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058-670-014
�rIL ''iA 1 -Al HENRY J. HOFFMAN NIS @ end Trevor Rd 4/10i NW of Truex Rd, Oroville r/ ao f/ Permit��727-85B,P,E,M(new sine fN ) Contr: LanceBros Const, Elk Grove 058-670-014 06-0831 SAUL, DONALD 3204 TREVOR RD; YANKEE HILL ^ Cont: LON SCHMIERER .7" GARAGE -AMM $ - lq -01 B07-0412 058-670-014 MISCELLANEOUS HVAC Change Out CHANGE OUT HVAC UNIT 3204 TREVOR RD SAUL, DONALD R JR BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 3204 TREVOR RD Owner: Permit NO: B07-0412 APN: 058-670-014 SAUL, DONALD R JR Issued Date: 03/05/2007 By KCG Permit type: MISCELLANEOUS 3204 TREVOR ROAD Subtype: HVAC Change Out OROVILLE, CA 95965 Expiration Date: 03/04/2008 Description: CHANGE OUT HVAC UNIT (530) 533-4523 Occupancy: Zoning: FR10 I Contractor Applicant: Square Footage: GALLAGHER'S HEATING & AIR GALLAGHER'S HEATING & . Building Garage Remdl/Addn PO BOX 35 PO BOX 35 LOS MOLINOS, CA 96055 LOS MOLINOS, CA 96055 Other Porch/Patio Total (530)384-2444 (530)384-2444 FEE INFORMATION DBM Heat Pump (Package Unit) $55.00 Total Charged: $55.00 Fees Paid: $55.00 Balance Due: $0.00 Receipt No: B2038 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License GALLAGHER'S HEATING 8: AIF 777334 / C20 C38 / 04/30/2008 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Sectio 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is ' u force and ect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects 03/05/2007 the applicant to a civil penalty of not more than five hundred dollars [$500); Please check one of the following: C traCtorS nature Date ❑ I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE AND the work himself or herself or through his or her own employees, provided that such improvements ❑1 WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). � E/1 I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by E]I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: J Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compansation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Carrier: State Fund Policy Number: 713-0013855 Exp. Date:05/0112007 Contractor's License Law.). (This section nee not be completed if the permit is or once fiun r�llars ($100) or less.) ❑ I AM EXEMPT under Section B. & P.C. for this reason: ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X 03/05/2007 compensation provision of Section 3700 of the Labor Code, I shall forthwith comply with those Owners Signature - Date visions. X 03/05/2007 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and Slate laws relating to building Si ture Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte Coun ffi ty, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte FEES. kCountv to enter the ab a mentioned property, for inspection purposes. I hereby certify that I am the rty owner ram orized t act on the roperty owner's behalf. /V 6QS/2007 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for N me Of P rml ee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) E] Owner ❑ Contractor OR;Agent for Owner RA/gent for Contractor FILE COPY Lenders Address City State Zip 16 BUTTE COUNTY APPLICANT INFORMATION DEPARTMENT OF DEVELOPMENT SERVICES PERMIT BUILDING PERMIT APPLICATION NO. AND SUBMITTAL REQUIREMENTS 24 HOUR rNSPECT10Nti: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834OFFICE '` #: ) 538-7541 A FEE WILL BE REQUIRED (ATTIME OFAPPLICATION ��ov Website: www.buttecounty.net/dds BIN tl **PLEASE PRINT CLEARLY** E-mail I.- ARCHITECT/ENGI NEER Name Address C"jl State Zip Phone Fax E-mail State License Number APPLICANT SIGNATURE �t I V For office use oniv Zoning APPLICANT INFORMATION Name �� r „ _5 H VAC r L�y� Address - No City '` State Zi Phone C39 4 / Fax E-mail APPLICANT SIGNATURE �t I V For office use oniv Zoning Flood Zone SRA yes - No Occ. Type Const' Subdivision Name Map Book Page Lot # Planner Date Approved: vv ER rum Jutslvii I I AL KtWUIREMENTS L K:IFORMSIBUILDIN0 FORMS1BldgApplSubRgmts.doc Page 1 of 2 T LOCATION AP# PROJEC osg'4`7o,0 [ Property Address Cross Street WORKER'S COMPENSATION Policy Number Carrier ' ` If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. Name LENDING AGENCY Address Description or Sco e of Work: LZ 161r)®-� o v Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued \,\,ill expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be 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. Received by: VAmount: Bldg SRA Receipt #: _Sheriff SMTP Date: Other Total REV 8-12-05 7 t Butte County Department of Development Services. o IN O T'C S 7 County Center Drive, Oroville, CA 95965(530) 538-7601 v^wv.buge county netjdds I t RESIDENTIAL APN: Permit No. owner. 