze 6. Applicant's Signature 7. Date: 8 - /% CONTRACTOR'S INFORMATION 8. Contractor's Name 9. Address ' . - S 10. Phone: 1 L Fax: 12. Contractor's License Number: 13. Certificate of Insurance: Yes F<P No: ❑ 14. Contractor's Signature: 14a. Date Signed: 15. Authorized A-ent: Lin .0 CA j�j.& TYPE OF WORK TO BE DONE 16. Please Check: Curb: ❑ Gutter: ❑ Sidewalk: ❑ 17. If Driveway List Type: 18.0ther Wrk - Describe: 19. Plans Attached: ❑ Yes ❑ No PERN(PT GRANTED In compliance with the above request, and subject to all terms, conditions (including those on page 2 of this permit form) and special conditions written below, permission is hereby ranted. 20. Conditions j� /,-x 7 &1 7 4 n e ' k 4, r i A, la," 2 u fi �-' .o e //18, / g1 ,l : 3- I Underground Service Alert U.S.A.) must be notified two working days prior to any excavation. 800-227-2600 21. ❑ All work shall conform to accompanying: Detail ❑ Plans ❑ Special Conditions ❑ 22. Date Issued 23. Expiration Date: 24. Surety: 25. Date Paid: �_ 26. Amount Paid: 27. Paid By: e, 28. Receipt No.: q/ t Mike Crump, Director of Public Works By: For Count 29. Final Inspection Date: 30. Inspected By: ❑ Compl ❑ Completed - Not OK ❑ Additional omments Attached Use only: ' 1 31. Comments: Note: If permits are faxed to any number besides (530) 538-4356, they can be delayed up to one week. Page I cf 2 ' arrePRTMENT O � 6V T TF 1,: o O < l O _ c pc0UN�yy AUC WOF� .Department .0 O u it t J. Michael Crump, Director of Public ® f B U t ork5 LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville. CA 95965 (5.30) 538-7266 (FAX) 538-7171 National Pollutant. Discharge Elimination System (l.PDES) Phase. ll Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement I & a �N 9 ACCR EJ Project Description: i� .5 � at- L• �p � 4iACZcIAZIs :���s Project Location and/or Parcel Number: �5Z0 i3�� �3�"�d AAA OQ0y`�� Aaw 05%3 By signing below, 1, the project owner/owner's agent, certify that this project WILL, NOT DISTURB 1 acre -or more.of land and that 1, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: Date: Less than I Acre NPDES & SWPPP Compliance Certification Butte County Stgtm Water Management Program Butte County Department of DevelopnentServlces evTrF °° 7 County Center Drive ° Oroville, CA 95965 0 _-,. o (530) 538.7601 Telephone c�UN'�y (530) 538-7785 Facsimile BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities,' including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: • I need to submit applications for septic and/or well to Butte County Environmental Health immediately. • I am required to bring the approved Environmental Health site plan and' approved sanitation clearance to the Building Division as soon as clearance is obtained. • I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building_ permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. ,Typically other required permits/clearances include, but are not limited to, verification the parcel was legally created, adherence to all mitigations and conditions imposed on the parcel at time of .creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: ' I Applicant Name: HIgSC,E-i(5-p, APN: OSS-Zc>,o-O%fi:6C0 Building site address: LFSZO IBIG, ,c3EN ,fid Zneyl l,__ Permit No.: BO! w -2Z'�/S I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: SIGNATURE OF APPLICANT 8 -r-7 —US" DATE Copy to Applicant/EH/File K:Fonns/BldgPennitwithoutClearances 020705 RECORDED MAIL TO: MY BUILDING DIVISION ENTER DRIVE CA 95965 X005-0049474 Recorded_ 1 REC FEE U-1ficiat Records I County of i CPIES iutte j c11+i'z ,t. 6iRIJBBS I aunty Clerk -Recorder! I 1 LV 101@;l5 l 22 -Alun -,'Z05 1 Page I of i AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying; pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations.. All that real property situate in the County of Butte, State of California, described as follows: =j e e chi i cLC1•, e a ' Date PROPERTY OWNERS: r LA2)ALZC_nE (M B ECA State of California ) County of '3u4i:, ) On before me, C•R (. i 5'Cv V --L1 Pwb (; C. personally appeared V0AL..TER- 1+6oabeci4C-P_ 15*V_i9 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 se/al. Signature Seal: CHRISTY L. HINKLE y COMM. # 1493928 NOTARY PUBLIC -CALIFORNIA A.P. # ' ZOO" COUNTY OF BUTTE Comm. Expires June 7, 2008 L. W Vector Dynamics Foundation System INSTALLATION INSTRUCTIONS for the State of California Version 9/212003 INDEX PAGE RELEASE SECTION NUMBER DATE INTRODUCTION 2 9/2/03 GENERAL INSTALLATION 3 9/2/03 PARTS LIST 4 & 5 9/2/03 LONGITUDINAL DEVICES 6 9/2/03 PIER HEIGHTS 7 9/2/03 SET-UP INSTRUCTIONS 8 9/2/03 FOOTER SIZES WIND ZONE I = SINGLE 9 9/2/03 - DOUBLE 10 9/2/03 - TRIPLE 11 9/2/03 - HIGH PIER 12 9/2/03 WIND ZONE II - SINGLE 13 9/2/03 - DOUBLE 14 9/2/03 - TRIPLE 15 9/2/03 V -DRIVE & PIER SYSTEMS 16 9/2/03 SOIL CLASSIFICATION 17 9/2/03 CONCRETE INSTALLATION 18 & 19 9/2/03 COMPONENT PARTS AVAILABLE UPON REQUEST Approval MA"ACTURSD ROMF111dODUS WAS FOUNDATION SYSTEM SBALTH AND SAFETY CODE. Q=ON ISM APPROVED $Ull= TO CORRECTIONI NOTED A"20VAL DOES NOT AUTHORIZE OR A"ROVB AM MISSIONS OR DEVIATION FROM RWREMEIM 01 APPLICABLE STATE LAWS AND RBGIA AIWM 3ftW Callfamle CODESAND 87ANDAlD DAMIS tai 19 FAe&5 �- BUTTE COUNTY BUILDING DIVISION APPROVED co I co N O O O 13'� FWLAYOUT --------- --------- SPdO®R ET MIG RO 4 > UJ rALW.Y R06- ' BE0R0", F ' UASTER BCD - WARpO8E5 b l 13.b, 36.0 .. { A -UNIT - �+ w ems. (. TaTAL a ADD 12-0 1REAi BOR SCRAP FROM DWDG ROOM AL Am D 2's 4.12• 4.9 r�.. 2'.10112• 2'.3• )'.9• 3.4112• 3',01/8'OPTIONA�ARPET -j, —■--/ —•— ------------- -- -- aGUEST FI 30 P:FO7 PSF Oj )O PSFQ7 30 PSF PSFOI 70 FSF30 PSF; Q,30 PIF 6 30 F9F 6 3O FSFO 30 F5F 30 . .... .......... Lam.......«.....�—_ BaR WRAP - - I 70 PSF I 70 F'SF P5F 3 30 P5F USE W/ OPT. RETREAT U5E SCRAP FROM 1NI5 5ECTION FOR 4 13.6 .14.0 13�i MASTER WARDROBE LPIO' B - UNIT - -w0 LINOIF �. L Y • 13'-5 In* 14'.6 V1' 4'•1' 4'.1 1/4' 4'.1 114' 5'.9 314' 4'.7 318' 4.2 3/8' ------------ - ----- --- — �� --- i M (BEARING WALLS) FSF-----------�(5� 7O PSF3 20 PSF O3 30 FSF 03 3J' PSF I IOL O 30 p5 Q 30 PSF V 30 FS /� 6 30 FR3 5 30 PSF -3 30 F5F 3 30 PSF ------------ ---------- ------------ (CLEAR SPAN) A Manufacturing West, Inc. - { 13-b, 4E-0 T '� I � �.•_ ;' � 1/ lJ°`d • 7 - C UNIT Lao L Oi :•± • _______________ \\ LDlO '• ------- %' Albany Division - Plonf ®972 2445 S.W. PACIFIC BLVD. ALBANY 41 97 321 Phone 541 926-8631 Fa: (8 6) 491 6847 DRAW D N 1 1 ILC CARPET &PIER LOC. J. HENRY • ••»••• 61DEwALL: 4- OR 6' 4' WALLS PRODUCT GOLDEN ESTATE �ODCL NO. GE 561K-05 ` e PIER CPIERAPACITY FOOTING SII( FCOUIR[D (S0. IN.) N0. (EBS.) 1000 PSF 1500 PSF 2000 PSF I ' 2000 286 192 144 ` Q 2500 360 240 ISD PIER FOOTING SIZC REQUIRED (S0. IN.) PIER CAPACITY — NO. (LDS) tODO PSf 1500 PSC 2000 PGF 3 4000 576 384 288 ' Q 5000 720 480 360 PI[R NO' ' 5 ; © FOOTING SIZC R[OUIRCD (S0. IN.) PIER FOOTING SIZE REQUIRED PIER CAPACITYso. NO' (EBS) 1000 PSI 1500 PS: 7 10000 1440 960 ® 12000 1728 1152 (SO. IN.) n. 2.142 DME 9-2%=D4 200D PSF 720 864 CAPACITY (E85.) 1000 PSF IS(HI Ptf 2000 PSF 6000 864 576 432 8000 1252 768 1 576 seEEl ' —A REvrsco- r- Gt-� -v7lou � . ..... .... .. ----- ------ ------- - IPA VYL 'o I- MINd ROOM .'-, —_.