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HomeMy WebLinkAbout061-490-020•�� ``` . . �_ _ _. ' y .r _ ' _ k `rte -sh6- _ Robert Cameron "_ya��1% E/S Forman Creek Rd., 4 mi.N.of Hwy* J + 162, Berry Creek q Permit #3011-79P,E(util. MH) ELEC.&/-'S-7� GAS_ 6—g— 7 �/ �� ry SUPPORT STRUCTURE REQ. COMPACTION TEST REQ. Perm•* #3221-84P,E til, MH) ELEC J� GA S 4. p• COMPACTION TEST RE kid SUPPORT STRUCTURE 'p'as LA -4 Contr� cifc, Mo5I'ular Concepts mV V3 Per289-84mi I;s glu 0 I 6.1_49-20 14 FORD49 MeRd, Oroville Permit#1745-87E(install ele/ex hse) 061-490-020 02-1540 CAMERON, ROBERT. 14 FOREMAN CREEK, BERRY CREEK RE -ROOF & REPLACE SIDING B07-0600 061-490-020 MISCELLANEOUS Ag Exempt AG BLDG 30X40 (SKIP LOADER, BAC 104 FOREMAN CREEK RD CAMERON, JOHN ROBERT & JANET LAG 07-1249 061-490-020 ISCELLANEOUS Ag Exemr EXEMPT 30X24 TO HOUSE TRAC 4 FOREMAN CREEK RD ANT 'RON JOHN ROBERT, 00 0-' 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: 14 FOREMAN CREEK RD Owner: Permit No: B07-1249 APN: 061-490-020 CAMERON JOHN ROBERT, Issued Date: 06/26/2007 By KEJ Permit type: MISCELLANEOUS 14 FOREMAN CREEK ROAD Subtype: Ag Exempt BERRY CREEK, CA 95916 Expiration Date: 06/25/2008 Description: AG EXEMPT 30X24 TO HOUSE TR (530) 589-1647 Occupancy: U-3 Zoning: U SH Contractor Applicant: Square Footage: OWNER CAMERON JOHN ROBERT, Building Garage Remdl/Addn 14 FOREMAN CREEK ROAD BERRY CREEK, CA 95916 Other Porch/Patio Total (530)589-1647 FEE INFORMATION DBEH Building Review Fee $75.70 DBOMSCF Ag Exemption Permit $115.98 Total Charged: $191.68 Fees Paid: $191.68 Balance Due: $0.00 Receipt No: B3430 LICENSE_ D 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 OWNER / / 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 Section 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 in full force and effect. 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 X 06/26/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; check one of the following: Contractor's Signature Date ppppPlleease I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE IhOMPENSATION, 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 1 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 ❑I 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.). ❑ I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: 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' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier: Policy Number: Exp. Date: (This section need not be completed if the permit is or one a hundred dollars ($100) or less. I AMEX MP under Sectio B. & P.C. for this reason: 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 la alifomia, and a t if I should become subject to the workers' 06/26/2007 compensatio rov' ons of Section 0 of the Labor I shall forthwith comply with those O er's Signature Date provisio�r s. � X 6/26/2007 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 State laws relating to building Sign re Date W NING: 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 County, 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 injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, 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 use opancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. Co n o ante a ove mentioned property for inspection purposes. I hereby certify that I am the pry o r o m authorize on I pro owner's behalf. CONSTRUCTION LENDING AGENCY ,�LEc��!'� D 06/26/2007 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) ❑ Owner ❑ Contractor OR; DAgent for Owner DAgent for Contractor FILE COPY Lenders Address City Stat ezip . 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 AGRICULTURAL BUILDING EXEMPTION STATEMENT 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. Buildings used for purposes other than described above or that are located in a flood hazard zone are not eligible for anagricultural exemption. Authorization of an agricultural exemption permit by the Department of Development Services does not preclude any requirements and/or review by the Butte County Public, Works Department, Butte County Fire Department, Butte County Environmental Health, or any state and federal agencies. Initials � AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. Initials 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 manufactured home, and 23 feet from a commercial/industrial buildings Initials AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum 23 feet from a residence and a manufactured home, and 40 feet from a commercial/industrial buildings Site Address: 14 FOREMAN CREEK RD Permit No: B07-1249 APN: 061-490-020 Square Footage: 0 Permit Type: MISCELLANEOUS Occupancy: U-3 Permit Subtype: Ag Exempt Zoning: U SH Description: AG EXEMPT 30X24 TO HOUSE TRACTOR Required Setbacks: Applicant: CAMERON JOHN ROBERT, Front: 20' Side: 20' Rear: 20' 14 FOREMAN CREEK ROAD Type of Construction: BERRY CREEKCA95916 (530) 589-1647 Type of Siding: Metal Owner: CAMERON JOHN ROBERT, Est. Const. Cost: $ 4,000.00 14 FOREMAN CREEK ROAD Roof Covering: Metal BERRY CREEK, CA 95916 (530) 589-1647 Floor Type: Concrete I declare under penalty of perjury that the building will be used as stated above, and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain the necessary permits, inspections and approvals to comply with the requirements in effect at th i and i to occupancy. Signature of owner: (} Date: 06/08/2007 FILE COPY BUTTE COUNTY 0 DEPARTMENT OF DEVELOPMENT SERVICES ° BUILDING PERMIT APPLICATION ° OFFICE #: (5'30)538-7541 FAX #: (530) 538-2140 :o C A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name Firstame r --oh Mailing Address �.0 'e") ; frfrx, � r City S,anw e Zip Phone �r Y Fax E-mail APPLICANT INFORMATION CONTRACTOR Name a6c Address /'► City City !=ip State Phone Phone Fax E-mail E-mail Lic. # 24 7� Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail I HM PERMIT NO. SV r7-1. BIN # . I PROJECT LOCATION I API Property Address City 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. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Xa 6Z,501 o12 9 Scl FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning 1. Flood Zone x SRA es No Occ. 3 1 Type Const. t Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: 0 Make sure your application is complete. fry Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at http://municipalcodes.lexisnexis.com/codes/butteco/ Reference Number: B07-1249 Location: 14 FOREMAN CREEK RD Parcel Number: 061-490-020 Owner Name: CAMERON JOHN ROBERT, Date: 06/08/2007 Phone: (530) 589-1647 Description: AG EXEMPT 30X24 TO HOUSE TRACTORS Signature of Property Owner: Date: 06/08/2007 FILE Butte County Department of Public Works J. MICHAEL CRUMP, DIRECTOR LAND DEVELOPMENT DIVISION Storm Water Managment Program 7 County Center Drive Oroville, CA 95965 (530)538- ' 7266 Telephone (530) 538-7171 Fax www.buttecounty.net/dds Qt. 0 d 0 0' 0 �$c v`'�$ National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment [LESS THAN 1 ACRE 1 Reference Number: B07-1249 Date: 06/08/2007 Location: 14 FOREMAN CREEK RD By: TMP Parcel Number: 061-490-020 Sub Type: A2 Exempt Owner Name: CAMERON JOHN ROBERT, Phone: (530) 589-1647 Description: AG EXEMPT 30X24 TO HOUSE TRACTORS By signing below, I the project owner/owners' 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 buildouts 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 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 this project that disturbes one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. Signed: Title: f FILE Date: 06/08/2007 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.nebdds OWNER -BUILDER INFORMATION 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 permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° 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. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° 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 obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license 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's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. 1. I PERSONALLY PL����O PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. AMR NO) 2. I (HAVE/HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME_ ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS CITY PHONE CONTRACTORS 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 Description: AG EXEMPT 30X24 TO HOUSE TRACTORS Reference Number: B07-1249 Applicant Name: CAMERON JOHN dRORT, Owner's Name: CAMERO RT, AP # : 061-490-020 //11 Signature of Property Owner: d Date: z6 —B U 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: 104 FOREMAN CREEK RD Owner: Permit No: B07-0600 APN: 061-490-020 CAMERON, JOHN ROBERT & J Issued Date: 05/04/2007 By KEJ Permit type: MISCELLANEOUS 14 FOREMAN CREEK ROAD Subtype: Ag Exempt BERRY CREEK, CA 95916 Expiration Date: 05/03/2008 Description: AG BLDG 30X40 (SKIP LOADER, B. (530) 589-1647 Occupancy: U-3 Zoning: U SH Contractor Applicant: Square Footage: CAMERON, JOHN ROBERT & JANET CAMERON, JOHN ROBERT Building Garage Remdl/Addn 14 FOREMAN CREEK ROAD 14 FOREMAN CREEK ROAD BERRY CREEK, CA 95916 BERRY CREEK, CA 95916 Other Porch/Patio Total (530)589-1647 (530)589-1647 FEE INFORMATION DBEH Building Review Fee $75.70 DBOMSCF Ag Exemption Permit $109.98 Total Charged: $185.68 Fees Paid: $185.68 Balance Due: $0.00 Receipt No: B2333 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 CAMERON, JOHN ROBERT &. OL:CRW_00401794 / / 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 Section 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 in full force and effect, 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 X 05/04/2007 the applicant to a civil penalty of not more than five hundred dollars [$500); Please check one of the following: Contractor's Signature Date r" 1, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE Wy COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR WORKERS' COMPENSATION DECLARATION 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 I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑1 HAVE AND 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.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: 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' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier: Policy Number. Exp. Date: (This section nee not be completed if the permit is for one hundred dollars ($100) or less.) ❑ I AM EXEMPT un Section B. & P.C. for this reason: I CERTIFY THAT IN TH PERFORMANCE F THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall no y any perso an manner so as to become subject to the Workers' Compensation I s alifomia, agree hat if I should become subject to the workers' 'ions �( 05/04/2007 compensatio pr of Se n 3700 o the Labor de, I shall forthwith comply with those Ow er Signature Date pr ' ions f/ X 05/04/2007 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 State laws relating to building Signature Date WARNIN .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 County, its officers, agents and employees from any and all claims and liability for personal ANDS. LL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, 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 use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. Cogo enter th ve mentioned property for inspection urposas. I hereby certify that I am the o r a uthorized to a property o e behalf. CONSTRUCTION LENDING AGENCY Ifo, nq1 5/04/2007 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for I Name of Pe ee G Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner ❑ Contractor OR; E]Agent for Owner ❑Agent for Contractor FILE COPY Lender's Address City State Zip 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 AGRICULTURAL BUILDING EXEMPTION STATEMENT 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. Buildings used for purposes other than described above or that are located in a flood hazard zone are not eligible for an agricultural exemption. Authorization of an agricultural exemption permit by the Department of Development Services does not preclude any requirements and/or review by the Butte County Public Works Department, Butte County Fire Department, Butte County Environmental Healtli, or any state and federal agencies. Initials dc—o AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. InitialsA 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 manufactured home, and 23 feet from a commercial/industrial buildings Initis c -t AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum 23 feet from a residence and a manufactured home, and 40 feet from a commercial/industrial buildings Site Address: 104 FOREMAN CREEK RD Permit No: B07-0600 APN: 061-490-020 Square Footage: 0 Permit Type: MISCELLANEOUS