058-670-014 06-0831 SAUI:-DONALD- Site Address: _32_04 TREVOR RD, YANKEE HILL _ At Cont: LON SCHMIERER'/ � I Jr Contractor. ' GARAGES 11' Type of Permit: 1 - SPECIAL CONDITIONS CHECKED BY FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE r t DATE JOB FINALED: A SIGNATURE: e = OK u... Me MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION Lj SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; FallIC/O-Concrete 4 Wtr; Loctn-Test-EaSement Needed -Regulator 5 Elec Loctn Clrncs-Grnd Amp Concrete 6 Yard Gas; Loctn-Test-Wrap . Nat Q or LPO Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -CIO to Grade 12 Gas and Electricity Tagged 13 Tie Downs Q Foundation Q 14 Exits 15 Cert of Occupancy 16 HUD Labelllrisignia Numbers Serial Numbers °'s DATE ID E C C O V E R S`C A R P O R T S `G A R A G E S oni Setbacks -Easements g§; Soils- z-DpthSpacing-Spacing 3 Decks, rders/Joists-Dcking-Brcing St _ -Guard/Handrails ood Awn; Posts Beams -Bea ms-Shthg Frmg-B ng S AI Awn; Columns-CnnctnsSplice-Decal-Enclsrs arp Wndws-Doors 7 E tri. - r ills-Anchrs-Studs -Rftrs-Trusses mg; Nailing -Veneer -Stucco -Lath R h'ihg-Roofing ,Steps -Doors -Landings raced Wall pnls �--�' s` - �° DATE POOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnncins-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFi 5 Elec Pool Lting; 15 volts-GFl 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes-Enclsrs=pnlboards4nsultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr, Fencing -Alarms 13 Bonding, Diving board or Slide c de 0 Pool Drawing i = OK RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR I DATE IPLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 3 Fig Garage; Soils-Steel-Elec Grnd Ftg Dpth, 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth ` 5 Stemwalls Main; Steel-Blockouts-Wrapped 6 Stemwalls Garage; Steel-Blockouts-Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test °'• 1.1 Wtr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd DATE 13 Plenums & Ducts; Cirnc-MaterialSupport4nsultn 14 GirdersSills-Anchr Bolts J oists-Vnts-C ripples 15 Acc & Vntltn 16 Insulation DATE IFRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces-PlatesSound 19 Bearing Walls over Girders & fir Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops, Furred Ceilings -Stairs -Chasers Tubs 22 Headers & Beams-Sz & Bearing 23 Hangers -Post Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 25 Frplc Ties or Type A Flue-Frplc Throat Cimc. 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctn Framing -RC Channel 29 Prprty Line Firewall & Opngs 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnls 38 Insultn-Walls-Ceilings 39 Infiltration-Walls-Wndws DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrncans Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz 9 ❑CU or❑AL AC Wire Sz ga ❑ CU or ❑ AL 48 Range Circ CU or El AL Oven Circ ya ❑ CU or ❑ AL Insulated Neutral ❑Yes ❑No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clmcs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector 53 Wtr Htr; Vent-Acc-C nibs in Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr Nail Prtctn 56 Shwr Pan; Test, First fir -Tub Acc 57 Test Tub & Shwr, 2nd fir - Tub. Acc 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping MECHANICAL 61 AC Ducts Insultn & Support 62 Vent Fan, Exhaust abv Insultn 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace -Vent Acc-Comb Air Rtrn[Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic � m DATE FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Cirnc-Comb, Air-Cnnctr In Garage; abv-fir-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Sts & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Cimc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Cimc 77 Elec Outlets & Rcptcls atKtchn Counter 78 Garage Fire Door, Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-DImc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Lottn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑ Yes ❑ No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frpic-Clrnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous Inspctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99. Fire Sprinkler BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 638-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP060831 B. C. Building Permit 01-16.04 pg 1 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: 05/22/2006 APN: 058-670-014-000 the Business and Professions Code, and my license Is In full force and effect. License Class: license Number: Site Address: 3204 TREVOR RD CON Map Index: Date: Contractor: Description: garage addition (1128) OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: SAUL, DONALD JR permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for such permit to file a 3204 TREVOR ROAD signed statement that he or she is licensed pursuant to the provisions of OROVILLE, CA the Contractor's State License Law (Chapter 9 commencing with Section 95965 7000) of Division 3 of the Business and Protessions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 530-533-4523 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 (8500).): ❑ I, as owner of the properly, 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 Applicant: SAUL, DONALD JR Code: The Contractors' State License Law does not apply to an 3204 TREVOR ROAD owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, OROVILLE, CA provided that such improvements are not intended or offered for 95965 sale. If however, the building or improvements are sold within one 530-533-4523 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 Contractor: ADVANCED ENERGY CONSTRUCTION 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.). 12168 GRANITE RIDGE RD YANKEE HILL nder Article of the Busine s an sslon ode 131 amP-R&U, Date: C7 Owner: (530) 877-8282 LIC# 538421 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: "License #: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 'Architect: ❑ 1 have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 1128 S.F. Policy #: Valuation: $27,072.00 I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comp with those provisions. Date: i. © L �(�(� l� � j I 1 "I / S - l 1_0G Applicant:A:SZ4l WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars (8100,000), in addition to the cost of l cJ J ,ljJ J ts-_O&1-7 compensation, damages as provided for in Section 3706 of the Labor 7t code, interest, and attorney's fees. ry� J (/L Q b _ ___ CONSTRUCTION LENDING AGENCY This oermit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resol lio to do work Ind icat above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Date: �_„�� Name: BY: PERMIT EXPIRES 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 rrruupon the above mentioned property for inspection purposes. authorize representatives of Butte County to enter Print Name: `/ 0 `U A D S r v Signature: . - Date:Lv `Act Z ZZiJG(v ❑ Owner ❑ Agent for Contractor W Owner ❑ Contractor Agent for B. C. Building Permit 01-16.04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP060831 B. C. Building Permit 01-16-04 pg 1 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: 05/22/2006 APN: 058-670-014-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 3204 TREVOR RD CON Map Index: Date: Contractor: Description: garage 8 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 Owner: SAU L, DONALD JR permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 3204 TREVOR ROAD signed statement that he or she is licensed pursuant to the provisions of OROVILLE, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95965 she is exempt therefrom and the basis for the alleged exemption. Any 530-533-4523 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).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: SAUL, DONALD JR Code: The Contractors' State License Law does not apply to an 3204 TREVOR ROAD owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, OROVILLE, CA provided that such improvements are not intended or offered for 95965 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 530-533-4523 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 Contractor: ADVANCED ENERGY CONSTRUCTION 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.). 12168 GRANITE RIDGE RD YANKEE HILL ❑ 1 pt underArticle of the Busine s an 6f�ssion ode ;Zxe Date: Owner: (530) 877-8282 LIC# 538421 111 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Architect: ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 1128 S.F. Policy #: Valuation: $27,072.00 �J I certify that in the of the work for which this permit is performance Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, �1 and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comp with those provisions. Date: A � nc77�� Applicant: - l_DG 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 �0&t_7 code, interest, and attorney's fees. J-22-- Ob - - - CONSTRUCTION LENDING AGENCY --- - • -This-permit is hereby issued under the applicable provisions of the Butte County Code andlor� I hereby affirm that there is a construction lending agency for the Resol do to do work indicat above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.)ov, Date: Name: BY PERMIT EXPIRES 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 B to County. I h reby authorize representatives of Butte County to enteruponthe above mentioned property for inspection purposes. Print Name: �0=J A L D C ` Signature: —7 Date: f A(22 j ZGUro ❑ Agent for Contractor ®/ Owner ❑ Contractor O Agent for Owner B. C. Building Permit 01-16-04 pg 1 J BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE 9: (530) 538-7541 A FEE WILL BE REOUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY* OWNER INFORMATION Last Name ®I.C.C. Nam IFp100-%-L_-C> Address \f CityA��) Ll, Slate CAZip � b -5 Phone 3 -3 3 Fax E-mail S,&J IrL A,6 ARCHI /TECT/ENG-INEEER/ Name O Address A5 5 N a. � City State Zip Phone'Fax E-mail State License Number 5 CONTRACTOR Name / (�O � _ 1 Glir�l/1 /�/Z� �CG•�c�a CN Address/ Gaars City (�� / /� -State �A zipgs96,- Phone )7-7_8282_ Fax E-mail Lic.#5�' 3jq Class ARCHI /TECT/ENG-INEEER/ Name O Address A5 5 N a. � City State Zip Phone'Fax E-mail State License Number 5 APPLICANT SIGNATURE X ��A I�_ L - i For office use only: APPLICANT INFORMATION Name ' t . . 7>�wt� �s� oWnl�dz Address SRA City I No State 71 Phone Book Fax E-mail Planner APPLICANT SIGNATURE X ��A I�_ L - i For office use only: Zoning Flood Zone SRA Yes I No Occ. Type Const.' Subdivision Name Map Book Page Lot # Planner Date Approved: nVFR FOR SUBMITTAL REQUIREMENTS PERMIT NO. B P06 M' BIN # PROJECT LOCATION . AP#o5-9- 6?c> -ol y Property Address City .&KAt; 415, OU)AJE/Z Cross treet ' q w 0 WORKER'S COMPENSATION- -Policy Number Q Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name NA Address Description or Scope of Work: i 9-2 � �c��i ?!ar✓ — Sq FT- Living Garage H28 Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew -action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. —y Received b Amount: Bldg 9 SRA Receipt #: 0+ I Sheriff V1 k SMIP (�; v go Other Date! \ �L Total SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A). Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bidgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for tion -residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form . ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ' ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). El 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the.person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 ;,.+.r_,,lL..3P•%w ..+--.:tom-«, ��a.}� ':- �7.�C,i'-+r. V v"t,.:.�y .Ji,; .•C- '.yr�V��?�.•7y:��!"-7yW_4ZFt tai:. &V, .._'+ ri ri 'ti..+:"7✓.`r�r •. ,rk _ COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION r . 7 County Center Drive, Oroville, CA :95965 Phone (530)538-7541 Fax (530)538-2140 r PERMIT APPLICATION DATA SHEET OWNER: �/ I V L ASSESSOR PARCEL NUMBER 7�01V Proposed Building Use: (. &fi" tC' 77 �/ 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. i tl 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 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: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Ti'e down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Hazardous Material Form �p I BJ 12. Acknowledgement of building permit application without required clearances. ❑ 13. Other �ning items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 14. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 15. Fire Sprinklers............................................................................................ ❑ 16. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... ❑ 18. Erosion Control Plan Required........................................................................ A (0. Fees as shown on the.attached Schedule of Fees Due Sheet.............................. ❑ 20. City of Chico Plumbing permit........................................................................ 0 21. Site plan and business license approval from the City of 5g.s�....................... 22. California Department of Forestry plan approval Eil-paid. Sent by: ............. 0Planning approval for (A) Use: (B) Parking: (C) Parcel Check: ............ 4. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 25. Fire Marshall Review (commercial projects only). Sent by: ...................... `p f /J 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑28. Contractor's license information. (Number, Name Style, Classification) ................... 014 .29. Worker's Compensation Carrier and Policy Number .......................................... /v 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: All of these When issued Telephone �fJT`� �� 7 ' / S� 3 and hold for pickup.�- I have been informed of the above items and requirements for obtaining a building permit. Applicant: !/ Date: 4, /It 16 6 1. Index perms application for the above items numbered: tKLL1,1Vdn Check Leiter 2. Additional items requi Contractor, design as advised of the above data by ❑ phone, &cl"mail, ❑ counter, by ate: Contractor, designe own , was advised of the above data by Q_jKone, ❑ mail, ❑ counter, by ate: Contractor, designer, owner, as dvised of the aboe d to by ❑ phone, ❑ mail, ❑ counter, y Date: Plans reviewed by: Date: ob Plans approved by: Date: Ili ,0.6 Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: S ! o Yellow: Building Division K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05 AA •'sv TO: Building Division = Development Services E H USE ONt v Plot Plan Attached Floor Plan Madied Sent to 8D/DS y OG /0 /lLf-- FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location Plan Approved for: Sewage Disposal---,._ Water Supply: Public Clearance for dwelling. Other Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist Building Clearance 9/2005 _Private Well 11 A�b D �1-4 k h Date BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 www.buttecounty.net/dds PHONE (530) 538-7541 FAX 538-2140 RECEIPT OF FEES SCHEDULE - RESIDENTIAL Owner saul, don APN No: 058-670-014 Application Date 4/11/2006 Permit No: 'BIP 06 0831 Permit Type: garage addition 1 BUILDING PERMIT FEES ESTIMATED AT APPLICATION $714.87 Plan Check portion of Permit Fee $285.95 $428.92 Balance of Building Permit Fee 2 FEMA BYes Flood Elevation Review $109.98 0 3 SRA* x Yes Fire Plan Check - Non -Refundable $95.00 $95.00 498 (State Responsibility Area) Building Inspection $109.98 $109.98 _ $20 NUN -REFUNDABLE portion of fees due at application $380.95 +,, RECEIPT DATE Tech/Asst FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION $490.93 LL 9715 FEES (BELOW) DUE PRIOR TO ISSUANCE OF PERMIT IE$431!63 4 Balance of Building Permit Fees (from No. 1 above) $428.92 4 IVIN7 5-79-0h 5 SMIP* :Strong Motion Instrumentation Program (Enter amount from permit system) 6 Additional Plan Check Fees (NON-REFUNDABLE) 7 Other*: 7a Other*: 8 IMPACT FEES - RESIDENTIAL* Applications After 2114/05 *F jPer Dwelling SFD ,, I Per Dwelling MFD ,> Per Dwellinc MH County 4096.87 3071.14 3117 KOurtni Chico Urban Area 5372.09 3995.45 4889 EI Medio Fire District 3128.31 2297.77 2326 North Chico Specific Plan 772 Little Chico Creek $8,792 $2.71j1L L At the time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. Applicant: ( Date: Q Pursuant to Government code Section 66020, you are hereby not' i d those Items followed by an "" may have been imposed ch your roject. You have 90 days from the date of approval of the porject or from the impostion of tft above referenced items during which you may protest. The requirements for a protest are specified in Goverment Code Section 66020(a). K:/Building/Forms/Schedule of Receipt Fees Residential 121205 °i SR -1, SR -3, SR-1/PD 7938.531 6757.081 7633.49 �c R-1 8031.53 6850.08 7726.49 °c R-2 7541.531 6360.08 7236.49 R-3 6780.531 5599.08 6475.49 RECEIPT DATE Tech/Asst Processing Fee is automatically added to impact fee total 0 $100.00 WATER TENDER FEE (Not collected when impact Fees Applicable) Enter Bat.# $200.00 9 KOurtni DRAINAGE FEES* 10 CHICO STORM DRAINAGE 770 Butte Creek $7,736 MASTER PLAN 771 Comanche Creek $8,069 772 Little Chico Creek $8,792 New construction, vacant land, on 1 acre or less - Enter 1 or less acre value RECEIPT DATE Tech/Asst 773 Big Chico Creek $6,596 774 Lindo Channel $8,139 775 SUDAD Ditch $6,975 776 Mud -Sycamore Creek $6,070 777 PV Ditch 1 $8,603 More than 1 acre, existing buildings - fees to be assessed by Public Works 10a Fee Determination Sheet Needed - Enter amount determined by PW THERMALITO DRAINAGE AREA 1 $652 Maximum 11 Per each new living unit on existing lots where full drainage fees have not been paid Temporary Dwelling 1 $130' At time of building permit 11a $130 annual renewal fee for first 4 renewals. Not to exceed $652. PROOF OF PAYMENT OF FEES (BELOW) MUST BE RECEIVED PRIOR TO ISSUANCE OF PERMIT. Forms will be prepared after plan check is. completed for applicant to take to respective district office. 12 SCHOOL DISTRICT FEES* 12a RECREATION DISTRICT FEES* At the time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. Applicant: ( Date: Q Pursuant to Government code Section 66020, you are hereby not' i d those Items followed by an "" may have been imposed ch your roject. You have 90 days from the date of approval of the porject or from the impostion of tft above referenced items during which you may protest. The requirements for a protest are specified in Goverment Code Section 66020(a). K:/Building/Forms/Schedule of Receipt Fees Residential 121205 t - f OWNER -BUILDER ILDEJR `GT.GR IFICti TION 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 material for construction of this proposed / property improvement: 'YES.[ ✓] NO [ ]. 2. I HAVE [ ✓] HAVE NOT [ ] signed an application for a building permit for the proposed / work: 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and -provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS. I PHONE TYPE OF WORK SIGNED: J PROPERTY OWNER: C1 DATE:d 1 (?/0 NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the Butte County Department of Development Services ��TT ADMINISTRATION `BUILDING t GIS ° PLANNING 0 o o 7 County Center Drive- ` Oroville, CA 95965 0 (530) 538-7541 Telephone (530) 538-2140 Facsimile OWNER -]BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a pennit Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation instrcance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your bbligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or. through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner builder' building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Scott Rutherford Chief Building Inspector NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. QWTMENr °o�'?�TT�0 Department of Public Works 1 p' C o u m y o f B u t t e OLAND DEVELOPMENT DIVISION c p / J. Michael Crump, Storm Water Management Program o �� Director 7 County Center Drive C U t4 Oroville, CA 95965 A�@QC wpR�y (530) 538-7266 " (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE] Project Description: Project Location and/or Parcel Number: o5 ' 6 70 _ 0/,;( 7revo-e- kl"d Y d -,.7L - 144 c, c-, Cor- q S`7'65--7763 By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional, Water Quality Control Board. Phased projects that contain multiple site 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. Sig ned: Title: Date: 4-111.1166 Less than I Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program . Revised 5/24/04 Butte Co untyDeparLment ofDeveloplz1ent services 0 1,11. ° 7 County Center Drive ° Oroville, CA 95965 (530) 538-7601 Telephone =� ° (530) 538-7785 Facsimilec0U 1 BUILDING PERNUT 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 e 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: 1 p tJ Arc. 7 a,,,- APN: e) 5_0 -6-70 -- 4 rY- Building site address: 0 Permit No.: �� 7x3 I have read, understoo and cept the terms and conditions as expressed herein as indicated submission of the above -referenced building permit application and my signature below: SIGNATURE OF APPLICANT DA E 4 Copy to ApplicanVEH/File Y`Fomu/BldePermitwithoutCleaanca 020705 by my April 25, 2006 Donald,Saul 3204 Trevor Road Yankee Hill, CA 95965-9763 Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX Assessor Parcel Number: 058-670-014 Building Permit Number: 06-0831 Thank you for submitting the plans for your building project. The plans have been reviewed and comments are listed below. Please respond in writing to each item by completing and returning the enclosed PLAN REVIEW RESPONSE FORM. Your complete and clear response will expedite the re -check and approval of this project. COMMENTS: /f. Existing Garage was constructed without Butte County building permits, plans approved by the building division and inspections. Provide construction drawings of the existing portion on your three (3) resubmitted plan sets and pay additional fees on this permit application. (/2. Indicate braced wall panel locations on plans for compliance of CBC 2320.11 requirements. Non -permitted portion of garage will need to comply with the requirements of CBC 2320.11 and braced walls will need to be indicated on plans for this portion of the building also. /-3. Provide alternate braced wall panel at location between 10' X 8' door area and 10' X 8' door, and if needed, on existing non=permitted portion of building for compliance of CBC 2320.11 requirements. /4. On submitted plans, elevations are not in agreement and do not correspond to the indicated scale of/4" to 1'. Provide corrected elevations. (/ 5. On page 6 of submitted plans, correct scale to reflect detail. e/6. On page 2 of submitted plans, clarify note on glu-lain. On page 3, clarify note on sill bearing plate thickness. ,/7. On page 3, the foundation details need to meet Butte County minimum residential garage wall foundation detail standards or provide engineering calculations for submitted details. Indicate type of fill in detail and clarify sill bearing plate thickness. /8. Submit 3 copies of plans with the corrections mentioned above. If you wish to discuss any of these requirements, please call (530) 538-7541. Refer to the Data Sheet for remaining non -plan check items. (You should have received this form when you applied for the permit) The counter staff will'answer any questions concerning the Data Sheet. Carl Nelson Plans Examiner 1 of 1 0 I �c ur s 4o. a� o ��nLno 3 o �� O?Orn Z Z Z;o D o{c {;o -n A 0 ,w mCm0' - rG �l 060 Z ;U PD Z°'m Din =r'a� ted`.".aa;��_°='- � % '/'�•1"s \\�1 ~ �� y � • � \ � \ ,`\•\ /;fit', 1.. A C /o r i' L 3 �� `` xSv�� , : pv o w . X - A setback bf. r. ff.from .property lines and a se. of 50ft. from the road r- Mirderline shall be clew. Strwtures or equipmer.- �, fbr 41 ft.- eave over h a r O&ow c.►se- .'�ifl'�y, Vii. �`'ti�•t� � .. . Refer to APPROVED PLANS for additional notes and information I for this project I Alternate Framing Details to change 10X11 Door to 12X11 Door and move to the otherside Scale V4°=1' 64' REVISION: BP# OG - 0831 Date 6 -16- 06 " BurTE COUNTY WILDING DIVISION APPROVE} 6111-10(. C,✓ 7' 3' 4' t r GAS t { 3t 4' fY. i I , ! PERMIT NO. 727-85B,P,E,M PERMIT EXPIRES q OWNER HENRY J. HOFFMAN CONTR. Lance Bros Const, Elk Grove s' ASSESSOR PARCEL _41-53-14 LOCATION N/S @ End Trev^or Rd, 4/10 mi NW of Truex Rd, Oroville OFFICE COPY Address !� JOB FINALE[ Signature GAS { 3t Meter By Date ELECTRIC �y4 Meter By Date y � • -°,v -- -- - - z Temp. Power Pole _. ti Called PG&E . � Temp. Elec. Service Called'PG&E ./ Temp. Gas Service e� Called PG&E !� JOB FINALE[ Signature J' = OK, O = Not OK - = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed iSketch) 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Con nec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/O to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B-1 Date Card -BI Date Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date ,3` V = OK 0 = Not OK NotA$plicable RESIDENTIAL JSingl•e and Duplex) *E = Not Ready Date UND FLOOR Plans OK exce t#'s Date FRAW4 (Continued) ning requir ments-Setb -E ents 4 ,P arty Line Firewall & Openings Ftg., M , So' -St le Zai Ftg. Depth 4 x Doors -One 3' -Check Garage -3rd story, 2 exits 3. F!9., Garage; S ils-Steel- / Fig. Depth tairs; Width -Headroom -Rise -Run -Landing -Fire Protection F ., PorthIs & Decks; Soils -Steel- V1'/" Fig. Depth W. P wood on Roof Overhang -Attic Vents -Rafter Outriggers Stemwalls, M ' St -Blockouts-Wrapped-4fab— Siding -Nailing -Veneer j* Gar ge; Steel -B lockouts -Wrapped -S lab cco Mesh -Drip Screed-Fdn. Vents-Underflr. Access Piers -Fireplace Ftg.-Steel 5 . axing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/0 -Sewer TestShear Wa s; Nailing -Bolt ,W9. Gas Pipe; Size -Anchors &Z 1 a Water Pipe; Test -Anchors -Regulator -Service Test erground 2. Plenums & Ducts; Clearance -Material -Support -Ins. eft3. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Q 4u ) 4 _ard-BI Date r foo± AA — Card -BI Date 0 J Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINA ans) OK except #'s Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except p's E Steps -Door & Sidelight Protection -Landings Smoke Detector 14 W r Ht.• ent- ccess-Combustion Airents-Clearance-Comb. Air -Connector - �In Garage; Above Floor -Ducts -Meeh. Protection e ' Ad ater Pipe; TAnchors-"Protec 'o 1 r & A ors- Protecti r> 5e B!f om Exiting 1 r Pan; Test, First Floor -Tub Access 6 G.F.I. &Bath Fixtures &Tub Access 18 t Tub & Shower, 2nd Floor -Tub Access 61. Ele . Trim & Subpanel; Breaker Sizes -Labels AP Gas Pipe; Size &Anchors t & Rails eplace or Stove; Clearances -Hearth 6t4! Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 6V Kit. t. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date , Card -BI Date 6j;. ec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except q's Swing -Landing -C loser -Damper X20. ure &Transformer Clearance -Ins. Protection Irl 69• tr. Htr.; Vents -Clearance -Comb. Air -Connector P.R. .- I arage; Above Floor-Mech. Protection • 2 ' .E .Receptacles Spacing -Lights &Switches at Doors Plb., Elec. &Mech. Equip. Listed for Location Si oxes & No. of Conductors -Stapled 7 '111arage; (G.F.I.)-Romex Protec. 2 " k Installed Close to Edge of Studs & C.J. 2 p. Ground made up w/Mech. Fasteners -Bond Gas & Water 2 Appliance Circuits in Kitchen & Conductor Size ed in Attic ❑Yes Guard Rails &Deck Construction -Post Caps ,26:'--SUWeed. Wire Siz / / a. Cu or AI-A.C. Wire Size / / ga. Cu or Al F nts &Crawl Hole Drainage &Wood -Earth Clearance Looked under Floor es 27. Range Circ. / g -Oven Circ. / / ga. Cu or AI, elated Neutral s ❑No ollowing instld.: Drive Yes g;-NO—Walks El Yes Planters E:] Yes Service-Riser Conductors & Ground -Main Disconnect 7 lZ9!Equip. Clearances; Panels-Motors-Mech. Equip.77_ A C. Itnit Disconnect-Clrnces-Brkr. Cond. Size -115V Outlet ,i �3�OClothes Closet Light -Shower Light 78, s Aboyw Roof; P bg.-Appliance-Firepl.-Clearance to Opngs. Wa I; Di nect, Electrical, Plumbing terior Elec. Trim; G.F.I. Receptacle -Underground Card B -I; Date r Card -BI Date entilation throughout House lass Protection Card B -I Date r6 - Card -BI Date Date MECH ICAL (Permit) OK except q's&,"qal C rrections from Previous Inspections Test -Meters Tagged; Gas -Electric C• Ducts; Insulation & Support & Sewer Connected -C/O to Grade -HD Approval Vent Fan; Exhaust above Insulation IAKWater 86. Energy Compliance Certificate -Other Certificates _33._Gendensate Drain & Overflow; Size & Grade 34.--F-urnace-Vent; Access -Comb. Air -Return Air Vent -115V outlet -35---M'tic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date ard-BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: Date FR1 ( Plans OK except q's ills; Proper Material & Anchors 3 alts; Studs -Nailing, Spacing & Bracing -Plates -Sound earing Walls over Girders & Floor Nailing D Stop in Walls (rat proof) 4 e Stops; Furred Ceilings -Stairs -Chases -Tub 4 Header & Beam -Size & Bearing 42.Hangers-Post Caps -Anchors -Connectors 4V Cing. Joist-Rftr. Ties-Purlin - Roof Brac_.-Truss-_Shthn_g-Rfn_g_.__ _..gg� 44.,PiTeplace Ties or Type A Flue -Fireplace Throat 4V Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 4 drm. Windows or Exiting Doors -Sill Hgt. & Dimensions -4�--�arage Fire Protection Framing (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS ,,�.. 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 5344541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE IT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Inspector Date 4 /3 — R COUNTY OF BUTTE _ DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE t�Wt�JEF� .40a- �l �-Z 7` PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. 57 P C -P, S� cJvAe N eL I nrJ-! ni 1 ��,.J r-...► J \ (AI l/ Inspector P J---6� Date �l COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise - Phone: 872-2961, Ext. 57 'CORRECTION NOTICE VNER ) V PERMIT NI A routine%inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or needladditional explanation, please contact this office immediately. 0P1 f s Inspector__ Date --Cc_ COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 ' 7 County Center Drive, Oroville — Phone: 534-4541 ;.` Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE vvvrveri / �/ PERMIT Ni Yom. f�0 A routine inspection indicates that the following violations of County Ordinance existlat the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or neeed� additionalrexplanation, please contact this office immediately. a Owner: Permit No. ENERGY C E-RT�I.F ICAT ION F3 t LOCATION A.P. No. DESCRIPTION OF INSULATION m ROOF Material Brand ' o�%9�a Brand Name 6-1�� Thickness(in hes) f- Thermal Resistance (R Value) a EXTERIOR 't Material 74%Le,,l- Brand Name Thickness(inches)_,3 Thermal Resistance(R Value) tf 11 CEILING , Batt or Blanket Type /3 �_-r�/y-(Brand Name _ Thickness(inches) Thermal Resistance(R Value) R-1 y Brand Name Minimum Thickness(Inches) Number of Bags Wt. per bag lb: Area covered(ft. ) Thermal Resistance(R Value) FLOOR, ELEVATED Material � '7 d Thickness(inches) G FLOOR,-W-"— Material Thickness(inches) Width(inches) Brand Name �•�`�' . Thermal Resistance(R Value) dr /� . Brand Name Thermal Resistance(R Value) L Material Brand Name Thickness(inches) Thermal Resistance(R Value) I hereby certify that -the above insulation was installed in the above building in conformance with the State of California Energy Requirements. lit -C WNER STATE CONTRACTOR'S LICENSE NO. �i��z. S NATURE OF TAStALLATION APPLICATOR DATE I hereby certify the above insulation and all required items as shown on the Building Department approved plans and attachments have been installed as required by the State of California Energy Requirements. All equipment, devices and materials are of the quality prescribed or are specifically approved by the State of California. F/OWNER (Please print) STATE CONTRACTOR'S LICENSE NO. 41 / . - // LIZ IS- IGNA R OWNER -� DATE THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. January 1984 JCOUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO - a 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER[�/ 1 / ZONI BUILDING PERMIT o R J. 1I�tI rA11A j71(l i�l T ' ZN Y SO. FT.. OCC. BUILDING VALUATION .7 �l W GV • P �+ OW p1 E R ;4 AUF V Z- 40 V� C/7, Tf3AC,TOR'S NAME � ��,� TELEPHONE CONNT/i]�,�`CTlE'SS McING A,7,tSS C �/C,iE^JV G (/� Fireplace ODD, -0 CONSTRUCTION LENDER UNKNOWN Total Valuation $ ." Filing Fee $ 10,00 LENDER'S MAILIN ADDRESS Permit Fee $ ,016 ARCHITECT OR ENGINE LICENSE No. Plan Checkin Fee 01 $ �, 0-0 y 'C-' $ ARCHITECT OR ENGI EER'S MAILING ADDRESS Permit fee $ BUILD% Z G ADD SS �(s FAlz> TecvO/e I -a-,6 • App /v PLUMBING PERMIT Filing Fee 10.00 vF- %,PWEX Rb Each Trap S1 2.00 ILX0.0 M 20.00 tZ*1r ow Water piping 5.00 5-,646 LOT NO. 3 SUBDIVISION NAME 1 PARCEL MAPEach 76_.3© qas water heater or vent 5.00 Gas piping system 1 -5 outlets 5.00 USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 —OV Mobile Home JSJGJWJ 10.00 e TYPE OF WORK New Addition❑ Remodel❑ Utilities❑ Installation❑ Other❑ Describe work: — Permit Fee $ t� Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 10ov OR LESS 100 AMP OR LESS 10.00 ��•11 V OO Main service EA. ADD•L 100 AMP 2.50 NEW CONST. ( DWELLING ` OR ADDNS. ACC. BLD I Z�ZQSq ft CONTRACTORS LICENSE 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 NEW CO ID R BRANCH CTLETITS 2.50 ea NEW-CONSTR. ( POWER APPARATUS.RESID. &) SINGLE OUTLET CIRZDLsom Ex. Occup(o TS DR FIXTURES BAL®30 FIXEDAPP LNS, OR Ex. OCCUp- OUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 i. Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 r@O 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 yagat said County in co eq ce of the granting of this per Date Signature o App ant — 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 Horne Installation Fe $ TOTAL PERMIT FEE $ 9 O oc P. GROUP TYPEO CONST. ILI PARC PD N ISSUE ✓ This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT OF PUBLIC BY ` PER EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date t�.5//,� ��- 3 6. Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF) PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLEy.CALIFORNIA 95965 - TELEPHONE: 916/534;4541 PERMIT APPLICATION DATA SHEET OWNER Permit No. 1�/ A. P. No. 44/ - 53 -/q Proposed Building Use Permit Fee Based Up�n: % Complete Contract Price DPW Valuation / Other (Explain) Building Inspector _ Date At time of permit application, I was advised the following data must be submitted prior to permit processing andlor issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2.,, Plot plans in duplicate./triplicate. . . . . . . . . . . 3. Complete plans in duplicate./triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . . 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner0, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . •Pre-Inspec. request to (Date) X17. Pre -Inspection for Required. Bu;Ialn �spector X1,8. Recorded copy of Agricultural Acknowledgment Statement. 19. Other When you issue the permit, process as follows.: Mail to owner. Mail to contractor. an Telephone —,C�6Sd ol'd or pickup at GC`s office. Deliver w./inspector. Other Applicant XAmlei_� Date r Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other Plans checked by- Plans y_Plans aooroved by Other By Date Date Copy—DPW To: Building Department From: Environmental Health . Subject Sanitation' Clearance. Obme . Location AP# , Plan Approvedfor: Sewage Disposal Water Supply, Hold Final. for: Water Supply Final Clearance O.K. for: Water Supply Clearance for _bedro m ouse obilehome or other Note*** •P R.S: Clerk Dat Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. 85s 7S87` / OF'EICiALRECOF �- 9017r COUNTY- Q41A kEV^CFif1S FdE0UE;5 rc ti PARTY Pao" MAO 19 1 i 07 Ian -..18 u The property described herein is adjacent to land or included EIF..AN01i�' i`�'•:l:f within an area zoned for agricultural purposes, and residents of this CLEftK.f7fCUhik'3 property may be subject to inconveniences or discomfort arising from FF.E• 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 zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. All that real �I. ',PARCEL A: situate in the Co Parcel 3, -as shown.on that Southwest quarter, Section M.., filed in the office_ of California, on December 12, and 30. PARCEL B: of Butte, State of California, described o¢u�onr. certain Parcel Map being a portion of the' 16, township 21 North, Range 4 East, M.D.B. &w the Recorder, County of Butte, State of 1979 in Book 75 of Parcel Maps, at pages 29 Nonexclusive easement for road and public utility purposes 60 feet in. width as shown on that certain Parcel Map being a portion of the South- west quarter,-�zSeIction 16, Township 21 North, Range 4 East, M.D.B. & M., filed in the office of the Recorder, County of Butte, State of California on December 12, 1979 in Book 75 of Parcel Maps, at pages 29 and 30. Date: r State of ) On this SS.' me, the County of ) Z ��mAa®ma�mmm®�©�cc>a�c�®ear® PATSY L. ( ARTER e. e NOTARY PUBLIC -CALIFORNIA Butte County a My Commission Expin:s May 13,198e � ■ ■aaaa�r�oa�aa■®�a���is��: PROPERTY OWNERS: the -= day of 19� before undersigned Notary Public, personally appeared / Personally known to me.' r to be the person(s) whose name( the within instrument and acknc executed`the same for the purpc IN WITNESS WHEREOF, I hereunto Present A.P. No. 411' 53-14 VEroved to me on the basis -11 ,.-. 6f satisfactory evidence. subscribed to %led:ge`d that ses aerein contained. ' y set my hand and official seal. /PIPone .W.1074 END OF DOCUMENT n