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058-550-016
RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 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. DAVID SPITZER AND JANET M. S. DOCK REAL PROPERTY OWNER/LESSOR MAILING ADDRESS MIKELUMNE HILL CALAVERAS CA 95245 CITY COUNTY STATE ZIP 11275 CHALAIR DRIVE INSTALLATION MAILING ADDRESS, IF DIFFERENT OROVILLE BUTTE CA 95965 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 04-0922 (530) 538-7541 BUILDING PERMIT NO. TELEPHONE NUMBER SIGNATURE OF LOCAL AGENCY OFFICIAL DATE NONE DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO. HBOS MANUFACTURING 2004 OAKWOOD 01-522F MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMUNUMBER GOOR23 N28078 A/B 27X52 ORE453274/5 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER AP# 058-550-016 HCD FORM 433(A) REV. 8/91 WHITE - County Recorder CANARY - FICD PINK - Applicant GOLDENROD - Building Dept. BUILDING PERMIT NUMBER: 04-0922 Address or location of unit: 11275 CHALAIR DRIVE, OROVILLE CA 95965 Legal Description of Real Property: 058-550-016 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: DAVID SPITZER AND JANET M S DOCK Owner's address: PO BOX 68, MOKELUMNE HILL, CA 95245-0068 INSIGNIA OR HUD NUMBER: ORE453274/5 SERIAL NUMBER OR V.I.N.: GOOR23N28978A/B MANUFACTURER'S NAME: HBOS MANUFACTURING YEAR: 2003 OFFICIAL APPROVING INSTALLATION: DATE: PHONE: (530) 538-7541 H.C.D. 513C RECORDING REQUESTED BY: Fidelity National Title of California Escrow No. 102672•SL Title Order No. 00102672 When Recorded Mail Document and Tax Statement To: Mr. and Mrs. David Spitzer P.O. Box 68 Mokelumne Hill, CA 95245 IIII III III I ILII I II IIII ill II I I IIIII 2Q3�2--fbrh 1 3433 Recorded Official Records CountyBUTTE f CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 12:30PM 15-14ar-2002 REC FEE 10.00 TAX 27.50 Maureen Page 1 of 2 APN: 058-550-016 GRANT DEED SPACE ABOVE THIS LINE FOR RECORDER'S USE The undersigned grantor(s) declare(s) g///a/(/7' Documentary transfer tax is $,;Z % 50 I X ) computed on full value of property conveyed, or [ ) computed on full value less value of liens or encumbrances remaining at time of sale, ( X ) Unincorporated Area City of unincorporated area of the FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Barbara Henslee, An Unmarried Woman hereby GRANT(S) to David Spitzer and Janet M.S. Dock, husband and wife as Joint Tenants the following described real property in the unincorporated area of the County of Butte, State of California: SEE EXHIBIT ONE ATTACHED HERETO AND MADE A PART HEREOF DATED: February 26, 2002 STATE OF CALIFORNIA, COUNTY OF � DPA.26dA_. ON 00 I before me, SUS • (—. a so Ily appeared "BARBARA HENSLEE" 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 eal. SignatureOf i Barbara Henslee .........-rte. ��� SUSAN L. LAFERTE } Commission 41265040 < NOTARY PUBLIC • CALIFORNIA ,71 NEVADA COUNTY MY COMMISSION EXPIRES MAY 25, 2001 MAIL TAX STATEMENTS AS DIRECTED ABOVE FD -213 (Rev 7/96) GRANT DEED Escraw No. 102672 -SL Title Order No. 00102672 EXHIBIT ONE PARCEL ONE: Parcel 2, as shown on that certain Parcel Map, filed in the Office of the Recorder of the County of Butte, State of California, on March 26, 1976, in Book 55 of Maps, at Page(s) 83. Reserving therefrom an easement as shown on said map. PARCEL TWO: An easement over Parcel 1, as shown on that certain Parcel Map, filed in the Office of the Recorder of the County of Butte, State of California, on March 26, 1976, in Book 55 of Maps, at Page(s) 83. PARCEL THREE: A non exclusive easement for road purposes and public utility purposes over a strip of land 60.00 feet in width, lying 30.00 feet on each side of a line beginning at a point in the East line of parcel 1, as shown on that certain Parcel Map, filed in the Office of the Recorder of the County of Butte, State of California, on March 26, 1976, in Book 55 of Maps, at Page(s) 83, which point bears South 000 26' 52" West, 207.05 feet from the Northeast corner of said Parcel 1, as shown on that certain Parcel Map, filed in the Office of the Recorder of the County of Butte, State of California, on March 26, 1976, in Book 55 of Maps, at Pagels) 83, thence from said point of beginning, North 610 00' 05" East, 232.51 feet; North 011 57' 35" East, 156.10 feet; North 140 47; 19" West, 119.90 feet; North 690 29' 00" West, 153.53 feet; North 090 31.' 