Occupancy: U-3 Permit Subtype: Ag Exempt Zoning: U SH Description: AG BLDG 30X40 (SKIP LOADER, BACKHC Required Setbacks: Applicant: CAMERON, JOHN ROBERT & JANET Front: Side: Rear: 14 FOREMAN CREEK ROAD Type of Construction: BERRY CREEKCA95916 (530) 589-1647 Type of Siding: Metal Owner: CAMERON, JOHN ROBERT & JANET Est. Const. Cost: $ 3,500.00 14 FOREMAN CREEK ROAD Roof Covering: Metal BERRY CREEK, CA 95916 (530) 589-1647 Floor Type: Concrete I declare under penalty of perjury that the building will be used as stated above, and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division an tain the ne ry permits, inspections and approvals to comply with the requirements in pffiwt at ttime d pr' to/occu Signature of owner: f Date: 03/26/2007 FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" APPLICANT INFORMATION OWNER INFORMATION Last Name City First Mailing Address City Ci Statgrp_ C� Zi Phone _/4g 7 lax E-mail E-mail APPLICANT INFORMATION CONTRACTOR Name City Address Zip City Fax State Zip Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENG/NEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail PROJECT LOCATION AP# I U U PV4y Ar_Ss l ey City (c PERMIT NO. r " I' 6( BIN # I 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. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK. ��x d i < < � o Sq FT- Living Garage Open Cov ❑ Structure Built without Permits % ❑ Proposed Change of Occupancy (Note previous use): U For office use only: Zoning Flood Zone SRA I Yes I No Occ. I Type Const. Butte County Department of Public Works J. MICHAEL CRUMP, DIRECTOR LAND DEVELOPMENT DIVISION Storm Water Managment Program 7 County Center Drive Oroville, CA 75965 (530) 538-7266 Telephone (530)538-7171 Fax www.buttecounty.net/dds CJC 0 0 0 O O National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment [LESS THAN 1 ACRE 1 Reference Number: B07-0600 Date: 03/26/2007 Location: 104 FOREMAN CREEK RD By: KEJ Parcel Number: 061-490-020 Sub Type: A2 Exempt Owner Name: CAMERON, JOHN ROBERT & JANET Phone: (530) 589-1647 Description: AG BLDG 30X40 (SKIP LOADER, BACKHOE, TRACTOR) By signing below, I the project owner/owners' 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 buildouts 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 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 this project that disturbes one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. 0— e, 4z_ Em -, wo- -41" FILE Date: 03/26/2007 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: 0 Make sure your application is complete. 0 Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every pe ued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or complete in one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite num f times, provided construction progress has been documented by the Building Division during each year during scheduled inspectsNo changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after a 'ration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon co letion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to oc py this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at http://municipalcodes.lexisnexis.com/codesibutteco/ Reference Number: B07-0600 Location: 104 FOREMAN CREEK RD Parcel Number: 061-490-020 Owner Name: CAMERON, JOHN ROBERT & JANET Description: AG BLDG 30X40 (SKIP LOADER, BAC Signature of Property Owner: FILE Date: 03/26/2007 Phone: (530) 589-1647 Date: 03/26/2007 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION 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 permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° 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. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° 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 obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license 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's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILLL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY PL TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEME YES OR NO) L"T I VE VE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: AG BLDG 30X40 (SKIP LOADER, BACKHOE, TRACTOR) Reference Number: B07-0600 Applicant Name: CAMERON, JOHN ROBERT & JAN Owner's Name: CAMERON, J IBX,4T ANET AP # : 061-490-020 Signature of Property Owner: Date: "I COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PER -MIT -NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 061-490-020 ZONING BUILDING PERMIT OWNER CE',iFON ROBERT TELEPHONE 5�°-1647 SO. FT. OCC. BUILDING VALUATION F so. LOU- 2040 . OWNERS MAILING ADDRESS 14 FORFYJJAii CP.EEK. RD. BERRY CREEK CP, 95916 CONTRACTOR'S NAME owner TELEPHONE —cont: 1600 CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 3040 ARCHITECT OR ENGINEER LICENSE NO. Fllin Fee $ 20.00 Permit Fee $ 63.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 14 FOREMANN CREEK RD. BETW CREEK Ener Pian Checking Fee Energy g $ $ PERMIT FEE $ 83.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ',O Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Ulil'Ities ❑ Installation ❑ Other Describe Work: RE -ROOF & 'REPLACING CEDAR SIDING ON BACK- SIDE OF HOUSE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I s I G w @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 600VOR UE Main Service zo.A OR LESS 23.00 LICENSED CONTRACTOR'S 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 the Business and Professions Code, and my license is in full force and effect. License Class LIC. NO. OWNER -BUILDER DECLARATION hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages astheir sole compensation, will do the work, and the structure is not intended or offered for sale. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the worker ' pensatio isions of section 3700 of the Labor Code, I shall at ply wtho pr Ions. X Date (�- ` C.� ? Signatyr of Applicant - ❑ Owner ❑ Contractor ❑ Agent A HA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service TO tOooA 46.00so WEE200A NEW CONST. DWELLING OCCUP. SO OR ADONS. ( & ACC. BLDS. 3.5¢FT. NON-RESIIDD. OUTLET 97,50 POWER APPARATUS d SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 @ 1.00 BAL @ .50 LNSI Ex. Occup. ouT>Frs AD.oEw 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE ;.A; D. FEES IMP FLOOD CDF PARCEL PD HD ISS This permit is hereby issued under the of e Butte County Code and/or Resolutions indi&tedab e o whic fees have By PERMIT EXPIRES ON applicable provisions to do work been paid. /„ (�f I Date /() p Te011 Receipt No. 354032 $83.00 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ••:•r 12,96) PAACEL NUUMM V.,,•.EA .w•�Ea i ww _.)