—PERFORMER SEAS -Ig'! GE 561K +#-8 2 BATH, LR, FR, RETREAT (OPT. SR 5), 2142 SO. FT. m Cn 00 Lu IPA VYL 'o I- MINd ROOM .'-, —_.—PERFORMER SEAS -Ig'! GE 561K +#-8 2 BATH, LR, FR, RETREAT (OPT. SR 5), 2142 SO. FT. mo 16. Cn 00 Lu LU 0 fir„owl ICLI oo (D O Ul TO: FROM: SUBJECT: Building Department Environmental Health Sanitation Clearance E.M. USE ONLY Slot Plan AnacMd door Ran Attached sant to G.D. ! " r 06, Owner Location AP# Plan Approved for: Sewage Disposal L/"*" Water Supply: Public Private Well Clearance for dwelling. Other Hold final for: Final clearance O.K. for: NOTE: /"I UVA Environmental Health Specialist 8/96 Date Env A 171 ----- -------- ----- EWROMMIENTAL HEAlTR,-W--- AUG 2 20M 7 COUNTY CENTER DRIVE .�j BEDA FAM m fa IPA ""ct"c C F -L D Ir LmNd ROOM A .FORMER ff I C:"� L- 4-�2' BATH, LR, FR, RETREAT (OPT. SR 5). 2142 30. FT. 3 a 9- * DEN c APPROVE® Butte County !rp ental ealth c, 0 a c Ul cl cn a) 01 cc O r Ul 02/07/2006 10:48 GOLDEN WEST HOMES 4 5382140 NO.001 D01 STATE OF CALIFORNIA NUMBER: BUSINESS, TRANSPICINTAToON AND HOUSING AGENCY °� �j OEDARTMENTOF MSION OPING AND COOES AND STANITY DARDS 874:3799 - 8 /�f4'J 1 J J ' MANUFACTURED HOUSING PROGRAM "►"°`� MANUFACTURER CERTIFICATE. OF ORIGIN. pnrrRtmrml#, ORIGINAL (PINK) FORWARD TO THE INVENTORY CREDITOR UNLESS THERE 13 NONE, THEN FORWARD TO THE PURCHASER (ORALER OR flUNSFER[Q. COPY 1 (4WITE) FORWARD TO THE DEPARTMENT AT P.O. BOX 1628, SACRAMENTO, CA OB,12.1026. MRTHIN FNE (5) DAYS OF REUL#.$L COPY 2 (YELLOW) OELNER TO THE TRANOPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION. .COPY a (GOLDENROD► TO U WTNNED BY THAW WUFACTuAER.—........ MCD AB7.0 • Side 1 . (7197] �.._ CHECK IF THIN IS A DUPLICATE MCMENTER ORIGINAL MCO N0. A9AN FACTURED HOME OR MULTI -UNIT jIq(1NUF.AC URED HOUSING NUMBER OF .... I SFD (SINGLE FAMILY DWELLING) ❑ MUMII (MULTI -UNIT MANUFACTURED HOUSING TRANSPORTABLE SECTIONS 3 COMMEE&I&C960 OCCUPANCY GROUP MANUFACTURER NAME: MANUFACTURER LICENSE NUM6ER: Ciiii MANUFACTURING WEST, INC. MN1126458 MANUFACTURER ADDRESS: ; SUGGESTED RETAIL PRICE: 495: PACIFIC BLVD SW ALBANY, OR 97321 i sl�Ie zl MANUFACTURER TRADE NAME: MODEL NAME AND/ORty)JNUMBER: DATE OF MANUFACTURE: GOLDEN WENT 72PER42564AH06 11110105 NAME OF DEALER OR TRANSFEREE (OWNERSHIP TRANSFERRED TO): CALIF. DEALER NUMBER OR DATE OF TRANSFER: TRANSFEREE DESIGNATION: GOLDEN PACIFIC—CHICO 1118851 11 18105 DEALER OR TRANSFEREE ADDRESS' 07 GARNER LANE CHICO, CA 95973 ,4 C. smee (r INVENTORY CREDITOR NAME_ GE COMMERCIAL DISTRIBUTION FINANCE INVENTORY CREDITOR ADDRESS: f&'45 TRILLIUM BLVB3RD FLOOR 5W AOFFMA STATUS, IL 6 2 (zip) SECTION -6 MANUFACTURER SERIAL NUMBER HCO INSIONA OR HUD LABEL NUMBER LENOTN WIDTH WEIGHT INCHES INCHES (POUNOSI 1 ALE0300340RA CRE 478940 672 162 \ 6460 Al.9030034ORG ORM 478a4l 672 162 26460 Z 7 P TRANSPORTER NAME: TRANSPORTER ADDRESS: Strad(Cwl _. 6bMal Z. I DESTINATION FOR UNIT DESCRIBED ABOVE: DEN PACI®IC—CHICOs�13407, LANE, 95.973 NCO" .,.GARNER cCHIC0�_,CA I wnTy Ian many at PaIIN woo Qb www d ft BIOIS N. ra.-sa is Intl ft Corm 12= 17e ow 410 CUT= . . F-600 en 11 , 18 105 M LINK ORFAGN (Cate) ► eu I �/ 61oIa -... SN;NATURE OF AUTHORIZED AGENT; ' pnrrRtmrml#, ORIGINAL (PINK) FORWARD TO THE INVENTORY CREDITOR UNLESS THERE 13 NONE, THEN FORWARD TO THE PURCHASER (ORALER OR flUNSFER[Q. COPY 1 (4WITE) FORWARD TO THE DEPARTMENT AT P.O. BOX 1628, SACRAMENTO, CA OB,12.1026. MRTHIN FNE (5) DAYS OF REUL#.$L COPY 2 (YELLOW) OELNER TO THE TRANOPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION. .COPY a (GOLDENROD► TO U WTNNED BY THAW WUFACTuAER.—........ MCD AB7.0 • Side 1 . (7197] �.._ RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 2006-0006236 Recorded I REC FEE 10.00 Official Records I County of I WORKED COPY 1.00 Butte I CANM J. GRUBBS I County Clerk—Recorderl I DD 010:1" 07 II-feb-2®06 I Page 1 of 2 IfII"III"II�'IIII"II'�II'�III" SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. WALTER J. AND SARA S. HEIMBECHER REAL PROPERTY OWNER/LESSOR 1454 NIGHTHAWK PLACE MAILING ADDRESS SANTA ROSA SONOMA CA 95409 CITY COUNTY STATE ZIP 4520 BIG BEND ROAD INSTALLATION MAILING ADDRESS, IF DIFFERENT CONCOW BUTTE CA CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 05-2245 530 538-7541 BUILDING PE 1T NO. TELEPHONE NUMBER SIGNAT/J CAL AGENCY OFFICIAL DATE NO DEALER NAME (if not a dealer sale, write "NONE') NONE DEALER LICENSE NO. CMH MANUFACTURING 2005 72PER42564AH05 MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMENUMBER ALB030034ORA/B/C 56 x 27, 48 x 13'6" ORE478940/1/2 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER 058-200-072 HCD FORM 433(A) REV. 8/91 WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD -Building Dept. +�ii f i� �i� �i� � iii t � `�i � �;i i�r iii Order No. 104517 EXHIBIT "ONE" PARCEL I: Lot 13 of Section 36, Township 22 North, Range 4 East, M.D.B.&M. EXCEPTING THEREFROM: The following described parcel of land: AICOMMENCING at the Southeast corner of the Southwest quarter of the Southwest quarter of Section 36; thence Northerly along the East line thereof, 353.50 feet to a point; thence Westerly parallel to the South line of said Section, 430.00 feet to a point; thence Southerly parallel to the East line of said Section, 353.50 feet to the South lien of said section; thence Easterly 430.00 feet to the point of commencement. ALSO EXCEPTING THEREFROM: The following described parcel of land: COMMENCING at the Southeast corner of the Southwest one quarter of the Southwest one quarter of said Section 36; thence along the South line thereof South 89038'51 " West, 430.00 feet to the Southwest corner of that certain parcel of land described in the Deed to Leo L. Neher and Betty Neher recorded February 26, 1953, in Book 663, at Page(s) 81, Official Records and the true point of beginning for the parcel of land herein described; thence from said true point of beginning and along the West line of said Neher parcel North 0°51'55" East, 239.25 feet; thence leaving said West line South 20101'29" West, 121.85 feet; thence South 0°51'55" West and parallel with the West line of said Neher parcel 125.00 feet to the South line of the' Southwest one quarter of the Southwest one quarter of said Section 36; thence along said South line North 89038'51 " East, 40.00 feet to the true point of beginning. . PARCEL II: Being a portion of the Southwest one quarter of the Southwest one quarter of Section 36, Township 22 North, Range 4 East, M.D.B.&M., and more particularly described as follows: COMMENCING at the Southeast corner of the Southwest one quarter of the Southwest one quarter of Section 36; thence along the South line thereof South 89038'51"West, 430.00 feet to the Southwest corner of that certain parcel of land described in the Deed to Leo L. Neher and Betty Neher recorded February 26, 1953, in Book 663, at Page(s) 81, Official Records; thence along the West line of said Neher parcel North 0°51'55" East, 239.35 feet to the true point of beginning for the parcel herein described; thence from said true point of beginning and continuing along said West line North 0°51'55" East, 114'.25 feet to the Northwest corner of said Neher parcel; thence along the North line of said Neher parcel North 89 ° 38'51 " East, 430.00 feet to the East line of the Southwest one quarter of the Southwest one ,quarter of said Section 36; thence• along said East line South 0051'55" West, 25.64 feet; thence leaving said East line North 86135'12" West, 390.30 feet; thence South 20101'29" West, 121.85 feet to the true point of beginning. , Parcels I and II above are pursuant to a Boundary Line Modification approved by the County of Butte, by Deed recorded June 23, 1982, in Book 2732, at Page(s) 353, Official Records of Butte County, and cannot be sold separately. Assessor's Parcel No: 058-200-072 2 " _ FOUNDATION, SYSTEM CERTIFICATE OF OCCUPANCY BUILDING PERMITS NUMBER: 05-2245 Addressor location of unit: 4520 BIG BEND ROAD, CONCOW Legal Description of Real Property: 058-200-072 SEE ATTACHED (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551.. Owner's name: WALTER J. AND SARA S. HEIMBECHER Owner's address: 1454 NIGHTHAWK PLACE, SANTA ROSA INSIGNIA OR HUD NUMBER: ORE478940/1/2 SERIAL NUMBER OR V.I.N.: ALB0300340RA/B/C MANUFACTURER'S NAME: CMH MANUFACTURI G YEAR: 2005 OFFICIAL APPROVING INSTALLATION: DATE: �` ` PHONE: (530) 538-7541 H.C.D. 513C e SITE PLAN REVIEW APPLICATION Date: Permit Number (if applicable) Q :�—dZ,2Y,j' APPLICANT INFORMATION Owners Name: Owners Address: /`` Q' ox Telephone No Situs Address: Proposed Use: AP# 65Y—x.00 -07.�- Parcel Size: ,? -qk 5' Residential ❑ New Single Family Residential Single Family Addition/ ❑ Single Family Remodel Mobile Home fll, w �,� of v, 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 ❑ Commercial Remodel ❑ Industrial Remodel ❑ Septic ❑ Well ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) 40 Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval '( Site Plan Stamped Approved By Date J� Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: " Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) Expansive Soils (Test for expansive soils and if verified proper foundation design required) SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See a_ ed) • Flood Zone:Flood Panel No.: C,Index Date: �C!A19 ❑ 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: F -R_ -S ('9 S('9 P-- piv_ Applicable Building Setbacks: Front Zoning Code , Streets & Highways Fire Prevention Subdivision Map Side t Side Street Rear �D r 1 30 Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2of5 Applicable Development Fees: Standard Fees ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ Other Subdivision Map Special Fees Amount Formula ❑ 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 CoStandards for Deed Creation: [I No El Yes Co ents: o�u5 S ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel '❑ Verify Legal Access ❑Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑. Obtain a Merger El Obtain a Lot Line Adjustment El 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 ❑ Subdivision Mau/Parcel Map: Map Date of Recording: Lot: Book: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Page: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development.. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for roa EJ 1 Page 4 of 5 I 4^ El 1 x Summary of Specific Requirements: This information provided in this summary is based on the application information and on the best available data at the time of review. CALarryslBuilding Permit Site Plan Reviewl.doc Page 5 of 5 58-20-72 3889-89E DiFEDE 4520 Big Bend Rd, Oroville a . '(inst11 power pole for well.) ........... COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - OrovilligACallAWnia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ,,.... PERM �T-NO. ASSESSOR PARCEL NUMBER ZO BUILDING PERMIT OWNER/ �ose,_ . V v e TEL ONE i! v - SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS .,- , `x_J:L> a' ( CONTRACTOR'SN E TELEPHONE Fireplace CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Total Valuation $ F1IIng Fee $ 10.00 LENDER'S. MAILINIADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$' Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS l Permit fee $ PLUMBING PERMIT` Filing Fee 10.00 ./ Each Trap 2.00 I f Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qaS water heater or vent 5.00 USE OF STRUCTURE SF❑ Duplex❑ Mobilehome❑ Other >"�warr / ' SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00ea TYPE OF WORK ) New ❑ . Addition ❑ Remtodel ❑ Utilities ❑ Installation ❑ Other [� Describe work: ar > u Esc !'_o 6Z Al 'G Permit Fee $ ntractor ELECTRICAL PERMIT Filing Fee 10.00 - Main service SOOV OR LESS 100 AMP OR LESS 10'00 0 Main service EA. ADD'L 100 AMP 2.50 SU CONTRACTORS LICEN LAW I declare under penalty of perjury (check one): ❑ 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. Classification 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 oR ADDNST AWELLIN GOCCUP.N) '/xQsgft S.l NEW CONSTR.MULTI-OUTLET NON•RESID ' BRANCH CIRC ITS 2.50 ea /POWER APPARATUS el (SINGLE OUTLET CIR. / Ex. Occup( OR FIXTURES 20®30C SALO 30 FIXED APLNS.❑ Ex. Occup. OUTLETS P(RESID.)REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 'f -D 15.00 . UD 9 , # r, u P1-17 - rzfor Permit Fee $ </ p 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. Contractor 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 against said Cou in nsequenceo���gr ting of this permit. X c�G �� 1 � c�� / Date Signature of Applicant — OwnerK 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 $ occ CONST TYPE TOTAL FEE $ HAZ I CUA I PARK SCHL FLD I PAR PD HD (SSU This permit is hereby issued under sions of the Butte County Code and/or work indicated above2for/l�jwhich fees R 'C ,OR QF PUBLIC By PERM T PIKES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No.,53E> 9 WHITE-D.P.W.. FELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Califgpi 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT �P 1911MI N0. A S51F. SSOR PARCEL NUMBER SCJ .2 ZO BUILDING PERMIT OWNER//� + D.SQ- V � GT% .lei TrLLPNONE Q c0 SO. FT. OCC.1 BUILDING VALUATIOtK OWNER'S MAILING ADDRESS V I s CONTRACTOR'S N E TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 1000 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 t Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 1 ' Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5,00 Each qas water heater or vent 5.00 USE OF STRUCTr - SF ❑ Duplex❑ Mobilehome❑ Other ;/-Or.� er / �e- SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00e . TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other (� Describe work: - � yr c' ]L� / � [� <l 2r /� �e t�v � 4)& t I4�- p v Q C/ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Mai n service 600V OR LESS 100 AMP OR LESS 10.00 'a• ®0 Main service ADD'L 100 AMP 2.50 CONTRACTORS LICEN LAW I declare under penalty of perjury (check one): ❑ 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. Classification ❑ 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 oR ADDNST l W CONS. DWEACCLLIN GOCCUPS. M OE 2+/22sgft NEW CONSTR. ULTI-OUTLET NO N.RESID BRANCH CIRCU ITS 2.50 ea POWER APPARATUS &) SINGLE -OUTLET CIR. Ex. OCcU OUTLETS OR FIXTURES P 20050¢ BAL®3O Ex. Occup. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 G e �� 15.00 CJv .2 Permit Fee S sa 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. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g 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 agai t said Cou an e•uence of the ting of this permit. X 49; c �/ � �� //`S / Date w 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 $ occ CONST TYPE TOTAL FEE $ HAZ 1 CUA PARK SCHL FLD I P R PD HD Issu This permit is hereby issued under sions of the Butte County. Code and/or work indicated abov, for which fees R R PUBLIC BY PERM T P RES Date —114 the applicable provi- resolutions to do have been paid. WORKS Date y Receipt No - 236 � WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT ., -,.t Y' `y-'-'.,:,rl..��.Y�'"*C�.,••-•,c.rr.+'fi14.'.•:,.«'-�.f�.�ti�`lSr.�•_3� ..;7r,:,{��ii-.�.•"w i�t.ri.;.sti. ��r�-�.` �P „t,' ., :t.,..u. - 1 COUNTY OF BUTTE - DEPARTMENT OF� PUBLIC WORKS- UtL=D]tNG-& ISION 7 COUNTY CENTER DRIVE - OROVILLE,P�L�IF�R�IIA 95965 -TELE HONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER �c��/ �— A. P. No,� 2___. Proposed Building Use Building Inspector Date 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. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 1 Driveway permit (con sU4ction approval required prior to occupancy) e C__ Pre-Inspec. reques�r Pre -Inspection for required ... Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: loqMail to owner. Mail to contractor. Telephone and hold fopickup at Coffice. Deliver w/inspector. Other /tel �sJ ��.c�7" �. L� Lo Date 4t_1 41�1 U �•-; C 1 /lam ra *^- `S' A rpn cC/:� tZ` -L4 G`- d e 0, 7-► 1 f -I 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_JnaiI—counter by—.date Contractor, designer, owner, was, advised of above required data by—phone —mai I—counter by date Plans checked Copy—DPW Date Plans approved by Sets of plans on hold in . File cabinet AP folder Date COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, brovil,le, 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 proposed property improvement (yes or no) 2. I (have/have not) �-A 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: �yy 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: Name0 ✓J 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 Socia Security Number Date � �g NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541 DATE Rosario.: ' ,..&.Louise..DiFede......:........I........_.__._..._...:.__....:...,.__.:.�.. ....._.. ...__.._._......._._......__.. _....._._._..,.._.._,.._...<-._._...M...-�-,..�..�. . ovem��er 'I 9R9 4520 Big Bend Rd RE: Permit #3889-89 Oroville', CA 95965 A.P. # 58-20-72 With reference to the above subject: Attached is: Application for permit .Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet Engr. Calcs Typical Plan Sheet Owner -Builder Verification Form List of Codes Enforced OTHER We need the following information: Permit application signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement. Complete plans in including plot plans. Plot plans in Structural details in Complete plans and calcs in by registered engineer or architect. Energy design including Street and drainage improvement plan approval from Land Development Section (DPW). sets of plans in accordance with the changes marked in red. Sanitation approval from Butte County Health Department at: 196 Memorial Way,'Chico 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, .Oroville, for Completed Owner -Builder Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. lXk OTHER A Boundary line modification was approved in 1982; however the Assessor's Should you have any questions concerning the above, please contact of this office. Stu Edell or Jim Glander Yours very truly, William Cheff Director of Public Works J.F. 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