03" East, 1:72.03 feet; North,33° 05' 33" East, 275.86 feet; North 090 39' 51" East,'..,.... 272.88 feet; North 060 07' 57" West,'1.37.74 feet and North 410 39' 39" West, 155.79 feet to:the beginning of'a` ' F,7.. --V, 140.00 foot radius curve to the right; thence along the arc of said curve, through a central angle'of 103° 27' 17".tan, •tc. 11h , arc distance of 252.79 feet; thence North 610 47' 38" east, 131.46 feet; North 530 28' 08" East; 180.80 feet; North:..; 380 33' 36" East, 181.34 feet; North 030 11' 01 " East, 199.91 feet; North 29* 14'.59" West, 289.71 feet:and North= t r:... ; 1_ 310 32' 49" West, 167.54 feet to the centerline of Big Bend Road, a county Road and the end of said line. 03/18/04 10:37 FAX 1 541 926 8016 GOLDEN WEST HOMES SLS -) WHITE CITY OAK Wn=M2 l�".00 HBOS Manufacturing, LP MANUFACTURER'S CERTIFICATE OF ORIGIN TO A MANUFACTURED HOME The undersigned MANUFACTURER hereby certifies that the new MANUFACTURED HOME described below, it the property of sold MANUFACTURER, and is transferred 24 DECEMBER 03 2328078 this day of 20 on invoice, No. OAKWOOD MOBILE HNS INC t0 outra�r+orow, osA�to. r<Ya. 7191 CRATER LAKE HWV whose address Is „ MITE CITY OR 97503 t A OAi(610OD 2084 MODEL YR Trade NamOther_ -- 52X27 CK3BR+2 01 522F Series or Medal Now � 324 APPROX. 600823 N2978 AB Serial No. Width In Inches (less eaves) 455 APPROX. - 624 APPROX. Shipping Weight �.� Length In inch s (tea eaves) The MANUFACTURER tertifles. the above statements are true and correct and that this was the first transfer of such new'MANUFACTURED HOME In ordinary trade and commerce. 12/24/03 Albany OR Executed onDirt at o�, • A*�_ Name of Manufacturer Signature of Company Official Manufacturer's 2445 Pacific Blvd. S.W. Address WNW City Albany State Oregon SL -32 4. valley Design 063 NOTES RESIDENTIAL ;PERMIT N0. 058-550-016 - 04-0922{ SPITZER, DAVID CHALAIR DR, YANKEE HILL i CONT: OWNER ! NEW MH PERM FND r Y }THE HCD FORM 433A FOR THIS MH CANNOT BE ;RECORDED UNTIL ONE OF THE FOLLOWING HAS BEEN TURNED IN TO THE BUILDING DIVISION: (1) LICENSE PLATE(S) OR DECAL (THE INSPECTOR MUST RETREIVE). ? (2) STATEMENT OF FACTS (ONLY ON NEW MH' S). )INSPECTOR TO VERIFY SERIAL & LABEL #'S. 5 SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER 099 �15�) Z?3- DETACH FOR SERVING UTILITY Address �il�[o.//(A—.,- ^ GAS Meter By Date ELECTRIC Meter By Date JOB FINALED (Date) Signature !s J=OK Zoning Requirements -Setbacks -Easements 0 = Not OK Footings; Soils -Size -Depth -Spacing -Connectors -Steel . = Not Pead�abi?_ MOBILE HOMES 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing �- Date MOBILE HOME UTILITIES (Plans) OK except #'s 6. Carports; Windows -Doors 1. Zoning Requirements -Setbacks -Easements Electric 2. Soils; Special MH Support Sketch Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 3. Sewer; Location -Test -Fall -C/0 -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. ectricity; Location-Clearances-Grnd-/ /Amp -Concrete .Gas; Location Test Wrap; / " L 'ft. LJ / P Nat. or/ /" L "ft./ 7/„(' LPG 7. Well Clearance & Disconnect 8- Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBI HOME INSTALLATION (Plans) OK except #'s 7 0 'ng Requirements -Setbacks -Easements tings; ' e- pacing -Marriage Line �i as; a errand -Valve -Connector T. 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 Date 21 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PER ANENT END SYSTEM (ONLY) Ao9oning Requirements -Setbacks -Easements . Fpetings; Size -Spacing -Marriage Line 3-. BI king s; MHJest-Dem&d-Valve Elect i y; MH st 6: ater; MH Test 7/ Water nd Sewer Connected Ga and Electricity Tagged Exits _10. cense Decals 11h. --Verify #'s with Office Date Card B-1 Date Card B-1 Date411W,6,,,Card B-1 Date Card B-1 I 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 1 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 i I i J=OK 0 = Not OK = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth Fireplace Ties or Type A Flue -Fireplace Throat Clearance 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main; Steel -Blockouts-Wrapped Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions' 6. Stemwalls Garage; Steel- Bloc kouts-Wrapped 6a. Hold Downs and Special Anchors 54. 