•,T CAS i County center Drive • Oroville, California 95965 • Telephone (530) 538-754 —11 APPLICATION AND PERMIT bZ-154`b7 MkW#O BUIIDINGPERMIT . um NE SO -C I BUILDING V ALUATION : TEUP-ONE I :SS ---- i'•OEA i M LJNG AOORESS Fireplace I i--- _ Total Valuatlon 00 L A?C^IECr OA ENG,NEEA I UC E+6E NO s - ; Filing Fee +�:�,'ECT CA ENGwEEAT 4A.L NG AC ESS Permit Fee Plan Checking Fee j S 3...�'.+.0 ACC HESS / - - - L7P I& u7r NO I sUaofva ON1NAUE USEOFSTRUCTURE Sc C Duplex O Mobilehome O Other SPEC:r TYPE OF WORK '••ew C Addition ❑ Remodel0—&'4'1) l tilliities O Installation ❑ <Other ❑ 1.'e Scr,be Work: //}/\ _ c— —&'4 /) L� r - 7 *F FEE PAl® 5 RA SHERIFF AAk6VN, RECEMb Energy Plan Checking Fee PERMIT FEE] S PLUMBING PERMIT Each Trap Solar or heat pump water heater j Water piping j Each gas water healer or vent I Gas piping system 1 - 5 outlets I Budding sewer Mobile Home I S; G; W Fling Fee� —20G, 7.00;— 23.001 1 5.00• 1 5.00' 15.001 15.00. @20.00' PERMIT FEE I s ELEC'iRICAL PERMIT I I Fling Fee 2C C-, Main Service oA u<ss :ooA oA uass ) � I 23.00 Main Service ( X. TO I.M. � j I 66.00' NEW CONS, Ow EU.Poc occuP OR ADONS. ( a ALC aws 1 0.5CF• : ��— UUITiOtITIfT NO ra RES,O ( 6MNCN Cp •T9 ) I @7.50 POwEA APPAMTUS a SNOL[ Otm.ET CIr1 - I I Ex. Occup. ( OVTU7 OR PcrTuaES Ex. Occup.( f°EOArPws. oA avnETT .++Es,o � EA, i I 5.00' Temporary Service i 23.00 htcbile Home Faclities 20.00 Misc. WFrmg 23.00 I I l PERMIT FEE S MECHANICAL PERMIT Fling Fee 1 20 C Heating Cooling t Hood j 6.50: Ventda:ior. I I PERMIT FEE I S Moble Home Installation Fee S Energy Inspection Foe $ occ CONST rrPE TOTAL FEE $ I NA:. 10. PEES i WP I RAoO I COf PAOCEL 00 This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do .Ncr''4 indicated above for which fees have been paid. By Date ReemptNo. PERMIT EXPIRES ON E w4I1rE•0 0.3 -0.0. CANARY -ASSESSOR PINK -INSPECTOR COLOENROO-APPLICANT Y .;1�.--.-•-r„r��•'l:-�. .vs--i - ,�, .:� t"'✓!r'r,�`iy^Yo^r1'+�•��a�,� :,� �e� r e i`/;�.-.-f I Permit.#1745-87 Robert Cammeron 14 Foreman Creek Rd t OFFICE COPY Address GAS Date--- Meter BY ELECTRIC Meter BY COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Califctthia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PA CEL NUMBER ZONING BUILDING PERMIT OWNER �pC TELEPHONE ,SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 4�JREI -UA IJ CA(L CRE(_ tL CONTRACTOR'S NAME TELEPHONE ,,,� L`•t ;. CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 14 ��RE MAN RV Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Oi/IL 1 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFW Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00 ea TYPE OF WORK New ❑ AdditionE],, Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: �-daU' -��/-�� T _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service e00V OR LESS 100 AMP OR LESS 10.00 /a, spol Main service EA. ADD -L. 100 AMP 2.50 Z,5— CONTRACTORS LICENSE LAW I declare under penalty of perjury (check -one): ElNON-RESID 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 El 1, 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) ontract- I, as the owner, am exclusively contracting with licensed contract- ors. ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code_ for this reason NEW CONST. DWELLING OCCUP.6 ( h2sgft OR ADDNS. ACC. BLDGS. , NEW CONSTR. MULTI -OUTLET 2.50 ea BRANCH CIRC ITS POWER APPARATUS &) (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES SAL SOC SAL50c Ex. Occup. OUED P TLETS (RESID.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ S'U Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree,to°'ssve, indemnify and keep harmless the County of Butte against all Iiabilities,�udgmerlts, costs, and. -expenses which may in any way accrue against-'s'aid County in"consegUence of the granting of this permit. �� f3 XY/ �� �. ��> f/'t Date h ^ <� E Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ U Occ"P. CONST*TYPEJ FLAOD PARCEL PD ND ssuE This permit is hereby issued under sions of the Butte County. Code and/or work indicated above for which 4 � / DIWECTO OF/P'UBLIC By ; PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been aid. p WORKS JQ Date `r— 9" — r_ � Ste. Receipt No. �3 �� WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Ca4iforniT-95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT Iir L/ ASSESSOR PA C L NUM ER 00 ZONING BUILDING PERMIT OWNERTELEPHONE G gE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 14 roteISMAQ Cki -- ?6 2 Q(f EC- V—'CONTRACTOR'S NAME �AA�+'� L., It TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS o E CR tZ Permit fee $ PLUMBING PERMIT Filing Fee 10.00 00 _ �Z1� 1 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFr Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is G W 10.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utii�liities ❑ Installation ❑ Other ❑ Describe work: G(, ay. Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10,047 10.00 Main service EA. ADD'L 100 AMP 2.50 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 CONST. DWELLING OCCi , OR ADDNS. ACC. BLDGS. /zQsgft NEW CONSTR. UTLET 2.50 ea NON•R ESID BRRAANNCCHHCIRC ITS POWER APPARATUS D (SINGLE OUTLET CIR, Ex. OCcup(OUTLETS OR FIXTURES 20@50Q DAL03O FIXED APLNS. Ex. Occup. OUTLETS Pi OR2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. lyirin 15.00 ° 9 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. {� I shall not employ any person in any manner so as to become subject LPA to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee. 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyof Butte to enter upon the above- oned property for inspection purposes. also agree s ve, inde ify an keep harmless the County of Butte against all liabil' ' s, ' dgme cos a enses which may in any way accrue agains aid u y ' copse a of th granting of this permit. X' Date,e ` Z_44 7 Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ occuP, CONST,TYPEJ FL000 PARCEL Po HD 159UE This permit is hereby issued under sions of the Butte County. Code and/or work indicated above for which CTO OF ELIC By rQ� PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date_ Receipt No. 14 %? !