7. Slab, Steel -Wrapped 55. 8. Piers -Fireplace Ftg.-Steel 56. 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 57. 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 58. 11. Water Pipe; Test -Anchors -Regulator -Service Test 59. 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 65. 17. Water Htr.; Vent -Access -Combustion Air Baffle 66. 18. Water Pipe; Test & Anchor -Nail Protection 67. 19. D.W.V.; Test Fittings & Anchor -Nail Protection 68. 20. Shower Pan; Test, First Floor -Tub Access 69. 21. Test Tub & Shower, Second Floor -Tub Access 70. 22. Gas Pipe; Sixe & Anchors 71. 23. Fire Sprinkler; Test 72. Elec. Outlets at Wood Panel, Int. & Ext. Date Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance Card B-1 Date Card B-1 Date Elec. Outlets & Receptacles at Kit. Counter 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 78. 26. Size Boxes & No. of Conductors Stapled 79. Elec. Receptacles in Garage (FF.I.)-Romex Protection 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al _ 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes 0 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 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground Date 89. Card B-1 Date Card B-1 Date 90. Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Corrections from Previous Inspections 36. A.C. Ducts Insulation & Support Gas Test -Meters Tagged, Gas -Electric 37. Vent Fan, Exhaust above insulation Water & Sewer Connected -C/0 to Grade -HD Approval 38. Condensate Drain & Overflow, Size & Grade Energy Compliance Certificate -Other Certificates 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet Address Posted 40. Attic Access & Platform if Furnace in Attic Date Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs-Naiiing 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 Ht. & Dimensions' 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date 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-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FF.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes _ 83. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing . 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/0 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: , r 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.neAdds PERMIT NO. BP040922 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' 058-550-016-000 ' the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address' L° ha 1 a ^ ► r D Date: Contractor. Map Index: 0 r007T e 84 06t? GS Description: NEW MH (1404) PERM FNDTN OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: SPITZER DAVID & DOCK JANET M 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 P 0 BOX 68 7000) of Division 3 of the Business and Professions Code) or that he or MOKELUMNE HILL, CA she is exempt therefrom and the basis for the alleged exemption. Any 95245-0068 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).): 2/ 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: SPITZER DAVID & DOCK JANET M 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 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' ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 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. O I 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 Engineer' ' insurance carrier and policy number are: Carrier: Policy #: Total Square Ft: 1404 S.F. Er", certify that in the performance of the work for which this permit is Valuation: $91,260.00 issued, I shall not employ any person in any manner so as to 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: 5/2 -7/04 (qs B Applicant: J�J Vel JQ,Ii W WARNING: Failure to secure workers' compensation coverage is to LL �/ / } /,. ` —f 3 M eele unlawful, and shall subject an employer criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of I AMOun!