� WHITE-D.P.W., YELLOW-ASSt33OR, PINK -INSPECTOR, COLD ENROD-APPLICANT t IPERMiT NO. 3011-79P,E � 7 I PERMIT EXPIRES 4 OWNER Robert Cameron owner CONTR. � LOCATION (A.P. 71-08-9 ) Forman Creek Rd. ' mi/of Hwy 162, Berry Creek E P - t Q, r Temp. Power Pole Called PG&E Janw. Elec. Serv.� } Called PG&E Temp. Gas Serv. Called PG&E 9 JOB FINALED (Date) • (Signatu ) f i MaFq Bldg. ' AFtin Stemwa I Slab Carport Footing: Slab Patio Footinq: COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS B ILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING rewall it Piping Pa pets t Floor Rest om Finish 2nV Floor Windoft Siding Roof Shea in Roofing Fdn. Vents Garage Vents Insulation Prov. for physical handicaoued Conformance of ex. Footin LE 3rd loor To out Water Pihvg Sewer Fixtures Water Htr. Heaters Appliances Gas Piping & Test Temp. Gas Sanitation Final / R mesn MECHANICAL Grd. Fifult Prot. Scrallch Heati Servl e B wn Coo ng T mp. Pole nish D is nder round erlor Lath ntilation Permanent oor Closer - is anal Inal MOBILEHOME UTI ITIE------------------- Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOM NSTALLAATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — 'DEPARTMENT OF PUBLIC WORKS 7 County Center Drivew - OlioviIle, California 95965 Telephone: 534-4541„ - ;APPLICATION AND PERMIT BUILDING 7V 1 OwnerT SQ. FT. OCC. BUILDING VALATICIN Mailing Address 6cfzs�,r4e- 45,10` ©I Telephone No. Contractor iie-a— Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Addresses FCwv_,gJ 6 120 Plan Checking Fee&/or Penalty Permit Fee z •. PLUMBING No.1 @rFEE4 PERMIT FILING FEE $3.00Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. �-- (� �— © Zoni g & Plag Water piping 1.50 Each gas water heater or vent 1.50 F s W.� ' S Fire Dept. Fire Zone Use Penni Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel p 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 .00 g. ec Parce pproval Plans Approval Lawn sprinkler system 2.00 W ADDITION ❑ UTILITIES OTHER ❑ Permit Fee $ Z• • — $ 3 -•^• ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 _ O OR LE Main service 10000 AMP ORSLESS 5.00 O U Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD•L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST "ACC. BLDGS.DWELLING CCUP, S) 20sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style le of: NEW CONSTRES'D, -OUTLET NON-RESID BRANCH CIRCUITS) 12.50ea NEW CONSTR. (POWER APPARATUS 8 NON-RESID. SINGLE OUTLET CIR. Ex. Occuo(OUTLETS OR FIXTIIRES 5 L25 Ex. OCCU FIXED APPLNS, OR p• OUTLETS (RESID•) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 , ®D License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. �C 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 Workmen's Compensation Laws of California. MECHANICAL NO -1 @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation FF2.00 Hood Permit Fee $ $ 1 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 Land Development Fee $ TOTAL PERMIT FEE $ -� authorize re senT of the county of Butte to enter upon the above -me o d p,for inspection purposes. Date -i 5 - 2 Signature of Permitee or Agent Receipt No. ?/� White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECT03e0f PUBLIC WORKS BY — Date .5- Z9— 7 wilding permit expires Date J, z 9,- F D • �, Za --� BUTTE COUNTY V) LDING �EpARTME� gl installs it be required for the Me mobilehome.. Z A setback of 5 ft. from the prgperty lines and a setback . of 50ft. from the road centerline shall be clear of structures or equipment except for a 2 ft. eave overhang. �ty Utility connections shall be wyt�% 4 ft. of the mobilehome, eitl directly behind or within thele r rt half of the roadside (left) of the b mobilehome. b is set of plans and specifications MUST' bo (e t on the job at all times and it is unlawful to r ,,nllke any changes or alterations on same without on from the' DepartmPInt of Public �1y4 r w �itten permiss Q�' 1�• , �� /• Works, County of Buttes- . 0 % "* ORE REPORT r Alft,OIRIGIV LOCATWAV _ Q—ORDERNUMBEA-- _ 43—� REG. R.U. JINCIDENT."I. qf START MO.�TE x -EA CO�NTY� UY Ce v FIRE NUMBER I FIRE NAME: REG. R.U. NO. thru SEC. TOWNSHIP>llw RANGE E L R 10 ❑s I.,. -❑W MILES DIRECTION FROM INNATIO FOREST, FIRE DIST., CITY & STREET NO., 5) f ETC. gi-ee& r i'ee /� F'ei�'tt-ri- 3 INCIDENT TYPE BIRO ❑FALSE ALARM ❑ TOP GO TO 10 4A RESPONSIBILITY (A -T ORIGIN)4 46 DIRECT PROT. RESP.('D.P.R•) STATUTORY Ref. ✓ STATE ZONE RESPONSIBILITY 10' ❑ WILDLAND BURNED OR THREATENED 2 SCHEDULE A D.P.R. ❑ STATE 33 UNPROTECTED �❑ DISTRICT 40❑ OTHER AGENCY D.P.R. Fl. CITY LOCAL ZONE ❑COUNTY OS ❑ SCHEDULE A D.P.R. ❑ U.S.F.S. ` 60❑ OTHER AGENCY D.P.R. (Unincorp) ❑ B.L.M. FEDERAL ZONE ❑ B.IA. 07❑ FEDERAL(except Military) D.P.R. ❑ N-P.S. 08 ❑ SCHEDULE A D.P.R. ❑OTHER FEDERAL ® ❑ MISCJOTHERVZONE') ❑ OTHER Av- 5 CAUSE (STARTS IN 0o0/OROONLY) ❑ Did not start in1 2 5 or, ❑ SMOKING ❑ EQUIPMENT ❑ LIGHTNING F1 DEBRIS ❑ PLAY W/FIRE ❑ CAMPFIRE ❑ ARSON )OTHER/MISC. F'10LA'ND USE(^STARTS IN 0<205 OROONLY) ❑ Did not start in<t 2 5 or 80 ❑ FOREST INDUSTRY DOMESTIC . v ❑RECREATION ❑ DUMP ❑ ROAD UTILITY, RAILROAD n UTILITY. ELECTRIC DDAMA( 5 oRQQ oN GE VU ❑ NO DAMAGE IN , Number of 1O2 5 OR8 Veh/Dwlg TIMBER &/OR YOUNG GROWTH WILDLAND VEGETATION (Other than T& YG) AGRICULTURAL PROD (Other than T&YG) DWELLINGS &/OR CONTENTS OTHER STRUCTURES &/OR CONTENTS VEHICLES & CONTENTS OTHER TOTAL ❑OTHER INDUSTRY- COMRCL. ❑WILDLAND []NON-WILDLAND ❑OTHER IN ❑ A .25 ACRE OR LESS ❑ B 2" ACRES ❑ C 10-99 ACRES ❑ D 100-299 ACRES ❑ E 300-999 ACRES ❑ F 1000-4999 ACRES ❑G 5000 ACRES OR MORE 00111IN91 Ll o., VEG. TYPE ACRES BURNED 1 5) TIMBER B.L.M- WOOD LAND B.I.A. BRUSH OTHER FED. GRASS 1 TOTAL AGRIC. PROD. CDF TOTAL ` 8D STATUT. RESPON. OF 10 ACRES BURNED STATE U.S.F.S. B.L.M- B.I.A. W.P.R. S. (Ex -BOR) ' OTHER FED. OTHER 1 TOTAL ❑ OTHER, GO TO 10 DISTANCE (Origin to head) ACRES FEET WEATHER (ESTIMATE AT SCENE) WIND I DIRECTION FROM TEMPERATURE M.P.H. I I o F 10 OVER PLEASE CDF 7540-130-0118 A • 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 ,,�?C®RRECTI®�9 NORTICE V BUILDING OR PROPERTY ADDRESS 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_ Z I / A COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number y for the following location: =� Owner Owner's Address Mobilehome Mfg. Model i- Year' 7 Insignia No. Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works Date `- By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. • f ti PERMIT NO. 3221-84P,E(MH) . PERMIT EXPIRES OWNER ROBERT CAMERON CONTR. owner ASSESSOR PARCEL 71-41-14 LOCATION ESS Forman Creek Rd, mi N Hwy 162 r Berry Creek Y 3 i i l� fff OFFICE COPY Address Temp. P GAS Meter By D�ZJ i Cal ELECTRIC �,D'✓tel//•y(�( Meter By v Dat�C I Temp. E E Called PG&E Temp. Gas Service Called PG&E JOB FINALED (Date) Signature J = ,pl� O = Not OK = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS Date MOBIL OME UTILITIES (Plans) OK except N's 1.,5orving Requirements—Setbacks—Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except ✓i's 1, Zoning Requirements—Setbacks—.Easements Soils; Sppoltl MH Support—Sketch 3. Sewer ocation—Test—Fall-C_/0—Concrete 2, Footings; Size—Depth—Spacing—Connectors 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails 4. IN r; Location—Test asement Needed (Sketch) 4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5 Electr ci•t ocation—Clearances—Grnd.—/ ` / A —Concrete 5, Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6.las; L orrTest—Wrap:/ /"L"ft./ /"Nat.orW. L"ft./ PG 6, Carports; Windows—Doors 7, VpKy Clearance 7, Elec. Card -BI Date , -� and -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date MOBILA46ME INSTALLATION (Plans) OK except N's Date POOLS (Plans) OK except H's 1, g Requirements—Setbacks—Easements 1, Setbacks—Easements F ings; Size—Spacing—Marriage Line 2, Soils; Compaction—Structure Stability 31_Gw, MH Test—Demand—Valve—Connector Electricity; MH Test—Crossovers—Breakers—Clearances 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4, Elec.; Receptacles and Lighting; Distances—GFI 5 rain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6, a r; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed Wper and Sewer Connected—C/0 to Grade—HD Approval 7, Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater s a Electricity Tagged 8, Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9. its; Insp.—Sketch 10, Cert. of Occupancy 9, Health Department Approval Card -BI 10. Plumb; Cir. Test—Water Supply Test Date Card -BI Date Card B -I to %rd -Bl Date Card B -I Date and -BI Date Card -BI Date Card -BI Date = OK = Not OK = Not Applicable RESIDENTIAL (Single and Duplex) = Not Ready , Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. O.W.V.: Fall -Fittings -Test -2 way C/0 -Sewer Test 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 55. Shear Walls; Nailing -Bolts 11. 12. Electric; Underground Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except p's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except p's 14. Water Ht.; Vent -Access -Combustion Air 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15, Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. 18. Shower Pan; Test, First Floor -Tub Access Test Tub & Shower, 2nd Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth Card -BI Date Card -BI Date 64. Elec. Outlets at Wood Panel; Int. & Ext. 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Date Card -BI Date ELECTRICAL Permit OK except q's 66. Elec. Outlets & Receptacles at Kit. Counter 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location 22. Size Boxes ll No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Foam -Looked Insulationin Attic ❑Yes 733.. ) Guard Rails &Deck Construction -Post Caps 25. 26. 2 Appliance Circuits in Kitchen & Conductor Size Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes El No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters Oyes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. 30. Equip. Clearances; Panels-Motors-Mech. Equip. Clothes Closet Light -Shower Light 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 78. 79. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opn s. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. 82. Ventilation throughout House Glass Protection Card B -I Date Card -BI Date Date MECHANICAL (Permit) OK except N's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. Vent Fan; Exhaust above Insulation 86. Energy Compliance Certificate -Other Certificates 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except p's Comments at Final: 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors 43. 44. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. _ Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: An entry must be made each time youvisit jobsite) COUNTY OF BUTTE - DERARTMENT OF PUBLIC WORKS ^' 7 Covnty Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT O. ASSESSO RCEL NUMBER zO'NG 1 BUILDING PERMIT ZTELEDw R PHONE SQ. FT. OCC. BUILDING VALUATION NER'S M LING ADDR SS [ V`! f/� a o V ONTRACTO N ME — �►F, C—oo�l�?c SNC TELEPHONE O T �p ACTOR' MAILING AD ESS a S, (v (} ►t s¢_ C(� l6Gj W Fireplace CONSTRUCTION L DER LWRDER'S NKN UOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGIN ER LICENSE NO. Plan Checking Fee ,$ �D Penalty $ ARCHITECT OR ENGIN R•S MAILING ADDRESS Permit fee $ BUILDING ADD? SIQ � PLUMBING PERMIT Filing Fee 10.00 �— Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUB D VISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USEOF S CTURE SF ❑ Duplex❑ Mobilehome Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORKPermit New ❑ Addition ❑ Remodel [:]Utilities ❑ Installation Other ❑ Describe work:��ih7 .y — Ae- of iAJJl knl•r� Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 °R LESS 100 OROR LESS 10.00 Main service EA. ADD•L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.&` OR ADDNS. ACC. BLDGS. / 2/20sgft CONTRACTORS LICENSE LAW I declare 1pl penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Profess' s Cole and my license is in full rce nd 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 NON.RESID R BRANCH CIRCTITS 2.50 ea NEW CONSTR POWER APPARATUS &) NON -RES ID. SINGLE OUTLET CIR. zo@soa Ex. Occup(OUTLETS OR FIXTURES eAL�3oe FIXED APP LNS. OR EX. QCCUp. FIXED OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ave placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating tg building construction, and hereby authorize representatives of the Countyot B to to enter upon the above-mentioned property for inspection purposes. I al agree to save, indemnify and keep harmless the County of Butte against all li ilities, judgments costs, a expenses which may in any way accrue against i Coun in onsequenc :of the granting of this`per lit. X _ _ _ v I �- Sign ure of pplicant — Owner Contractor Agent An 0S pe mit is required for excavations over 5'0" deep and demolition or construct- ion of st ct res over 3 stories iin��height. Mobile Home Installation Fee $ &0 TOTAL PERMIT FEE $ 0, OCCUP. GROUP TYPE OF CONST. PARCEL PD HD ssuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREC OF PUBLIC BY PE T EXPIRES Date the applicable to do resolutions to do fees have been paid. WORKS Date,/ X. �� Re o._ZlaO 15 "11 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT OWNER COUNTY OF BUTTE - DEPARTMENT OF4PUBL;-1C'WOR,KS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 J PERMIT APPLICATIbN DATA SHEET f Permit No. L y tri C�i i"� Q—L uA) k A. P. No. // _ ';//- Proposed Building Use. Permit Fee Based Upon Building 'Inspector 1 \---i- ,1 , Complete Contract Price Other (Explain) DPW Valuation Date i At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted.. . . . . . . . . 2. Plot plans in duplicate/triplicate. . . . ... . . . . 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 In (no., name style, classif.) 14. Owner -Builder Verification (Given to owner[], Mail to owner El 15. Improvements may be required. . . . . . . . . . . . 16. Mobi lehome Installation Data. . . . . . . . . •. . 17. Pre -Inspection for Pre-Inspec. request to Required. Building Inspector 18. Other t When you issue the permit pro as llows: _TelephoneX5'7 /:and hold 'for-pi.cl Other Appl ican (Date) t f -Mail to owner. Mail�to contractor. p at// ff+ ice.=) Deliver w/inspector. Date / O� Copy of plans sent Health Dept., ' Fire­Dept.;1, bth1er Date During the plan checking process, the -following datas—must be submitted prior to permit issuance. (For required items'. not checked above at time -of application, circle item.) 1. Index permit fiabove Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail By Date Plans checked by Date Plans approved by Date Other Copy—DP.W Other s Ot .'' ,.1s... - • .t• v ,- ` +�..a�»iii ,• BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS } 7 County Center Drive, Oroville, CA,. PHONE: 534-4541 - MOBILEHOME INSTALLATION SHEET�;� '-;R^-.y • t�..i .:�.ywr--.r. q... ...a.:...•...`ry Yi.'^<rezw.a+ . ! R 1. Owner's name: +- v n . f C 2. Installer's name:; �-:o LA 9 ''`Is the 'site currently under permit? Yet No .R (If yes, furnish permit number ) OR {+ -I -the-sfte-an .existing site? Yes h. (If'44 `furnish two (2) plot plans.) 4. Will the iriobilehome be located at least 5 ft. away fr septic tank and leach fields and 'r clear of all setbacks.'and easements? Yes / No (If no, clarify 5. •What is the mobilehome electrical rating? ----------------------- "-420 Amps 6. What is the mobilehome site service rating? --------------------- J Amps 7.. What is the mobilehome site circuit breaker rating? ------------- Amps 8. Is there any other electric load to be'served by the mobilehome siteservice? ---- ------- ------------------- ----------------------- Yes No (If yes, identify the load and size: (Load) (Amps) '9. What is the mobilehome site gas pipe size? ti -------- -------, 3J� (in.) 7 7 -10..`-What-is the .type of gas _service? ------ Natural - LPG -vll. -Vhat is the gas' pipe length from meter .or'taak to the mobilehome?, �, (ft.) 12. What is the mobilehome gas demand? -----=------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) 11q BUTTE COUNTY BUILDING DEPARTMENT' APPROVED y 4. Will the iriobilehome be located at least 5 ft. away fr septic tank and leach fields and 'r clear of all setbacks.'and easements? Yes / No (If no, clarify 5. •What is the mobilehome electrical rating? ----------------------- "-420 Amps 6. What is the mobilehome site service rating? --------------------- J Amps 7.. What is the mobilehome site circuit breaker rating? ------------- Amps 8. Is there any other electric load to be'served by the mobilehome siteservice? ---- ------- ------------------- ----------------------- Yes No (If yes, identify the load and size: (Load) (Amps) '9. What is the mobilehome site gas pipe size? ti -------- -------, 3J� (in.) 7 7 -10..`-What-is the .type of gas _service? ------ Natural - LPG -vll. -Vhat is the gas' pipe length from meter .or'taak to the mobilehome?, �, (ft.) 12. What is the mobilehome gas demand? -----=------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) 11q BUTTE COUNTY BUILDING DEPARTMENT' APPROVED to .2{j �„�� If' other than single wide Mobilehome Mfr. U .11-4 4 furnish Setup Model No. t.%�-�` Year i Fidth (ft.) Box Length (ft.) Tagalong or Expando Size_ft. x ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from front of mobilehome unless otherwise specified, i ootin s (check one) Ingle 1�. Wood either pressure treated or ` foundation grade.' 13&xM 0 2. Other (sp�ify) in. (in:) .nter support Center support u rt (check one) locations* p footing sizes ( - o M (in.) (ft.)(in.) L (in.) (in.) I � RZ:E (ft.)(in.) p (in.) (in.) (in.) :- (in.) (in.) .- --' _U __ - - . j . 1 . I __1 . a4 3,v (ft.) (in.) (in.) (in.) a � If center piers are other than drawn above, draw in -locations, spacing, and dimensions. 1: Concrete block. •2. Other (specify) Tagalong or Expandd'# show support details. ),-2, x3 0 1 -- Typical Support (in.) (in.) Footing Size _Max. - Pier Spacing • S b -- Max. Overhang (f t. . 'BUTTE COUNTY BUILDING DEPARTMENT APPROVED I •• �'�'I i ��•. .tai".���, �';. �•�ti VA 01 �� ® l�II�II�h�IDIYI. 00*.---- ---- - -- -- O® 6x o �Q�3 36x30 'mall,,M O }�^t4' ' - V, 1A rLpx ------- -- I r — -- — -- - --- -- — Herrg- I o +l ....� T ( • 1. ' �. .�'� . ! KA 2ND G• 1,T 1 1 11r"'r ( la e Y l l (OI' all ,SUPPORT PIERS 4000# 24"x24" m 10 000# 60"x24" (3) 60006 36"x24 FOR FIELD SUPPORT DETAILS. SEE DWG'S. S-1 and S-3 OF INSTALLATION MANUAL: OLOIN WE >� SO. FT. NOMEll IJW 1. WAAENAti C CARPET LAYOUT AND z SANTA ANA. Cs, t ►►0141,11141935. BEAM FIELD SUPPORT m ORAWN Mr /j. ORwO NO M .. >70 LiT I Zc VA 01 �� ® l�II�II�h�IDIYI. 00*.---- ---- - -- -- O® 6x o �Q�3 36x30 'mall,,M O }�^t4' ' - V, 1A rLpx ------- -- I r — -- — -- - --- -- — Herrg- I o +l ....� T ( • 1. ' �. .�'� . ! KA 2ND G• 1,T 1 1 11r"'r ( la e Y l l (OI' all ,SUPPORT PIERS 4000# 24"x24" m 10 000# 60"x24" (3) 60006 36"x24 FOR FIELD SUPPORT DETAILS. SEE DWG'S. S-1 and S-3 OF INSTALLATION MANUAL: OLOIN WE SO. FT. NOMEll IJW 1. WAAENAti DRAWING TITLE. CARPET LAYOUT AND wool NO RIDGE SANTA ANA. Cs, t ►►0141,11141935. BEAM FIELD SUPPORT PIERS U5. ORAWN Mr 01 �� ® l�II�II�h�IDIYI. 00*.