-r? e eiued A A compensation, damages as provided for in Section 3706 of the Labor o code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY T is p i ' her y iss der a applicable provisions of the Butte County -Cod . ?ndlor I hereby affirm that there is a construction lending agency for the esol i o d ork i d ove for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.)/\, By Date: S Z Name: Z% �� PERMIT XPIRES ON. Address: (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 the above mentioned property for inspection purposes. Print Name: lhel Signature: —a Date: % C,% lbLt Owner 0 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 o4aq zz- ATE. _ OQ _ O APN. 05 - O -01co -01c ZONING: Fit-� OWNER'S LAST NAME: OWNER'S FIRST NAME: PHONE r-�, aaq - a26 90 TREET ADDRESS: O FAX: ITY. ZIP: ` 5 �4 E-MAIL: V SITE ADDRESS: ,Tv CITY. ZIP: ` n ` i . CA 5 — NEAREST CROSS STREET: TRACTIL,OOT P APPLICANT NAME: STREET ADDRESS: FAX: CITY, ZIP: E-MAIL' CONTRACTOR NAME: JA PHONE: STREET ADDRESS: FAX CITY, ZIP: E-MAIL: LICENSE NUMBER LICENSE TYPE ARCHITECT/ENGINEER NAME: PHONE STREET ADDRESS: FAX CITY, ZIP: LICENSE NUMBER E-MAIL' DESCRIPTION OR SCOPE OF WORK: ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) S N MJ 25m:� -� F Lam; X O C, S IRA 'Z -'S ,13 A, (L 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: _ aP It x'74.95- + 5 -PA 15 :2. q8 Application Received by: Date: 4 •o¢ Receipt number: 39544 Amount Received: �}-�7 q3 TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance E.H. 113E ONLY Plot Plan Attached Floor Plan Attached Sent to'B.D. Qf& 1A , /L S S Owner Location AP# Plan Approved for: Sewage Disposal,_ Water Supply: nn Public Private Well Clearance for dwelling. Other o�a 9 yu Hold final for: Final clearance O.K. for: NOTE: / 3iv—y�-1 Environmental Health Specialist Date 8/96 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140_ PERMIT APPLICATION DATA SHEET OWNER: I-'ITZf,= ASSESSOR PARCEL NUMBER Proposed Building Use: 11 (°(+J IM• no t M ! ✓1�� Counter Technician: �� Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 0� 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. ❑ 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 supportin documentation in duplicate. O 7. Statement of Intent for No - f ntial+ Buildings. 8. Manufactured homes:( .) at s nd installation ins ,�' �Aarriage line info,j ),dloor Plan, (�D)�ie down or fnd plans, all in I 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 s�ite. plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. �[ 16. Other ��` nTTnn i ./_ /Y t'1/'Ylntr�/ s(!� �f%'S�i�.� %f,>,�•�//� - LG�� GfNL!/7• rT Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ t ❑ 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 .............................. ❑ x\22. City of Chico Plumbing permit........................................................................ 23. California Department of Forestry plan approval ❑ paid. Sent by: Ea' 24. Planning approval (A) User W_ (B)Parking: (C) Parcel Check: ❑ 25 ' --Contact Land Development about _ Improvements, _ Drainage ......................... �a 26. NPDES Form............................................................................................. 1pf 27. Encroachment Permit for driveway from the Public Works Dept ........................... r ' ❑ 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).....................•a4- �A ❑ 32. Letter of Signature authorization......................................:............................. 91 . 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ -35. Existing, violations and/or expired permits......................................................... 36. Deed Restriction...... ................. ....,,,,..... 37.00 rant Deed, 0' Title/Statement of Facts, D�elter from Legal Ownerk to H.C.D. -©. 38. Other: n i oo -y- 0 y-❑ 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: K A ( 4 ) (/7r LJrt'� 1. Index permit application for the above items numbered: _ 2. Additional items required Contractor, designer, owner, was advised of -the above data by Contractor, designe wne was advised of the above data by Plans reviewed by: C. Date: qate Structural reviewed by: Date: o Note transfer by: Date: Date: Plan Check Letter ie, ❑ mail, ❑ counter, by Date: 2 Z • 0 e, ❑ mail, ❑ counter, by Date: Yellow: Building Division Date: f` vri 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 d P 1'r?- i ---Q PROPROSED BUILDING USE 4 evv t1 N PE2M r -,-10-r4 1. BUILDING PERMIT FEES --- Balance Due ..................... $ 74 95 --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ 2. SCHOOL DISTRICT FEES Oao v t Lt_E "es +4 (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ 36C A.P. # 058 •55G- o I t,, DATE 4�3Z04- RECEIPT # DATE REC. ..,pklq� (5_,;� r? -e f 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 489M aid at Building Division) 152. S. 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. 315 4 -e -?4- 4/2- 0 4— Commercials . ftg.) X = $ Sq. Ftg. Amt. 10. OTHER �M I f� 9.9^- A 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 an checking process. APPLICANT DATE Z (� 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) Aer 01'04 02:44p p • 2 4-1-04 Butte County Building Department attn: Tammie P. re: authorization of agent, I hereby authorize KELI S-A VKO to act as, my agent for the sole-purpose of signing-in. my-.name` for building permits for parcel APN 058-550-016. This authorization is valid from April 1 until April 30, 2004, inclusive,, David-H. Spitzer (209) 286 1790 da-vespitzer @goldrush.com dspitzer@ Stockton.k 12.ca.us -Aj r 01 04 02:44p 1621 Brookside Road Stockton, CA 95207 Phone: (209) 933-7445 Fax: (209).954-924 I"FhX STAGG HlGtf SCHOOL :.: .1�; 7� Cp ti ►�/ Vic: try,: .f7tP . / To: A'IT�J,', T l'llt'./ From: DtW/ � Fax: �� 3 �� v Pages: p�ll Phone: Date: 4-1--l— Re: f —/_ Re: f 2kO i %Dt- A(EX)f—CC: Xl,'J'r'qent, ❑For Review 0 Blease Comment_ G1. Please-Repty 0 -please Fteeyck e Comments: •� �_� `' � _ 0•-�� ��1 O r School District A.P. Number Property Owner BUTTE COUNTY SCHOOLS IMP -ACT FEE CERTIFICATION FORM # (Or* form per Building) OPIC)VIL-LIE 460-4 Building Department No. Jurisdiction:, city County Property Location/Address District Identification No. �AI641 School District certifies that (Applicant) (City) '7(state) V (Zip Code) has complied with the requirements of Resolution No. /07 by payment of $ ii Q representing sqUare feet. 1 2926 $ FULL MMGATION $ A School District Representative Date Paid by Check # Remarks: You 'may protest the Imposition of ths fen klentifted.above by submitting a wMeq protest to it* DWbict. In compliance wKh Gwiarrinmt Code SectlonVA*i), vilihin 90 days from the daft fen am paid. Failure to submit atirriely, welt nprot*WwlIJ'prohM you from diallenging the Imposl0on of the fees In any court acftm K, subidg ent to the School Dbtnc�t Representative signing this Butte County Sdxmb Impact Fee Cardfication Form, the School Ustrid Is notified the", ,, Local Planning Agency that this project Is being rwlewed under the California Environmental Quality Act (CECft this project may be subject to idditlonal school fe".to fift rittigals.its Impact on the school distrileft edvook. White (applicant), Yellow (building department), Pink (school district) feefom.xis (10/03)drnm k. t^3� C> 4-0q a a BUTTE COUNTY APR 2 6 2004 DEVELOPM ENTO. SERVICES 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. I personally plan to provide the major labor and materials for construction of the proposed property impr vement : YES )< NO ❑ 2 I HAVE)(HAVE NOT ❑ signed 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: CITY: 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: CITY: PHONE: CONTRACTOR'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: �K PROPERTYOWNER MA V " XDATE:_ NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification mast be completed and returned to our office before we are permitted to issue the permit. OVER I OWNER BUILDER INFORMATION I 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 -builder" 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 fir license number cn all parmits for hich they apply. If youplan 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 Cmcluding 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 seveial 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 insmuance. ♦ For more specific infomaation 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 Lav', 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. hformation about licensed contactors may be obtained by contacting 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 aware of these matters. The building permit will not be issued until the verification is retuned. jer,'iftiflild CVira, C.B.O.' ing Inspection NOTE: n's Owner -Buddy InfOmwdon is required by Section 19830 of the California Health and Safety Code: OVER 1 T j � PACIFIC CONSULTING ENGINEERS 2150 BELL AVE., #145 SACRAMENTO CA. 95838 Ph. 916-564-6028 FAX 916-564-6029 VERTICAL DESIGN RIDGE BEAM SUPPORTS OAKWOOD HOMES 7191 CRATER LAKE HIGHWAY (HIGHWAY 62) WHITE CITY, OR 97503 (541) 826-8887 Fax.: (541) 826-9292 Roof Live Load Roof Dead Load: Building Module Width: Metal Piers: Soil Bearing Pressure: Input Data: Calculations: Vertical Load at Mod -line: Loads at Mod -Line: Max. Support Spacing: DATE: 11/11/02 JOB No. 03-1501 HBOS Manufacturing MODEL 01-522F KELI DOCK 11202 CHALAIR DR., OROVILLE, CA 95965-9770 RI = Rd = D = P = SI = W =RI+Rd x D/2 = 30 psf 10 psf 26.67 feet 4,000 lbs 1,000 psf No. Location Loads Footing Size No. of Piers & ( ft.) ( Ibs.) ( In. sq.) PIER RATED LOADING FRONT 1 0 1,289 14 Fnd. 2 4.83 2,844 20 1 -4,000 lbs 3 10.67 2,933 21 1 -4,000 lbs 4 15.83 2,489 19 1 -4,000 lbs 5 20.00 2,267 18 1 -4,000 lbs 6 24.33 5,026 27 2 -4,000 lbs 7 38.85 6,804 31 2 -4,000 lbs 8 40.93 3,578 23 1 -4,000 lbs 9 45.93 2,378 19 1-4,000 lbs 10 49.85 1,689 16 1 -4,000 lbs REAR 11 52 644 10 Fnd. A0 ©�-©q2.2 BUTTE COUNTY BUILDING DIVISION APPROVED 533 psf BU4LUINC DEPT. DOPY. LATERAL DESIGN OAKWOOD HOMES 7191 CRATER LAKE HIGHWAY (HIGHWAY 62) WHITE CITY, OR 97503 (641) 8284887 Fax.: (541) 8284292 Input Data: Design Wind Pressure ( 75 mph exp. C ) Seismic Load Factor Roof Dead Load Wall Dead Load Floor Dead Load: Exterior Wall Hehgth Roof Helgth: Building Length: Building Width: Anchor Bok Working Load, 5/8" x 10" CALCULATIONS: Wind Load: Seismic Load: SHEET No, 2 OF 2 JOB No. 03-1501 27 x 52 Mfg'd. Home P = 20 psf SI = 0.186 i Rd = 10 psf Wd = 10 psf Fd = 10 psf Ht = 8 ft. Rht = 4 ft. L = 52 ft. W = 27 ft. AB = 1,134 lb's Vw=P x (Rht + Ht) = 240 pli Vs=SI x (Rd+Fd+Wd: = 5.58 plf Seismic in Longitudenal Direction: . V long.= Vs x L = 290.16 plf Seismic Controls No. of 5/6'x 10" AB req'd. at side wall = 4 bolts even E GI � Seismic in Transverse Direction: V tran.=Vs x VA = 150.66 pif Wind Controls No, of 5/6'x 10" AB req'd, at end wall = 6 bolts C V 60NL`( TOTAL No. OFVENTS: Min. underfloor venting Is 150 sq, ft.of vent for every 1000 sp. fL of underfloor area. VAC" Total underfloor area = 1,404 sq. ft. Total No. of 6 " x 14 " vents =XON#r, y CO AC14 -� sew �5� ccy VS o S NG 0 SS 5-19-04 07:32 PACIFIC CONSULTING ENGINEERS ID=9165646029 EM Ible SMInt ROOt Simpson A35F Tie Plate For aa4 P.T. 8IM Pte Each Anchor Bolt'Faetah 6-8d's' J6 -X IV .®.' Neils to Rim Joist & 6-8d's to Sill Plate W/ rx rx 9/16' Ws" End Well: 2-- A35F'at'each Anchor Bolt Side Well: 1- A35F at each Anchor Bolt P.0 CHANGE ORDER #1 FOR BUTTE COUNTY PERMIT No. 04-0922 TO JOS-Ro'9 0 450t DATE: 5113/04 OAKWOOD HOMES SCALE! . 7191-CRATERLAKE NIazHWAY (HIGHWAY -6L . JOB No: 0.4-66.4. KEL.1 DOCK WHITE CITY, OR 97503 1120-2 CHALAIR-DR., (641) 82648V Fax.: (6W626-9599 OROVILLE, CA 95965-9770 ,P anc.--CanULTING EUu-E s- , 2150 Bell Avenue 0143 Ph: 916-584-8028 Sacramento.-CA.9643&Fax� 948-1 8_ !e 05-19-04 67:32 w 9 PACIFIC CONSULTING ENGINEERS PACIFIC,' CONSULTING -ENGINEERS 2160 Bel Ave. Sdte #146 ...... Sacrament, CO. 85838 Phony 916.584.6028 VIA FAX: j s3 0 - S 3 S- ZG .4,0 DATE:. TIIGLE: � � �-vt•/ ID=9165646029 P.01 Fix M564.8029 FROM: NUMBER OF PAGES INCLUDING COVER -SHEET: IF YOU'DO NOT RECEIVE ALL OF-TfM PAGES OF-TIHE' TRANSMISS-ION, PLEAS€ CALL THE SENDER. COMN(ENT'S: r�, National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACREI 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 $700.00 made payable to the State Water Resources Control Board to obtain such a�permit if my project disturbs 1 acre or more of land. I, further, certify that this project will not disturb 1 acre or more of land. I am aware that submitting false and/or inaccurate information may result in revocation of grading and/or other permits or other sanctions provided by law. o � EN�RCNMENrA( w M HEA(Ty m. AR �0 r I gm ci�a f >,e 7CpN C�fin �t 1,1 N�'CENTERC .RIVE �. 6 Wt- "" I N 1 � mI . �•a tm y6'"� UrR � l llf f `l�EE 6�l7i6G-' 1, STUDY TWO 1, 9ATF - dQ. SCT. f !" - `• PPiEVB'i ilAR Ih������ 0AK%V003 HOOM1 3 :nc t:' ��' �� '� — �• ry --- Cps — I AI GAW Divt;60N - P23 x,1-1 �, • , .. 1 fC' Dl�' PL -4, t {— o ;-- I �1i ^�^�,a—Ut _— 1 2435 S.W. PACInC til VO- s ��_— snea f Ae..ta s_r�_1}: .'}► AL$dN`� X7517 ewa+I. ar : So 82E1-6831 Pholm aaxoe vi.e re�eaNarun ALBANY UtVB®JOI4 J. I�V1�C SITE PLAN REVIEW APPLICATION Date: AP# Permit Number (if aonlicable) Il • _ 0 . APPLICANT INoti22, FORMATION Parcel Size: ?j: nil Owners Name: JD :"Q . Owners Address: ���X - �.4 Telephone No.: U i �� qeD Situs Address: \IPA Proposed Use: Residential ❑ New Single Family Residential ❑ Single Family Addition ❑ Single Family Remodel ® Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary• Travel Trailer ❑ Multi -family • Non-residential ❑ New Commercial ❑ Commercial Addition ❑ Commercial Remodel ❑ New Industrial ❑ Industrial Addition ❑ Industrial Remodel Other JE Septic Well ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) jj Approved d ❑ Resolve Problems Prior to Approval ' ❑ Site Plan Stamped Approved By Date I — 2 — e Pace 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: • ® Snow Load Area: rZ -re ❑ 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) 11 SRA - (CDF to determine specific requirements) ❑ - 100 -Year Flood Plain: (See attached) • Flood Zone: X • Flood Panel No.: 05-75c!- Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamatio�oard) E3 North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement • Zoning: F R - 2 Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval ne --for-encroachments into SRA setbacks. Pa.2e2of5 Zoning Code Streets & Highways J re evention 'vision Map Front Side "SC) Side Street Rear Height Waterway N/A N/A -N/A ' ❑ Setbacks drawn on site Plan. ❑ CDF approval ne --for-encroachments into SRA setbacks. Pa.2e2of5 Applicable Development Fees: Standard Fees Amount Formula ❑Fire • ❑ School' ❑ Parks/Recreation ❑ Roads ❑ Sheriff .. ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road Thermalito Impact ❑ 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 Q 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: 1 ❑ Parcel Deemed to be legal ❑ Verify Leval Parcel ❑ Verify Legal Access ❑Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ 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 Map/Parcel IV1ar): bA Q �30 1.x,1 G Ll :TtJ &-fZ Map Date of Recording: Lot: Book: Page: ❑ Use Permit/Minor Use Permit • Permit Number: Date 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 on slopes steeper than 30%. The Erosion Control Plan must be prepared by a registered civil engineer oro er qualified professional and be submitted to and approved by the Department of Pw Works. ❑ A plan prepared by a certified arborist, botanist or landscape architect that shows the existing on-site mature trees, located in any area proposed for buildings and vehicular access, and provides for methods to protect the trees identified to be preserved, shall be provided to and approved by the Planning Division prior to the issuance of building permits and/or prior to grading or vegetation removal. The removal of mature trees shall be minimized, where possible. A mature tree shall be defined as a tree with a trunk measuring 4 inches in diameter, 4 feet from ground level. Mature trees removed shall be replaced on a 3 -to -1 ratio, utilizing existing oak tree stock. Each tree to be preserved shall be surrounded by a circular zone (minimum 40 -foot radius) identified by an orange fence during construction activities. No vegetation removal, soil disturbance, or other development activities shall occur within the fenced area. ❑ 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. Page 4 of 5 d- 0 N n7 b u 89' 30. 32" w 5. %4 COR. SEC. 34 (S 69° 90' 52"%'v 2569. 47 RCC. PER R.S. 33/92) TOPPER L.S. 2780 PER R.S. 33/92 LEGEND, BA515 OF GEARING: • FOUND MONUMENT AS NOTED TheSourh fine of the S.E. i4 of Section 34 shown as • rUUND/4"..P i.5. 2693 589" 30' 32' W on the Record of Survey filed in book 33 of Maps of Page 92, Butte Couafy Record;. O SET 314'i.P. 1.5.2843 L.' 0 jir CCR �kC. 34 j283, 2566.62 NOTES: ONo avidenee of domestic vvier avellebje. '•"e7 Frx'iooei 5ccii� Lines are record and mre.lvrcd es per R. S. 5V95 � l 1 s 88` 18' 00' w A 727.88 A ��iu�otiii 4`1 ++ J r 00 A y 25.73 Ac, \ 1 / A7 J 89' 30. 32" w 5. %4 COR. SEC. 34 (S 69° 90' 52"%'v 2569. 47 RCC. PER R.S. 33/92) TOPPER L.S. 2780 PER R.S. 33/92 LEGEND, BA515 OF GEARING: • FOUND MONUMENT AS NOTED TheSourh fine of the S.E. i4 of Section 34 shown as • rUUND/4"..P i.5. 2693 589" 30' 32' W on the Record of Survey filed in book 33 of Maps of Page 92, Butte Couafy Record;. O SET 314'i.P. 1.5.2843 L.' 0 jir CCR �kC. 34 j283, 2566.62 NOTES: ONo avidenee of domestic vvier avellebje. '•"e7 Frx'iooei 5ccii� Lines are record and mre.lvrcd es per R. S. 5V95 C OY Butte County Department of Development Services www.buttecounty.net/dds 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538.7785 Facsimile October 22, 2004 Ian P. Dock PO Box 8936 Chico CA 95927 RE: Incomplete permit process for HCD 433A (mobile home on a permanent foundation) David Spitzer and Janet Dock, 11275 Chalair Drive, Oroville CA Ap# 056-170-057; Permit 03-1181 Dear Ian Dock; Your check, payable to HCD is being returned to you; due to failure to complete the permit process as referenced above. You will need to contact our office, and talk to one of our Permit Application Assistants. Who will assist you in determining what you will need to finish the permit process. This process must be completed before the mobile home can be removed from California State license rolls and added to Butte County rolls as real property. If you have any questions regarding this process, please call (530) 538-7541, and ask for a Plan Application Assistant. Thank you, Gwyn Benedict Office Assistant II ; N ANTE • E BUILDING DIVISION COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE — OROVILLE, CALIFORNIA 95965 —TELEPHONE: (530) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT NO. O�-211 Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. 0,53,— �5 �5 C) , �l ZONING OWNER � PHONE NO. _ 01S � /01S r OWNER'S ADDBOX / LOCATION OF BUILDING lair d USE OF BUILDING r `----- c,4c4cr SIZE OF STRUCTURE � �'X�'=11�0.FT. TYPE OF CONSTRUCTION: WOOD FRAME STEEL CONCRETE OTHER (Specify) TYPE OF SIDINGL ROOF COVERING FLOOR TYPE ESTIMATED COST F CONSTRUCTION de AG Buildings shall comply with the minimum front, side, and rear yard setback requirements of the applicable County Ordinances as follows: FRONT SIDES ZO fit/ REAR AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobile':- Mme, and 40 feet from a commercial building. I declare'under penalty of perjury that the building will be used as stated about, and the purposed use confirms with the AG Building definition. If any change in use or occupancy of the b ing is made, I will contact the Building Division and obtain any necessary permits, inspections, and approvals to co m yJith thne� meats in effect at that time and before occupancy. . /ll Date 1 Z -3/--D 2- Signature of Owner Permit Fee - $60.00 The above described AG Building is exempt from � L2q I R(o FL OD ASIS Receipt No. �/ Manager Building Dipsioa— By . AO� 9� White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod —Applicant 16, 119 Date 0`3 0)lt t J ' �wti pH t`J°i 1' 11 D 6NT' t J j 1' 11 D 6NT' •�I