---- ---- - -- -- O® 6x o �Q�3 36x30 'mall,,M O }�^t4' ' - V, 1A rLpx ------- -- I r — -- — -- - --- -- — Herrg- I o +l ....� T ( • 1. ' �. .�'� . ! KA 2ND G• 1,T 1 1 11r"'r ( la e Y l l (OI' all ,SUPPORT PIERS 4000# 24"x24" m 10 000# 60"x24" (3) 60006 36"x24 FOR FIELD SUPPORT DETAILS. SEE DWG'S. S-1 and S-3 OF INSTALLATION MANUAL: OLOIN WE SO. FT. NOMEll IJW 1. WAAENAti DRAWING TITLE. CARPET LAYOUT AND wool NO RIDGE SANTA ANA. Cs, t ►►0141,11141935. BEAM FIELD SUPPORT PIERS U5. ORAWN Mr /j. ORwO NO "Ivisso /T '. w4 I • Z!o 8$' ,_ k .� -� ..:....u.^;�3�ry;-.•.,,., ' ' ^..ate. � •I•T' MR���� LiT I JCOUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 35965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. a - ASMESSOR PARCEL NNUM EI w I( ZONING A- . sit BUILDING PERMIT OWNER TELEPHON SQ. FT. OCC. BUILDING VAL ION OWNER'S MAILING ADDRESS .i � 111/17 ASK. Ode) CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ "1.10:00— LENDER'S MAILING ADDRESS &`(j/iJ Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 15' Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILD I f ADDRESS ` ,�� PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 � r Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex[]MobilehomeN, Other SPECIFY Building sewer 5.00 Mobile Home10.00e am nu TYPE OF WORK New F-1 Add ition❑ Remodel❑ Utilities,X Installation❑ Other[:] Describe work: A oZ t�%�QE04�� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 11001FAMOR LESS 100 AMP UPS 10.00 Q Main service EA. ADD'L 100 AMP 2.50 NEW CONST.( OCCUP.& OR ADDNS. ( ACC. BLDGS. I 2/4sgft 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 19 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 CTRCTITS 2.50 ea NEw COIJSTR. ( POWER APPARATUS &) NON -RESID. SINGLE OUTLET CIR. 20050e Ex. Occup(o OR FIXTURES eAL®900 FIXED AXED A PP LNSOR Ex. Occup. OUTLETS (RESI,D.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 /S,00 Misc. Wiring 15.00 Permit Fee $ U Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. �i I shall not employ any person in any manner so as to become subject, fi to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ r , 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 liabili ' judgme c sts, and expenses which may in any way accrue gainst o n conpque o the granting of this permit. X / Date Signature of Applicant — Owner UK Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. PAR L P HD IssO This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT R OF PUBLIC BY�'HITE-D.P.W.. P IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS 0 4.3 [Receipt No.��T� YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT In v COUNTY OF BUTTE - DEPARTMENTtd.F�PUe3LIC WORKS BUILDING DIVISION _ 7 COUNTY CENTER DRIVE -•OROVILLE, CALIFORNIA, 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET ' Permit No.— OWNER ��� C?�'J A. P. No. 21 Proposed Building Use L/ 11 i Permit Fee Based Upon: Complete Contract Price DPW Valuation Other (Explain) Building Inspector l.�'( Date /o���� 7` At time of 'permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2. Plot plans in duplicate/triplicate. . . . . . . . . . . 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 owner❑, Mail to owner ❑ ) 15. Improvements may be required. •. . . . . . . . . .. 16. Mobilehome Installation Data. . . . . . . . •. Pre-Inspec. request to 1177: Pre -Inspection for Required. Building Inspector (Date) // Ot her A --J r I When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applicant _a-��i. Date��' 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 By Plans checked by. Plans approved by Other Copy—DPW Telephone .= Date Date ii Other Date To: Building Department From: Environmental Health Pubjec Sanitation Clearance �, Owmer Location Ap# Plan Approved for:. Sewa ;e disposal crater supply Hold final for: •rater. supply Final, clearance O.K,. for: water .supply Clearance for bedroom mobile home. Other DOTE. { Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT 64--37508 FOR RESIDEI?fIAL DEVELOPMENT Section 26-5.1 of the Butte County Code requires this acknowledgement OFFICIAL RECORDS be recorded prior to issuance of a building permit. Bl, -,TE COUNTY -CALF.- The property described herein is adjacent to land or included PARTY SHOWN I nn t within an area zoned for agricultural purposes, and residents of thiOCT 6 I go 0 property may be subject to inconveniences or discomfort arising fro LEANgR M.Br..,Ki_k the use of agricultural chemicals, including, but not limited to herftJW$#e&FC(0dAKCQd, and fertilizers; and from the pursuit of agricultural operations including, but not REFmited 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 disconfotm from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: �` � �)� C -%O �/ .. C EAs � X 00A/ oq� ��� Sa u A', u��.e�f',� oil %lam E4s7� I l / �Gu tr.t'h •� ?� .CJs.e��> �i9,c.¢•E �G�9 r i� /i7 �, �, v�,,,o s �`.yiL4►� y o:r�.o.v`S� A G'o��c2•0�ioc, �cco2d �E r m 6c ,e 3� /,9/0 ,\i.� ,Q >/ / �" 23 Z fi�,��o �SrC' ��o T s-,�.c� '�6 F �ia�r► Ihf Sn:c'y� 9 e � e- o �� 71 .4 r/ fro < /io AO o)(7 Date: PROPERTY OWNERS: SL'cVe of California ) On this the 8th day of October 19 84 , before SS. me, the undersigned Notary Public, personally appeared County of gilt-tP ) John RobertCameron and Jamet Cameron L/ Personally known to me. Lw Proved to me on the basis of satisfactory evidence. to be the person(s) whose names) are subscribed to SHARON .,1 MCGFI _r the within instrument and acknowledged that they NOTARY PUBLIC - CALIFCR'RA executed the same for the purposes therein contained. sura couivw l IN WITNESS WHEREOF, I hereunto set my hand and official seal. My comm. expires APR 5, ; a 94, �.. Notary Pub c Present A.P. No. 71 -17Z -6-6Z 12 Assessor's Pamel • - u scale: i LocationAddress/ Phone No. Site T6 i0 - Contact Name 0d*W2%2= Zoning: General Plan Desig: Size, Acres 4.00" PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: r SITE PLAN Assessor's Parcel Number 12* -Scale: 1 •ja & r_'r _ rii ter. - • W;I FOR OFFICE USE ONLY PROVIDE FOR ALL Zoning: ADJACENT PARCELS SIZE (AC): General Plan Desig: ZONING: Size, Acres GEN PLAN: F a.W USES: SITE PLAN r Assessors Parcel Number: ® ® [z] -- ®©— d Fal © Scale: 1" = 0 0� TFo Owner Name O O Address/ Phone No. /'le. Site Location C6r 6c -at Contact Name OG"W MM FOR OFFICE USE ONLY PROVIDE FOR ALL Zoning: ADJACENT PARCELS SIZE (AC): General Plan Desig: ZONING: Size, Acres GEN PLAN: 4.W USES: