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062-510-056
6 51-56 CHARLOTTE KEEFER Bald Rock Rd, 400'N To Hill Rd, LCtu PErmit#3694-87P,E(ele-for ell &r lot development) ,'r 62-51-5 V Permit#1015-89B,E(new gara e) ,06? -510:-056- r „ 06-0111' t VANDERVORT.:y 1' y 200 BALD ROCK RD,' BERRY CREEK Cont OWNER °CONV=GARTO"SFDWELLING- .062-510-056-, r06-09912 RUSSELL' 200 BALD -ROCK RD; BERRY CREEK,, Cont: OWNER `' TRANSFER 06- 11.1 �V V v . /✓ I i� 11 062-510-056 RUSSELL1 r 06-0992 , E- ,, N OT tz S 200 BALD ROCK RD, BERRY CREEK '� ` Cont: OWNER TRANSFER 06-0111 r r !A L t ' i I APN: Permit No. Owner. Site Address: Contractor. /I • / Type of Permit @ 0 / r4 O(';� e 0 r r f t r 1 ' a t } PHFrirrn RY i t t� t r Y .f t SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE \ ♦ L i. DATE JOB FINALED: i i • SIGNATURE: , = OK o = Not OK s WANUFACTURED HOMES GATE PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; FalUC/O-Convete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-DIrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap . Nat ❑ 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 /O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DA Pool Drawing MISCELLANEOUS. DECKS•C0VERS`CARP0RTS`GARAGES 1 Zoning -Setbacks -Easements _ 2 Ftgs; Soils Sz-OpthSpacing-CnnctrsSteel 3 Decks. Girders/Joists-Ocking-Brcing Stairs-Duard/Handrails _ 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors _ 7 Electric _ 8 Frmg; Sills=Anchrs-Studs-Rftrs-Trusses _ 9 Siding; Nailing-VeneerStucco-Lath _ 10 Roof-, Shthg-Roofing —I I Ext; Steps -Doors -landings 12 Braced Wall pnls 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; S teel-Cnnctns -Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Enctsrs; Conduit Entries Terminals-Disted 7 Elec Bonding; Metal w/5'-Drcltng Egp-Htr 8 Elec Gmdng; Eqp w/5' Crcltng Eqp-Pool Ightg Bdxes-Endsrs=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 e`er dr �a. r. — = OK v Nnf _ RESIDENTIAL (Single & Dup(e)() DATE JUNDERFLOOR. DATE IPLUMBING i 1 Zoning -Setbacks -Easements -Flood -Slope 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 3 Ftg Garage-, Soils-Steel-Elec Grnd Ftg Dpth. 4 Ftg Porches/Decks; SdilsSteel Ftg Dpth 5 Stemwalls Main; Steel-Slockouts-Wrapped 6 Stemwalls Garage; Steel-Blockouts-Wrapped 61 Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 1.1 Wtr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd 13 Plenums & Ducts; Cirnc-MaterialSupport4rtsultn 14 GirdersSills-Anchr BoltsJoists-Vnts-Ctipples 15 Acc & Vntltn 16 Insulation #y} oma, oa` DATE FRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces-PlatesSound 19 Bearing Walls over Girders & flr 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-Cnndns s 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac TrussShthg 25 Frplc Ties or Type A Flue-Frplc Throat Clmc 26 Attic Acc; Sz & Rmz PFtcfn-Draft Stopans 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 X -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-Fndtri Vnts-UndrfIr 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 s s DATE JELECTRICAL 40 Fxtr & Tmsfrmr Clmc4ns 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 wlMech Fstnrs 45 Gmdng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ga ❑ CU or ❑AL AC Wire Sz ya ❑ CU or ❑ AL 48 Range Circ ga ❑CU a ❑AL 'Oven Circ ga ❑ CU or ❑ AL 1ns41ated Neutral ❑Yes ❑No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrnrs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke -Detector 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr Nail Pctctn 56 Shwr Pan; Test, First flr-Tub Acc. i 57 Test Tub & Shwr, 2nd flr - Tub-Acc S8 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping o'`• o��` o'A mss` m DATE MECHANICAL 61 AC Ducts Insultn & Support 62 Vent Fan, Exhaust abv Insultn 63 Condensate Drain & Ovrflw, Sz & Gude 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic v v 0 FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim, & Subpnl, Breaker Sis & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Clmc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Cimc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door, Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv flr 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 Dscnnd, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-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-C/O to grade -HD Apprv) _ 97 Energy Cmpinc Cert -Other Certs 98 Address Posted -99. Fire Sprinkler 0 Q•�• 0 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 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 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 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 Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder .will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Artic I ot the Business and Professions Code Date:: Im. Own- WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 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. O 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: PERMIT NO. BP060992 Issued Date: 05/01/2006 APN: 062-510-056-000 Site Address: 200 BALD ROCK RD BCK Map Index: Description: TRANSFER OF OWNERSHIP FROM BP #06-0111 Owner: RUSSELL, ALICE V. 338 IRENE AVE ROSEVILLE, CA 95678 (916)773-5658 Applicant: RUSSELL, ALICE V. 338 IRENE AVE ROSEVILLE, CA 95678 (916)773-5658 Contractor: License #: Architect: Engineer: Carrier: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 ❑ 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' i compensation provisions of Section 3700 of the Labor Code, I shall �1.9 forthwith comply with those provisions. �7 _ I Date:0� �` -OG) Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor . code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the. applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to do work indic ted above for which fees have been paid. . Qt' performance of the work for which this permit is issued (Sec 3097 Civ.) . gyDate: Name: G� PERMIT EXPIRES ON: �/ +o9 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 substan any official form or document of Butte County. I hereby authorize repres@ntatiives of Butte County to enter upon the above mentioned property for inspection pur ses. Print Name: {� ✓ _ ( �( [, L Signature: Date: / Z Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit o1 -16-o4 pg i 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. BP060992 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: 05/01/2006 APN: 062-510-056-000 the Business and Professions Code, and my license is in full force and effect. Site Address: 200 BALD ROCK RD BCK License Class_ : License Number: Map Index: Date: Contractor: Description: TRANSFER OF OWNERSHIP FROM BP OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the #06-0111 Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a Owner: RUSSELL, ALICE V. signed statement that he or she is licensed pursuant to the provisions of 338 IRENE AVE the Contractor's State License Law (Chapter 9 commencing with Section ROSEVILLE CA 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 95678 violation of Section 7031.5 by any applicant for a permit subjects the (916)773-5658 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 Code: The Contractors' State License Law does not apply to an Applicant: RUSSELL, ALICE V. owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 338 IRENE AVE provided that such improvements are not intended or offered for ROSEVILLE, CA sale. If however, the building or improvements are sold within one 95678 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 (916)773-5658 sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Artic the Business and Professions Code `' �' Date WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: ❑ 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. 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: 0 S. F. Policy #: Valuation: $0.00 ❑ 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' Q compensation provisions of Section 3700 of the Labor Code, I shall .l1► ✓ 1 69 ) forthwith comply with those provisions. Date: JI -oG Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to do work indic ted above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) By: Date: Name: ��ihVIP,/1l��a2i1_ Address: PERMIT EXPIRES ON: ❑ 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 substan any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection pur ses. Print Name: / Qi V f Signature: Date: /50 Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 March 10, 2006 Butte County Building Department 7 Center Drive Oroville, Ca 95965 RE: 200 Bald Rock Berry Creek, Ca 95916 AN: 062510-056 To Whom It May Concern: We recently sold the above property to Alice Russell. We currently have a Building Permit (#J P � co — 0 ) I ) for a remodel on this property and wish to transfer it to her. Please call with any questions. Thanking you in advance, Char Vandervort (530)589-1300 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. r 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: YES .[1C ] NO [ ]. 2. I HAVE [ ] HAVE NOT [x ] 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 PHONE TYPE OF WORK SIGNED: PROPERTY OWNER DATE: 0 % NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This vPrifir_atien must be com.nleted and returned to our office before we are permitted to'issue the Butte County Department of Development Services ADMINISTRATION BUILDING GIS PLANNING o : / ° o �� o o 7 County Center Drive o Oroville, CA 95965 0-` (530) 538-7541 Telephone c0U t4 (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 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 your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ tii 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 maybe 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 insurance. 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 obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be 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, C-` Scott Rutherford Chief Building Inspector NOTE- This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. ,• RECORDING REQUESTED BY ' Bidwell Title & Escrow Company AND WHEN RECORDED MAIL TO Natte Alice V. Russell StreAdd. 338 Irene Avenue Zip,State Roseville CA 95678 %ip order No. 00226675-001 2006-0014149 Recorded I REC FEE 10.1@ Official Records I TAX 218.90 County of I Butte I CRNM J. SRUBBS I County Clerk -Recorder! 1 CP 09:@M 22-*ar-206 I Page 1 of 2 SPACE ABOVE THIS LINE FOR RECORDER'S USE Parcel No. 062-510-056 GRANT DEED THIS FORM FURNISHED BY BIDWELL TITLE & ESCROW COMPANY ,The Undersigned Grantor(s) Declare(s) Documentary Transfer Tax is $218 . 90 ❑ City/Town of 0 computed on full value of interest or property conveyed, or * Unincorporated Area ❑ full value less value of liens or encumbrances remaining at the time of sale ❑ Monument Fee of $10.00 FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Dennis L. Vandervort and Charlotte H. Vandervort, Husband and Wife as Joint Tenants hereby GRANT(s) to Alice V. Russell, an unmarried woman the following real property in the City of County of Butte, State of California: Dennis L. Vandervort 0 Unincorporated Area SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF Document Date: March 3, 2006 State of California County of Butte } SS. Charlotte H. Vandervort On Har(4-A'1 �j , 'a-&&�e , before me, K.Larson Notary Public, personally appeared Dennis L. Vandervort and Charlotte H. Vandervort Personally known to me (or proved to me on the basis of satisfactory evidence) to be the.person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. n '1 Signature � . LCt • cc.M � Ul o-�cc � � � fit. � i � FOR NOTARY SEAL OR STAMP a 111, 1 n1408830vCalitomia CountyApr. 1, 2007 MAIL TAX STATEMENTS TO: Same as Above STEOGRANTOEEO C.i Order No. 00226675-001 EXHIBIT A D REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: . HAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF -IFORNIA, DESCRIBED AS FOLLOWS: PARCEL A: PARCEL 1, AS SHOWN ON PARCEL MAP BEING A PORTION OF THE SOUTHEAST QUARTER OF THE SOUTHWEST QUARTER OF SECTION 28, TOWNSHIP 21 NORTH, RANGE 5 EAST, M. D. M., WHICH PARCEL MAP WAS FILED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 5,1982, IN BOOK 89 OF PARCEL MAPS, AT PAGE 26. AP NO. 062-510-056 PARCEL B: RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES OVER ROADS, AS SHOWN ON THE PARCEL MAP FILED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA ON AUGUST 5, 1982, IN BOOK 89 OF PARCEL MAPS, AT PAGE 26. Butte County Department of Development Services• ou're agEn IN O T E S 7 County Center Drive, Oroville, CA 95965 .� Y (530) 538-7601 v4ww.buttec0.Ltntynelidds RESIDENTIAL APN: Permit No. ..Owner-. 062-510-056 _ 06-0111 i✓' VANDERVORT Site Address: 200 BALD ROCK RD, BERRY CREEK — Cont: •OWNER � Contractor. CONV-GAR TO SF DWELLING o� c ��ts q'z�-c� �� - — Type of Permit: a w -N --e 2, OFFICE COPY t Address F I iGAS Meter Dat ELECTRIC Meter By Date i ECTAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FINALED: SIGNATURE- = OK .nu MANUFACTURED HOMES MISCELLANEOUS DATE • PERMANENT FOUNDATION Lj SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; FaII/C/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 LP❑ Inch Sz I Ft Lngth 7 Blckrig; 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 0 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE D E C K S'C O V E R S`C A R P O R T S `GARAGE S 1 Zoning -Setbacks -Easements 2 Ftgs; Soils-Sz-Dpth-Spacing-Cnnctrs-Steel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls °'o °mac °�• ds DATE IPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel -Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w15' Crcltng Eqp-Pool Ightg Bones-Enclsrs-pnlboards-Insriltn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr, Fencing-Alanns 13 Bonding, Diving board or Slide `cam a �� Pool Drawing s r = OK = Not OK RESIDENTIAL (Single & Dup4ex) DATE JUNDERFLOOR DATE IPL YMB NG " 1 Zoning -Setbacks -Easements -Flood -Slope S tr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth S ipe; Test &Anchr-Nail Prtctn 3 Ftg Garage; Soils -Steel -Flet Grnd Ftg Dpth. 5 WV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First fir -Tub Acc -D 5 Stemwalls Main; Steel-Blockouts-Wrapped -57T t Tub & Shwr, 2nd flr - Tub-Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped SSGas Pipe; Sz 8- Anchrs 6a 7 59 Fir�Sprinkler; Test Slab, Steel Wrapped / q . (` 6D'S'ard Gas Piping a--� C /L Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test °' tt Wtr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd DATE M E C H A N I C A L 13 Plenums & Ducts; Clrnc-MaterialSupport-Insultn 61 AC cts Insultn & Support 14 Girders-Sills-Anchr BoltsJoists-Vnts-Cripples — 6 ent Fan, Exhaust abv Insultn 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16. Insulation 64 Furnace -Vent Acc-Comb Air Rtrn[Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic O.• °� °�A °`mac DATE IF R A KkN G 17 s Proper Materials & Anchrs DATE F I 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 66 Ex,1kSteps-Door & SideLt Prtctn-Landings 19 Bearing Walls over Girders & fir Nailing Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr 21 eFSt.ps, Furred Ceilings -Stairs -Chasers -Tubs rage; abv-fir-Ducts-Meeh Prtctn s & Beams-Sz &Bearing Bedroom Exiting 23 ngers-Post Caps-Anchrs-Cnnctns ?l� & Bath Fxtrs & Tub Acc-Spa Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg F Arc Fault 25 Frplc Ties or Type A Flue-Frplc Throat Clmc ec Trim & Subpnl, Breaker Szs & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 73 Stairs, GuardlHandrails 27 Bdrm Wndws or Exiting Doorsill Ht & Dimensions 74 Frplc or Stove, Clrnc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 EI Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs QQqKtchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clmc 30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Sta�Width-Hdrm-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door, Swing -Landing -Closure 3ywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 A uct in Garage Damper 33 Siding -Nailing Veneer tr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc MM �h Prtctn; LPG Appince Undr House 3" drain 35 Glazing Area -Glass P rtctn -SkyLts-Plas tic 8T Plmb; Elec & Mech Eqp Listed for Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnls 83 Insultn-Foam-Looked in Attic 38 Ins u ltn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth // Z' �Uf'I 86 CImc Dmge Planters [--]Yes ❑No 87 Stucco Brown 0 -Finish 0` o'er 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-CImc: to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 t Elec Trim, GFI Rcptcl-Undrgrnd DATE JELECTRICAL 40 Fxtr & Tmsfrmr Clmc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors��tltn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 orrections from previous Inspctns 44 Eqp Grnd made up w/Mech Fstnrs •ab 95 Gas Test -Meters Tagged, Gas-Elec 45 Grndng Electrode Bond Gas & Wtr 96 W & Sewer Cnnctd-CIO to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI rgy Cmpinc Cert-0ther Certs 47 Subfeed Wire Sz 9 ❑ CU or DAL Address Posted AC Wire Sz ga D CU or DAL 99 Fire Sprinkler 48 Range Circ ga OCU or DAL Oven Circ ga ❑ CU or ❑ AL —1 ,2 '0 ` Insulated Neutral ❑Yes DNo o�� 0\c o'er 0�s 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp Iothes Closet Lt-Shwr Lt -Spa Lt moke Detector Insulation Certificate BUU,DING OWNER: BUMING LOCATION: 11 2-00 Description of Installation ROOF Material Thickness (inches) BUILDING PERMIT #:$9 ®� Brand Name Thermal Resistance (R -Value) CEILING Brand Name ' Batt or Blanket Type Thermal Resistance(R-Value) Thickness Cinches)/?i 1/evs Brand Name Loose Fill Type Ib Minimum thiclaness �_ inches Connector's minimum installed weight/ft — Value) Martufacturer's installed weight per square foot to acheive Thermal Resistance (R - EXTERIOR -WALL Brand Name iLA Material Z TinermalResistance (R -Value) Thickness Cinches) 4f. ; RAISED FLOOR Material Thickness (inches) SLAB FLOOR Material _ Thickness (inches) Width ('inches) _ Brand Name Thehnal Resistance (R -Value) Brand Name Thermal Resistance (R -Value) FOUNDATION WALL Brand Name Material rrmal Resistance (R -Value) Thickness (inches) qgZ Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Ener Me. tciency Standards for new residential buildings contained in Title 24 of the Califomi dministrativy a � L►cense Number eneral Contractor (Builder) � !� �( Data Signature and Title Sub Contractor (Insulation lnstallet) Signature and Title License Number Data TO T� B��IBUILDZNGr. PRIOR TO FINAL INSPECTION THIS CERTIFICATE MUST•I3E PROVIDED___ - - . I I n- vncmt+n WTTHIN .THE r e ' �. +� �;. C�' � 1 .� � %. 'T• .� _ �� ! f J �� r �fy� i �. ' �� Nk f �� � p •fit �' .. ! ., 1 � , � �`-. � ����'. � , V � .� r , e • } ' �.��_�.�.�� �.... -�.�—. _ �. �...�+w�ti�--'�--.`+!'�Y�«�..�.w�Y} e �wY'y�^I.c. �-.T r�'1r. r.. �.T".��-SYa=+�J«��$�,1r,r�� � ',A/���'M; COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 • CORRECTION NOTICE '. OWNER PERMIT NO A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of j work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. ` Date Inspector hh•-./J"�� i : REV 4/05 Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 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. BP060111 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 02/21/2006 APN: 062-510-056-000 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. Site Address: 200 BALD ROCK RD BCK License Class : License Number: Map Index: Date: Contractor: Description: GAR CONVERSION TO NSF(993), COV(172) 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: VANDERVORT, DENNIS L. &CHARLOTTE H. 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 pursuant to the provisions of 16 LOWER PIE TREE LN the Contractor's State License Law (Chapter 9 commenting with Section BERRY CREEK, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95916 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the (530)589-1300 (530)589-5724 applicant to a civil penalty of not more than five hundred dollars ($500).): char@lakeoroviIlerealty.com OLi I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: VANDERVORT, CHAR & DENNIS owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 16 LOWER PINE TREE LANE sale. If however, the building or improvements are sold within one BERRY CREEK, CA 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 95916 sale.). (530) 589-1300 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: ❑ 1 am Exempt under Article 3 o:fhe Bcine Professions Code i Date: "I 2! Owner: A' WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for License #: workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. O I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier:— arrier:Policy#: Policy #: Total Square Ft: 1165 S.F. O 1 certify that in the performance of the work for which this permit is Valuation: $67,297.00 issued, I shall not employ any person in any manner so as to Census Code: 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 0 forthwith comply with those provisions. t IJ Date: Applicant:/1 I WARNING: Failure to secure workers' compensation coverage is u' 0 v 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 interest, fees. code, and attorney's CONSTRUCTION LENDING AGENCY This permit 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 Resolutions to do work indicated apove Pr which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) r r �� Name: By: i) ``Datte: N: PERMIT EX IRES O 1 "� 1 -f 1'7 Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection � Lll, Print Name: 2 /2 i�/%.e? Signature: , h I& Ale 414 Date: f Owner O Contractor ❑ Agent for Owner O Agent for Contractor 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. BP060111 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 02/21/2006 APN: 062-510-056-000 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. Site Address: 200 BALD ROCK RD BCK License Class : License Number: Map Index: Date: Contractor: Description: GAR CONVERSION TO NSF(993), COV(172) 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: VANDERVORT, DENNIS L. & CHARLOTTE H. 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 pursuant to the provisions of 16 LOWER PIE TREE LN the Contractor's State License Law (Chapter 9 commenting with Section BERRY CREEK, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95916 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the (530)589-1300 (530)589-5724 applicant to a civil penalty of not more than five hundred dollars ($500).): Char@lakeOrOVlllerealty.com 1KI, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: VANDERVORT, CHAR & DENNIS owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 16 LOWER PINE TREE LANE sale. If however, the building or improvements are sold within one BERRY CREEK, CA 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 95916 sale.). (530) 589-1300 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed t pursuant to the Contractors' State License Law.). Contractor: ❑ 1 am Exempt under Article 3 of he Bpsine Professions Code �/G Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for License #: workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Total Square Ft: 1165 S.F. Policy #: ❑ 1 certify that in the performance of the work for which this permit is Valuation: $67,297.00 issued, I shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. W!.� y�I351$ Date: Applicant: -1 I WARNING: Failure to secure workers' compensation coverage is • 00 unlawful, and shall subject an employer to criminal penalties and one)13��� hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. �Jo� CONSTRUCTION LENDING AGENCY This permit 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 Resolutions to do work indicated ove r which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) r Name: By: 14 4 Date: 2-2J-06)Address: PERMIT EX 1RES ON: / "9 km Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representativesof Butte County to enter upon the above mentioned property for inspection purpose Print Name: _� f� /7-A) Df IZ. �/ � Signature: Date: �/ Q f Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION **PLEASE PRINT CLEARLY** t 21y7. 0':'sNtIP $(D."7'1 OWNER Last Name E P'✓�D irs Name / L N /y 1 S T Address l L auJE� t j n) , / lz G c L 4 N E City c y State', Zip Phon6�3D �8`!- Fa Email Lf h4 r �QI�L'G ra ✓I ��E o�C� 0 I r4::. CONTRACTOR Name 3 A All C_ A 5 A ad ✓L Address LUN GP_ l3 U I L -D E re— ZCity city Zip State Zip Phone E-mail Fax E-mail Planner Lic. # Class r4::. APPLICANT NAME ARCHITECT/ENGINEER Name Address Pv Ci y /t �C� ty� E JUZ C� City Zip n.' l `7 State Zip Phone Type Const. Fax E-mail Page State License Number APPLICANT NAME Name C J2 UD 7 - Address) & L -6 E IZ A 1'0g- I Az�--C LA /vim Ci y /t �C� ty� E JUZ C� State Zip n.' l `7 P e F �3D 457,4 ai�h ' � (� ►^O I l -� h jai ,C�6 APPLICAIVT SIGNATURE X 4Cv>7 For office use only: Zoning Property Address 200 Olki ,D 2e� < A Flood Zone I SRA I(Yes)l No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BIN # LOCATION AP#� 2 _ s o — o -5 Property Address 200 Olki ,D 2e� < A City �Ei2 >� Cross Street U!.t 1 jj 14 1 L L 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 lVbyy'' 1VE dre OVER FOR SUBMITTAL REQUIREMENTS K:TORMSMILDING FORMS1BldgApplSubRgmts:doc Page 1 of 2 Descri tion or Scope of Work: PER-& �I�� cL 'E-' I3U1L�,u� O . SHAIUC-60 TD �€5lAC Sq. Footage O y k11U ON 672) Structure Built without Permits Proposed Change of Occupancy (Note previous use): q,p�G1E 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. Received by,.6 Amount: Q Bldg 204 .9R SRA Receipt #: Sheriff dnew" sw SMIP Date:'�_0(p 2 Q Other Total REV 6-16-04 f� SUBMITTAL REQUIREMENTS The following drawings and. specifications must be submitted to the Building Division in order to apply for a permit: INCOMPLETE SUBMITTALS WILL NOT BEACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! Ea--` 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. &K 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (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. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ - 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1.. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2. Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (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. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMSMILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 �•� ' .H. Y Plot Plan Attached Floor Plan Attached Sent to BD/DS t TO: Building Division —Development Services A -W J Rk FROM: Environmental Health SUBJECT: Sanitation Clearance UP U o e-e_u o cc- T o'oo 2;�e- ,6 �0- CK -,1i0 ~ o �� Owner Location AP# Plan Approved for: Sewage Disposal. Water Supply: Public Private Well Clearance for dwelling. Other. Hold final for: Final clearance O.K. for: NOTE: Environmental Health Sp c' list ' Date Building Clearance 9/2005 BMW I'i COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION' q 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: aIAC]P' tot+ ASSESSOR PARCEL NUMBER lD�-5I0' OJG Proposed Building Use: enc y( mi - lU SF Dawl Vim 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��1J 1. Site plans,(1). 4 sets, signed by the preparer of`the plans. :EW 2. Complete pans,.; 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.",� ��Z v ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate; Wet -stamped and signed, in duplicate. ❑ 11. Letter of intentfo� non-residential' buildings!, ❑ / 12. Hazardous Material Form S�j 13. Acknowledgemegt of�building permit application without required clearances. ❑ 14. Other Remainin9_�9items needed to issue the permit. (May require additional plan review upon receipt of the following items.) Vahitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable FireSprinklers............................................................................................ ❑ 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by w ❑ 18. Soils Report and/or Engineered Foundation required ........................................... , ❑ 19. Erosion Control Plan Required........................................................................ i 20. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ .. 21. City of Chico Plumbing permit........................................................................ 22. Site plan and business license approval from the Cit��,of Biggs .............................. 23, California Department of Forestry plan approval' paid. Sent by: ��i/ - oK. 24. Planning approval for (A) Use: i�(B)Parking: ice -(C) Parcel Check:........2 VSi�.c 25. Contact Land Development about _ Improvements, _ Drainage ........................ i26. NPDES Form............................................................................................. 27. Encroachment Permit for driveway from the Public Works Dept ........................... 28. Contractor's license information. (Number, Name Style, Classification) ................... _❑ 29. Worker's Compensation Carrier and Policy Number .......................................... �J 30. Owner -Builder Verification (_Given to owner, _Mailed to owner) ..................... 0 31. Letter of Signature authorization.................................................................... 04 // 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction......................................................... .::.............................. ❑ i_ l 35. 1:1 Legal description, ❑ M.H. Title, title search, registration or MCO ......................... J 36. Other:_ 37. Other: When issued Telephone (r;,2n.,)5V3i0 DWr*r and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant:/�>�/�/1 / 7'� Date: 1. Index permit application for the above items numbered: Plan Check Lett 2. Additional item Contractor, desig r, own was advised of the above data phone, ❑ mail, ❑ counter, by TU Date: Contractor, �designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, b r Date: Of Plans reviewed by: Date: Plans approved by: Date: I�Plf 00.4 Structural reviewed b Date: tructural approved by: Date: (�~ Note transfer by: Date: Yellow: Building Division 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 VANDERVORT APN No: 062-510-056 Application Date 1/18/2006 Permit No: BP 06-0111 Permit Type: GARAGE CONV TO NSF 1 BUILDING PERMIT FEES ESTIMATED AT APPLICATION $2,147.00 Plan Check portion of Permit Fee $858.80 $1,288.20 Balance of Building Permit Fee 2 FEMA DYes Flood Elevation Review $109.98 0 3 SRA* Yes Fire Plan Check - Non -Refundable $95.00 $95.00 $204.98 (State Responsibility Area) Building Inspection $109.98 $109.98 NON-REFUNDABLE portion of fees due at application $953.80 FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION $1,063.78 FEES (BELOW) DUE PRIOR TO ISSUANCE OF PERMIT $5,491.80 4 Balance of Building Permit Fees (from No. 1 above) 5 SMTP* - 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 County Chico Urban Area EI Medio Fire District North Chico Specific Plan A SR -1, SR -3, SR-1/PD 0 Per Dwelling t SFD # I Per Dwelling MFD 1 4096.87 3071.14 5372.09 3995.45 3128.31 2297.77 MH 3117.43 4889.56 RECEIPT, DATE Tech/Asst Jw t n 1/18/06 Kourtni (44_5�Zq 2-9-0L $1,288.20 L(y 52 2 $6.73 L-12.2422 7633.49 R-1 8031.53 6850.08 7726.49 ti° R-2 7541.53 6360.08 7236.49 R-3 1 6780.531 5599.08 6475.49 Processing Fee is automatically added to impact fee total 1 9 WATER TENDER FEE (Not collected when impact Fees Applicable) Enter Bat.# $4,196.87 Lru S�q 2 °I^o6 (" W DRAINAGE FEES* 12 SCHOOL DISTRICT FEES* 12a RECREATION DISTRICT FEES* MH 3117.43 4889.56 RECEIPT, DATE Tech/Asst Jw t n 1/18/06 Kourtni (44_5�Zq 2-9-0L $1,288.20 L(y 52 2 $6.73 L-12.2422 7633.49 CHICO STORM DRAINAGE MASTER PLAN 770 Butte Creek $7,736 7726.49 771 Comanche Creek $8,069 New construction, vacant land, on 1 acre or less - Enter 1 or less acre value 7236.49 773 Big Chico Creek $6,596 774 Lindo Channel $8,139 6475.49 776 Mud -Sycamore Creek $6,070 RECEIPT DATE Tech/Asst $100.00 THERMALITO DRAINAGE AREA 1 $652 Maximum Per each new living unit on existing lots where full drainage fees have not been paid $4,196.87 Lru S�q 2 °I^o6 (" W $200.00 12 SCHOOL DISTRICT FEES* 12a RECREATION DISTRICT FEES* Kourtni 10 10a 11 11a CHICO STORM DRAINAGE MASTER PLAN 770 Butte Creek $7,736 RECEIPT DATE Tech/Asst 771 Comanche Creek $8,069 New construction, vacant land, on 1 acre or less - Enter 1 or less acre value 772 Little Chico Creek $8,792 773 Big Chico Creek $6,596 774 Lindo Channel $8,139 775 SUDAD Ditch $6,975 776 Mud -Sycamore Creek $6,070 777 PV Ditch $8,603 More than 1 acre, existing buildings - fees to be assessed by Public Works Fee Determination Sheet Needed - Enter amount determined by PW THERMALITO DRAINAGE AREA 1 $652 Maximum 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 $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* Oroville High/Pioneer 101 ,r,D I Oroville 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: 6vo"D� Date: L '� Lq Pursuant to Government code Section 66020, you are hereby no-tifiecrthose Items followed by an " " may have been imposed od your pr sect. You have 90 days from the date of approval of the porject or from the impostion of the 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 2 q-40 Z-9-06 BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM FEATHERRIVER RECREATION AND PARK DISTRICT (FRRPD) ❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD) ❑ PARADISE RECREATION AND PARK DISTRICT (PRPD) ❑ DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) �����J� Building Permit Number Property Owner (s) l) jb�&IL V aO7"Z - Project Location /Address Subdivision Name Assessable Sq. Ftge Type of Residential Development (check one) New Development Sin ily-Detached Single Family -Attached Alteration/Addition(s)Non-Residential to Residential Multi -Family Dwelling Mobile home Mobile home replacement verified by Assessor Department Demo Permit (date issued ) �verified by Building Department Comments: ❑ FRRPD ❑ CARD ❑ PUD ❑ DRPD certifies that: Applicant Name Mailing Address Phone Number City State Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of: Dwelling Units @ $ Square Feet @ $ Remarks: Paid by Check No: Paid by Cash: Recreation and Park District Representative per unit for a total of $ per sq foot for a total of $ Receipt No: WX Zip , 10 A IBUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (Ona form per Building) School District li'1�-�/6� Building Department -No. A.P. Number t�0�' 5 /O-L95-6iurisdiction: � City County Property Owner V Y ra Vo C7 '- Property Location/Address t9O /5,'f Z—% AP,(j 61,e 12-10 • Subdivision Lot No. ....................................................................................., q9 Residential Development Q Q Sq. Footage No of "Living Mobile Home Addition/ . Supplemental to (Group R) Units Installation Conversion Permit # *(No foundation inspection) %3L hb . C ON NC=2 7''L -lb' ,�:........................................................................................ I> W G -Z L//4/ 1. Deed Restricted Sq. Footage (A ach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial 0 Sq. Footage New Addition -> 6, 2-1-66 (including Exterior Roofed Areas) Representative Istrict Identification No.., 4r/,,,School IU -! in / District certifies that 41bo (Street Address) (City) / (State) c has complied with the requirements of Resolution No. representing 9 Q 3 square feet. School District Representative Paid by Check # - Remarks: Date VCU-Lk4)r)Qi (Applicant) (Phone Number) (Zip Code) by payment of $ FB 2926 $ ULL MITIGATION $ � 6 Dq 6 Date -s Notice: You may protest the Imposition of the fess Identified above by submitting a written protest to ti» District, In coemplicompliance,with Government Cods Section 66020(a), within 90 days from the date fess are paid. Failure to submit a timely written protest will prohibit you from challenging the Imposition of the fenIn any court action. N, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, tha School District Is lity notified by the applicable Local Planning Agency that this project Is being revlewed under the California Environmental QuaAct (CEGA). this project maybe s~ to additional school fees to fully mitigate its Impeet on the school district's schools. White (school district); Yellow (building department), Pink (applicant) teefonn.xb (3105)ddnm AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 12006®000%8,5 Recorded I REC FEE 16.00 Official Records I County of I COPIES 3.50 Butte I Cr NDACE J. GRUBBS I County Clerk-Recorderl I I KL 01:55PM 14 -Feb -2006 I Page 1 of 4 ILII ISI IIS I III 11i161II IIS �101II�I AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents ofthis.property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that.real property situate in the County of Butte, State of California, described as follows: Date 191 PROPERTY OWNERS: State of California County of \ On personally appeared_ before me, 1 known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument d acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/h /their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the strument. WITNESS my hand and official seal. Signatu A.P. # Seal: ALL-PURPOSE ACKNOWLEDGMENT State of California SS. County of �>�L Layla !Milder, Notary Public On ©� before me) TATFI r" _ (NOTARY) personally appeared V R414.E S' 4 L, ersonally known to me - OR - r COMM. W WILDERAYLA V o NOTARY PUBLIC-CAUFORNIA +n BUTTE COUNTY 0 COMM. IXP. FEB. 22.2007 J " Is ase to be the person(o whose named) is/arO subscribed to the within instrument and acknowledged to me that he/sye/yKey executed. the same in his/l/er/their authorized capacityves), and that by his/hpr/tl6ir signatures(g on the instrument the personA, or the entity upon behalf of which the. person(k) acted, executed the instrument. Pd an official seal. v Layla(Wider, NOR'ry publsa OPTIONAL INFORMA ON The information below is not required by law. However; it could prevent fraudulent attachment of this acknowl-. edgment to an unauthorized document. CAPACITY CLAIMED BY SIGNER (PRINCIPAL) INDIVIDUAL CORPORATE OFFICER TITLE(S) SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT OTHER L v RIGHT THUMBPRINT t �a OF E SIGNER o n APA 5/99 VALLEY -SIERRA, 800-362-3369 PARTNER(S) ATTORNEY-IN-FACT ❑ TRUSTEE(S) F] GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT OTHER L v RIGHT THUMBPRINT t �a OF E SIGNER o n APA 5/99 VALLEY -SIERRA, 800-362-3369 ALL-PURPOSE ACKNOWLEDGMENT State of California ss. County of 3c" TTL On - 9 c before me, Gayla Wilder, (Votary Public , (DATE) � (NOTARY) personally appeared SIGNER(S) ersonally known to me - OR - GAYLA WILDER V COMM. # 1399916 9 Q NOTARY PUBUC•CAUFORNIA Q g BUTTE COUNTY 0 IL COMM. EXP. FEB. 22, 2007'6 on t!!5tfi!!5 ast y .euid.e=e to be the person(sl whose name(,`) is/afe subscribed to the within instrument and acknowledged to me that V/she/they executed the same in IyV/her/thVir authorized capacity(Vs), and that by hi�/her/tl?ir signatures(,✓) on the instrument the person(s�, or the entity upon behalf of which the person(V) acted, executed the instrument. OPTIONAL $N• ORMMION The information. below is not required by law. However, it could prevent fraudulent attachment of this acknowl- edgment to an unauthorized document. CAPACITY CLAIMED BY SIGNER (PRINCIPAL) DESCRIPTION OF ATTACHED DOCUMENT INDIVIDUAL CORPORATE OFFICER TITLE(S) PARTNER(S) ATTORNEY-IN-FACT TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) APA 5/99 TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT OTHER d d r RIGHT THUMBPRINT 'S OF E r SIGNER o a VALLEY -SIERRA, 800-362-3369 ON -N,. 00225674 EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE„ STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: PARCEL A PARCEL 1, AS SHOWN ON PARCEL MAP BEING A PORTION OF THE SOUTHEAST QUARTER i OF THE SOUTHWEST QUARTER OF SECTION 2& TOWNSHIP 21 NORTH, RANCE 5 EAST, M. D. M., WHICH PARCEL MAP WAS FILED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 5, 1982, IN BOOK 89 OF PARCEL MAPS, AT PAGE 26. AP NO. 062-510-056 t PARCEL B: - RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES OVER ROADS, AS SHOWN ON THE PARCEL MAP FILED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA ON AUGUST 5, 1982, IN BOOK 89 OF PARCEL MAPS, AT PAGE 26. � W�' TTFQ. ENCROACHMENT PERMIT OU o, o c o\ 0 o I oc y007 County of Butte Department of Public Works County Center Drive Oroville, CA 95965 °u 9 C l!C Phone: (530) 538-7681 Fax: (530) 538-4356 All information except signature must be typed or legibly rinted Permit #-. WORK NOTIFY COUNTY 24 HOURS BEFORE IS TO BE STARTED Assessor's Parcel / (Required): V Property Owner's Name:n� a �K —Number Phone: Property Address: PROPERTY Mailing Address (If Different): OWNER 2 Work will be performed by: ❑ Contractor ❑ Property Owner Contractor's Name: Phone: Address: Fax: WORK Contractor's License Certificate of Insurance currently ❑ Yes ❑ No PERFORMED BY Number: on file with Department? Applicant is: ❑ Property Owner ❑ Property Owner's Agent ❑ Contractor ❑ Other: I / WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the County roads and highways, all in accordance with County ordinances and general laws. Signature: Date Signed: Road affected: Time and Duration of Encroachment: ❑ Permanent Encroachment ❑ Temporary: From To LOCATION Type of Encroachment•. ❑ Driveway ❑ Roadway ❑ Culvert ❑ Fence ❑ Pipe/Pipeline ❑ Sign/Billboard ❑ Other Site Plans Attached: F-1YesEl No PERMIT IS: ❑ GRANTED ❑ DENIED Conditions: In compliance with the above request, and subject to all terms, conditions (including those on page 2 of this permit form) andspecial conditions written below, permission is hereby ranted. 1. ❑ Underground Service Alert (U.S.A.) must be notified two working days prior to any excavation. 800-227-2600 2. ❑ All work shall conform to accompanying: ❑ Detail ❑ Plans ❑ Special Conditions 3. ❑ Other Conditions: PERMIT r r CONDITIONS �� v 'wQ be filled (To in by County) We 7'!!!L Date _ _ n / / Expiration Surety: Issued: SCJ Date: Date Amount Paid Check Receipt Paid: Paid: By: No: No.: Mike Crump, Director of Public Works By: Road District: Inspected By: inspdkron ❑ ompleted - OK ❑ Completed —Not OK For County Results: Additional Comments Attached Use Only Comments: Note: Ifpermits are faxed to any number besides 530) 538-4356, they can be delayed up to one week. Form: 200o6EP Pagel of 2 GENERAL CONDITIONS 1. It is understood and agreed that the County has prior right to the use of its rights of way. It is further understood and agreed by the Permitteb that the doing of any work under this permit shall constitute an acceptance of all the provisions contained herein and failure on the Perrmittee's part to comply with any provision will be cause for revocation of this permit. Except as otherwise provided for public agencies and franchise holders, this permit is revocable at any time. This permit is to be on job at all times while the work is being done. 2. All work shall be done subject to the supervision of and to the satisfaction of the Public Works Department of the County of Butte. The Permittee shall, at all times, during the progress of the work, keep the County Highway in as neat and clean a condition as is possible and upon completion of the work granted herein, shall leave the County Highway in a thoroughly neat, clean, and usable condition. 3. The Permittee agrees by the acceptance of this permit to properly maintain any encroachment placed by the Permittee on any pad of the County Highway and to immediately repair any injury to any portion of the highway, which occurs as a result of the encroachment, until such time as the Permittee may be relieved of the responsibility of such encroachment by the County Department of Public Works. 4. It is further agreed by the Permittee that whenever construction, reconstruction, or maintenance work upon the highway may require the installation provided herein shall, upon request of the County Department of Public Works, be immediately moved by and at the sole expense of the Permittee. 5. No material used for fill or backfill in the construction of the encroachment shall be borrowed or taken from within the County right of way. 6. At least one lane of any public road, under the jurisdiction of the Board of Supervisors of Butte County, and other public roads junctioning or intersecting therewith, shall be kept open for travel by the general public at all times. No public road under the jurisdiction of the Board shall be closed to travel by the general public without special permission, in writing, from the Board of Supervisors. 7. The Permittee, by the acceptance of this permit, shall assume full responsibility for all liability for personal injury or damage to property which may arise out of the work herein permitted or which may arise out of the failure on the part of the Permittee to do the work provided for under this permit In the event any claim of such liability is made against the County of Butte or any department, official, or employee thereof, the Permittee shall defend, indemnify, and hold them and each of them harmless for such claim, 8. All excavations shall be backfilled and compacted immediately after work therein has been completed. Trenches shall not be left open farther than 300 feet in advance of pipe laying operations or 200 feet to the rear thereof, unless otherwise permitted by the Engineer. Unless otherwise permitted under the Special Conditions, backfill shall be place and mechanically compacted in such a manner that the relative compaction throughout the entire fill within the County road right of way shall conform to the percentage of compaction as stated below. Permittee shall notify foreman 24 hours before backfilling and/or paving. a The relative compaction from the bottom of excavation to a plane five feet (6) below finish surface grades shall be no less than ninety percent (90%) as determined by Test Method No. Calif. 216-0 of the Materials and Research department, State of California, Transportation Department, Division of Highways, or other approved test method. b. The relative compaction from a plane five feet (5) below the finish surface grade to said finish surface grad shall be no less than ninety-five percent (95%) as determined by the above testing method. Permittee shall bear all costs and responsibility for compaction tests. c The relative compaction from a plane five feet (5) below the finish surface grade to said finish surface grad shall be no less than ninety-five percent (95%) as determined by the above testing method. Permittee shall bear all costs and responsibility for compaction tests. Material for use as trench backfill in any existing or proposed roadway section shall be sand, shall be place in 8" lifts, and be compacted to a relative compaction of not less than 95%. Material for use as backfill in roadside gutter excavations shall be the native material and be compacted to a relative compaction of not less than 90%. Any pavement cutting shall be scored, or saw cut before trenching. Minimum depth of cover over all underground facilities shall be 30 inches, except drainage culverts. All installations, parallel with roadway, shall be placed as close to the right-of-way line as possible. No portion of the backfill(s) shall be compacted by ponding or jetting. All pavements, curbs, gutters, sidewalks, borrow ditches, pipes, headwalls, road signs, trees, shrubbery, and/or other permanent road facilities impaired by or as a result of construction operations at the construction site(s), or at other ground(s) occupied by materials and/or equipment, shall be restored immediately upon backfilling or the excavation to the original grades and cross sections, and to a condition as good as, or better than; existed prior to the construction. All surfacing materials of roadways and driveway approaches cut or damaged by or as a result of construction operations, shall be replaced within ONE WEEK following the backfilling of excavation, weather permitting, with compacted layers of surfacing materials at least as thick as the existing, and no less than two inches (2") of asphalt concrete over eight inches (8") of aggregate base, according to current California State Specifications. 9. Whenever necessary to secure permission from abutting property owners, such authority must be secured by the Permittee prior to starting work. 10. The future safety and convenience of the traveling public shall be given every consideration in the location and type of construction. Permittee shall cause to be placed, erected, and maintained all warning signals, lights, barricades, signs, and other devices or measures essential to safeguard travel by the general public over and at the site of work authorized herein. 11. If the construction work covered by this permit is to be done by a private contractor hired by the applicant, applicant shall notify contractor as to the special conditions and requirements contained herein. Page 2 of 2 Butte County Departmelzt ofDevelop7zel2t Sel prices o ��TrFpo 7 County Center Drive ' o Oroville, CA 95965 0 ~ (530) 538-7601 Telephone LOUR- - (530) 538-7785 Facsimile BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: I need to submit applications for septic and/or well to Butte County Environmental Health immediately. ® I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for' disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building D_ iyision. 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: APN: �; �� � 15� Applicant Name: 1� Building site address: Permit No.: I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: -- -- ... 1)A F. Department C o u n t J. Michael Crump, Director Public f B u t. Works LAND DEVELOPMENT DrVMON Storm Water Management Program 7 Count' Center Drive Orowile, CA 95 965 (530) 538-7-266 (FAX) 538-7171 National Pollutant Discharge Elimination System/ (NPDES) Phase ll Construction Storm Water Permit and Storm Water Pollution Prevention Pian (SWPPP) Acknowledgement (LESS THAN I ACRE] Project Description: k Project Location and/or Parcel Number: 0240 * 4zj �l��G 6T By signing below, L the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that L therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed. soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project. that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: 0ZG/'Q J'6 io Date: OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary. delay in processing and issuing your building permit. No building permit will be issued until this verification is received. \'1 . I personally plan to provide the major labor and material for construction of thisro osed P P \ 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 PHONE TYPE OF WORK SIGNED: . PROPERTY OWNER: DATE: NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must. be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 2005-0075127 RECORDING REQUESTED BY Recorded I REC FEE 10.00 Bidwell Titt row Company Official Records I TAX fEr',.90 County of I But I AND WHEN RECORDED MAIL TO CANDACE J. GROES I County Clerk—Recorder! N�111e Dennis L. Vandervort I StreetI 3C address 16 L. Pine Tree Lane 09:00AM 12—Bec-2005 I Page I of 2 Zip state Berry Creel, CA 95916 IIII III III I IIII I IIID i IIII IIII i II Order i\b. 00225674-001 SPACE ABOVE THIS LINE FOR RECORDER'S USE Parcel No. 062-510-056 GRANT DEED. THIS 17ORM FURNISHED BY BIDWELL TITLE & ESCROW COMPANY The Undersigned Grantors) Declare(s) Documentary Transfer Tax is $163 . 90 l ❑ City/Town of ❑ computed on full value of interest or property conveyed, or 0 Unincorporated Area Mr" full value less value of liens or encumbrances remaining at the time of sale ❑ Monument Fee of $10.00 FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Robert D. Selvage, an unmarried man hereby GRANT(s) to Dennis L. Vandervort and Charlotte H. Vandervort, husband and wife as Joint Tenants the following real property in the ❑ City of 0 Unincorporated Area County of Butte, State of California: SEE EXHIBIT A ATTACHED .HERETO AND MADE A PART HEREOF Robert D. Selvage Document Date: November 28, 2005 - Statc of California County of Butte } SS. On ti 5 ; ZS 1 1�C _, before me, the undersigned, a Notary Public in and for said County and State, personally appeared _Robert D. Selvage Personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose namc(sJ'1 iarc subscribed to the within instrumentand acknowledged to me that hc1shc/they executed th.e same in 61 . iher/their authorized capacity(ics), and that by er/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature FOR NOTARY SEAL OR STAMP K. CARSON Commission*1408834 Notary,Pubitc =California rT v San Francisco Cou� My Comm. Exp. Apr. 1, 007 MAIL TAX STATEMENTS TO: Same as Above BTEC/GRANTDEED AND WHEN RECORDED MAIL TO: y � BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2006-0007835 Recorded I REC FEE 16.00 Official yyRecords I Countte f COPIES 3.50 O NDRCE 3. 6Rt1BBS I County Clerk-Recorderl I I KL 01:55PH 14 -Feb -2806 I Page 1 of ii4 II AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this.property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Date —�9� PROPERTY OWNERS: State of California County of \ On before me, personally appeared /V 0 k2 Z Aloctal / f personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrumentd acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/hX gnature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed ment. WITNESS my hand and offici Signature A.P. # � Z -:t t 6 S � Seal: 1 t.hc-.I Isi3ill} .E 83Iqm 1 t3�j=a!ra3 4jf11� I K- 3 A 33'` sio in I o io I tpq I 8::3-d9'-#I M12: 10 J ' i ALL-PURF ASEVACKNOWLEDGMENT State of California SS County of ���' On al -101-0 —b personally appeared _ ersonally known to me before L, -OR- GAYLA WIL V COMM. # 1399916 0 o NOTARY PUBUC-CAUFORNIA BUTTE COUNTY COMM. EXP. FEB. 22.2007 j Gayla Wilder, Notary Public . (NOTARY) Is wee 'to be the person(o whose named) . is/aro subscribed to the within instrument and acknowledged to me that he/sWe/%ey executed. the same in his/leer/tVir authorized capacity(�t''es), and that by his/hp(r/tlXir signatures(o on the instrument the person(4), or the; entity upon behalf of which the. person(l) acted, executed the instrument. i nd an official seal. ��. Gablg Wilder, Notary Public OPTIONAL INFORMA ON The information below is not required by law. However; it could prevent fraudulent attachment of this acknowl-,' edgment to an unauthorized document. CAPACITY CLAIMED BY SIGNER (PRINCIPAL) DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER TITLE OR TYPE OF DOCUMENT TITLE(S) I ❑ PARTNER(S) ❑ ATTORNEY-IN-FACT NUMBER OF PAGES ❑ TRUSTEE(S) i ❑ GUARDIAN/CONSERVATOR DATE OF DOCUMENT ❑ OTHER: I I OTHER d z SIGNER IS REPRESENTING: RIGHT THUMBPRINT NAME OF PERSON(S) OR ENTITY(IES) OF E r SIGNER o a i APA 5/99 VALLEY -SIERRA, 800-362-3369 B I ALL-PURPASeACKNOWLEDGMENT State of California SS. County of 66117-C On - 9--9 to before me, Gayla Wilder, Notary Public , (DATE) (NOTARY) personally appeared L 077-c— SIGNERS) Q-fe—r'sonally known to me - OR - Q GAYN WILDER COMM. # 1399916 NOTARY PUBUC-CAUFORNIA O BUTTE COUNTY O COMM. EXP, FEB. 22, 2007' on t e as1 y. �e to be the person(sl whose name(,6'j is/afe subscribed to the within instrument and acknowledged to me that 11/she/they executed the same in hiX/her/their authorized capacity(Vs), and that by hi�/her/th-ir signatufes() on the instrument the person(, or the' entity upon behalf of which the person(s'j acted, executed the instrument. I 1 _ ial seal. Gayla Wilder, Notary Public OPTIONAL TNF-09MAT'ION The information below is not required by law. However, it could prevent fraudulent attachment of this acknowl- edgment to an unauthorized document. CAPACITY CLAIMED BY SIGNER (PRINCIPAL) DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL CORPORATE OFFICER TITLE(S) SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT RIGHT THUMBPRINT OF SIGNER APA 5/99 VALLEY -SIERRA, 800-362-3369 OTHER e t .a E r 0 a PARTNER(S) ATTORNEY-IN-FACT TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT RIGHT THUMBPRINT OF SIGNER APA 5/99 VALLEY -SIERRA, 800-362-3369 OTHER e t .a E r 0 a Order Na. 00225674 EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: PARCEL A: PARCEL 1, AS SHOWN ON PARCEL MAP BEING A PORTION OF THE SOUTHEAST QUARTER OFTHE SOUTHWEST QUARTER OF SECTION 28. TOWNSHIP 21 NORTH, RANGE 5 EAST, M. D. M., WHICH PARCEL MAP WAS FILED IN THE OFFICE OFTHE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 5, 1982, IN BOOK 89 OF PARCEL MAPS, AT PAGE 26. AP NO. 062-510-G56 PARCEL B: RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES OVER ROADS, AS SHOWN ON THE PARCEL MAP FILED IN THE OFFICE OFTHE RECORDER OFTHE COUNTY OF BUTTE, i STATE OF CALIFORNIA ON AUGUST 5, 1982, IN BOOK 89 OF PARCEL MAPS, AT PACE 26. . J t .. _ ..i .�.. '► ;, sf. f!''�K+�F"•�:,�;`I"4{', '!t.^ .. k�}".tig('vt:.�.s. .� J t 3694-87P4E ' Charlotte Keefer cTown Hill Rd. Bald Rock Area OFFICE COPY Address M r Date - M 2 Meter By Dat � '2 -r i ..1•i j• €/r,r1'�..,•i-ate n y4 Y. ...4w'.xiy,-� T'.{- er.: h--'rtiian•-.,�.S,..r4.. ..-�,.r-.� .- _ n;. J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT -NO. •� 7 County Center Drive - Oroville, Galifornik 95965 - Telephone: 916/538-7541; APPLICATION AND PERMIT - ASSESSOR PA CEL•NUMBER ZONING BUILDING PERMIT OWNER r__ ,7�7 -4--' r �� % L- I� %,y;5)9,/-/ I' //�, /6/ 'C t•/ TELEPHONE ,/— �7��1 ' U �7 S0. FT. OCC. BUILDING VALUATION OWNER'S M/tAIILINNG A/DDLR—ESS &// ,�. lb4Z, Z46111V,4 `CONTRACTOR'S NAME '' T+ eI&EP,�H.,O N:E CONTRACTOR'S`MAI LIN G ADDRESS Fireplace CONSTRUCTION LENDER { rt UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER An 4 LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAICI`N-G ADDRESS J - Penalty $ BUILDING ADDRESS Fi i Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP F Water piping 5.00 , Each qas water heater or vent 5.00' USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other El Describe work: -O t �7ci'.I _. Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 ` Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F -1I 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 � EJ 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) ®� I, as the owner, am exclusively contracting with licensed contract- /' ors. (Sec. 7044) F -1I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.al , OR AODNS. ACC. BLDGS. / /20Sq ft NEW CONSTR. MUCTI-OUTLET '2,50 Be NON.RESID BRANCH CIRCUITS) /POWER APPARATUS&I \SINGLE OUTLET CIR. EX . OCCUpOUTLETS OR FIXTURES 20e50s .ALO 30 FIXED APP LHS, OR \ EX. Occup. OUTLETS (RESIO.) EA.) 2.00 Temporary service ' 10.00 Mobile Home Facilities n 15.00 Misc, Wirin g f�iYt a C J e � t, % /s, 0 TE Permit Fee $ (�! Contractor WORKMEN'S COMPENSATION INSURANCE I 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 Xto 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 comply1with such provisions or this permit shal I be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Hood 3.00 Ventilation penult Fee $ Contractor 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 authorize representatives of the ;County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County'in consequence of the granting of this permit. X 7���1It -1 1,4, � Date Signature of Applicant— �OrnefE] Contractor E] Agent An OSHA permit is requiredlfor 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 $ Vk OCCUP. CONST.TYPC JSCNOOL I FLOOD PARCEL 1 PD 1 ND 1 'ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which /DIRECTOR OF PUBLIC \, _ B {/GL ��� y PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date /�%.fil/S7 /�� Receipt No. _� "� ( WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS t 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise Phone: 872-6307 CORRECTION NOTICE J OWN I ERMIT 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 DE TA IL // N.[Z?ot�.e \ r �OWiV RILL WAY OR 24-9 Af ; New k.r // � �� y�' •� 11,14 , �, !'' / 1 ` •' PARCEL 2 /.SI IC Ik ct r S Nbt� a a. t� 0= �.i�' • cuu+ARlEAv�, ! , iae Ac . A. ,v SCALE ! 30' 1 X LOCATION MAP L EGEAID X COUND AS /NO/UrEO A SET 4'RE9AR is 4wz ' a CAM&ArEQ owcr t4 7/ MAI3 fI IV wAii OC WELL S/rf BASIS OF BEAR/NCS ;PARC£L - CO ? TME BASIS OF BEAR/NGS AS TN£ EITEJpdt 3.71 •c. w&^, URr Ove PARCEL / Of 7/ Gf A"o a S 45cywm Y : srf J `\v\yy JTJr A'IOVUMEA/73 SHOWN AS fW,WQ C ,f67.tK7/dKf CL1V7.A/Nf17 W \\� f �: BE/NG PARCEL / OF 7/ OF AAPS 5/, QD1,j zaz.se' l G TME SE k, OF SW / OF \\ s7T. co' / SEG / NOl° 31'fr'W �' � . NO rc AGR/COLTl,RAL STATEMENT FOR RES/DENTiAL OEI'EGOPA/ENT - Zi73 OA? 46Z wF,eerS TN/S PROrfR7y, 'VEYOR'S CERT/F/C "' "' �•J •rl..rn •r w a ,( QTc COUNTY SURVEYOR'S CE/1T/F/C4Tf ' /•[[O lyery •.;�,N CONfO,rMINL( .1VJ� yF ��,tlfM(MIJ Of (N( • O•Y N•f Cr •NO LOCJI :!N jt 7NIS w/OP co xcw—f .y/(N 1✓! n!O[//ffwlM/1S G[ /Nf fGV- O/Vit/ON J, ..: tia_ :Q:.':O MC�.rLJJ!! J//I d!/ JNO LOCO[ ORO/NJNCf. 7NlI 7Y/J /1 /!% j.� Ia•[ar COMAP. JA N/OfM OOrLO: Jr. JO / 1t! ��<1O �r �•C ✓. J: j� , L:di cn f.jL ,n(n�nt! /J trt couN,v sun�rro.� ?f C0?DE?5 CE.PT/F/C.ITf T O/V 28, T2/IU, RSE,M.DAt, /N THE UN/A/CORPORATED AREA OF BUTTE COUNTY, CAL/FOR/V/A. A'OR BERRr CREEK MEALrA, CARE /NL 4osi: /N /P,/OLV/1 LP LNwL/f✓/P If A/w6 twtN/fw7[r /7Jrco.O'p!o [N rwL OF!/CL O/ rNL /(///{ fdVwrf p/ab11JY! ,/wOfp Cfp/at ngn N.r<"'!" g�associd es AI�GIfK /2. O. WX /S7,6 0--04"W& UZ. ffV46 �w Ph. (9/6J 531•/9// Si 13.3 L, \� 3 N �d COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION-ANIrPERMIT PRMIT N / ASSESSOR PA CEL�jJ UMBER ^/ ZONING BUILDING PERMIT T ELLEVA/la � /—LLL GS/!�if0 SO. FT. OCC. BUILDING VALUATION OWNfEfR.SMG RESS `L�✓��` .4 VZ-- �U.� /, 'CONTRACTOR'S NAME G S_1 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 ENGINEE 'S MAIL ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ G PLUMBING PERMIT Filing Fee 10.00 Q A 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 Gas piping system 1 - 5 outlets 5.00 SF ❑ Duplex❑ Mobilehome❑ Other Building sewer 5.00 SPECIFY Mobile Home S G W 0.00ea TYPE OF WORK j New ❑ Addition ❑ Re odel ❑ Utilities ❑ installation[- Other ❑ Permit Fee $ /`j (� Describe work: /%,,o• i Contractor ELECTRICAL PERMIT Filing Fee 10.00 –�— Main service 100v OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW NEW CONST. DWELLING OCCUP.ai) '/z¢sgft I declare under penalty of perjury (check one): OR ADONS. ACC. BLDGS. NEW CONSTR. MULTI -OUTLET 2,50 ea ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BusinessPOWER NON-RESID BRANCH CIRC 5 ( APPARATUS &I and Professions Code and my license is in full force and effect. (SINGLE OUTLET CIR. I License No. Classification) Ex. OccupOUTLETS OR FIXTURES DA 030 El 1, as the owner, or my employees with wages as their sole compen- FIXED Ex. OCCUp. PLNS R OUTLETS (RESID )EA.) 2.00 sation, will do the work,and the structure is not intended or offered Temporary service 10.00 for sale. (Sec. 7044) Mobile Home FacAlities 15.00 I, as the owner, am exclusively contracting with licensed contract- M4 ors. (Sec. 7044) .Wiring yij ❑ I am exempt under Sec. , Business and Professions Code PreLhs ��Q for this reason Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 10.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ 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. Cooling I shall not employ any person in any manner so as to become subject Hood 3.00 to the W. C. laws of California. Ventilation Notice to Applicant: If after making this statement,should you become subject permit Fee $ to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ is correct. I agree to comply to all County Ordinances and State Laws relating Energy Inspection Fee $ to building construction, and hereby authorize representatives of the Countyot U Butte to enter upon the above-mentioned property for inspection purposes. TOTAL PERMIT FEE $ I also agree to save, indemnify and keep harmless the County of Butte against OCCUP. CONST.TTPE SCHOOL FLOOD PARCEL P11 ND ssu all liabilities, judgments, costs, and expenses which may in any way accrue I againsts id C nt in co uenc f the granting of this it.% X `` 16� / This pe it is hereby issued under the applicable provi- Date sions f he Butte County Code and/or resolutions to do Signature of Applicant - 0 ner Contractor 11Agent work In Gated abo ; for which fees have been paid. An OSHA permit is require or excavations over 5'0" deep and demolition or construct- E OR OF PUBLIC WORKS ion of structures over 3 stories in height. BY Date ®U Receipt No. to WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT EXPIRES Date TO Suildinv Department FROM: Environmental Health SUBJECT: Sanitation Clearance -��- a�� Owner Location AP# Plan Approved for: Sewaqe Disposal _ Water Supply f/ Hold final for: Water Supply Final clearance O.R. for: Clearance for bedroom mobile ome. Other NOTE * * * Water Supply 16Ai Date Sanitarian ;ti�'"i%;r • 4 ! AGI. f ^A -r ,� _4. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 1COUNTY CENTER DRIVE - OROVIAE. CALI�ORN.IA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET ` Permit No. OWNER I A. P. No. '7 Proposed Building Use aa—Z.,14 Building Inspector Date r. At time of permit application, I was advised the. following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . — 2. Plot plans in duplicate/triplicate, signed by preparer of plans. 3. Complete plans in duplicate/triplicate, signed by preparer of plans. 4. Complete engineered plans and calcs, with wet signature on plans. 5. Plans with Energy Design Compliance Statement. . . . . . 6. School District "Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . K 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.) Owner -Builder Verification (Given to owner[], Mail to ownerE]) 15. Improvements may be required. . . . . . . . . . . . 16.,IjVlopp*IehhyjjnjIIatiEon&ta. . . . . . . . . .77��li�/l�//`�'�Pre-Inspec. request o (Date) PrepIonr .. __ _ Required. Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. 20. Plot plan approval from city of _ 21. — — 22. — — — -- 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 /� _ —.— Applica%- A Z Date - Copy of plans sent Health Dept.; Fire Dept., Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 4 -- 2. Additional items required: _ —_— Contractor, designer, owner,.was advised of above required data by—phone---naiI—counter by date Contractor, designer, owner, was advised c? above required data by—phone—mail—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATI IIII AND PERMIT PERMIT NO. ASSESSOR PA CEI UMBER ZONING BUILDING PERMIT '� drj /� f t _`UYf�jJ` l�-li�/A GQ? SO. FT. OCC. BUILDING VALUATION O�WNIE///SIMC� RE59 `f1-/,',�/�, ^ 'CONTRACTOR'S NAME o �, 1, /' �j°j CONTRACTOR'S A LING ADDRESS F irepl ZZ CONSTRUCTION LENDER � UNKNOWNI Total V $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEE 'S MAIL ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5,00 - 1 Each pas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S FG I W 0.00ea TYPE OF WORK New ❑ Addition ❑ Re odel ❑ Utilities ❑ Installation[]Other ❑ Describe work: �E�! ^r n/.� .f i-(.(' Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 �— 0V OR L Main service 1000 AMP ORSLESS 10.00 �, C 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 BusinessPOWER 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 OCCUP.e OR ACDNS. (ACC, BLDGS. /:¢sgft NEW CONSTRU TI-OVTLET NON•R ESID BRANCH CIRC ITS 12.50 ea APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20®70C eAL930 FIXED PREA.) 2.00 Ex. Occup. OUTLETS (RESID ) Temporary service 10.00 Mobile Home Facilities 15.00 Misc Wirin 1 -.Z 9 /' Ic'I G✓ (� �- , G'� ilife "Jh5 xv SISI Permit Fee $ L% WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against ainst s id C nt in cogseuen�� the granting of this per. X Date % !J Signature of Applicant — 5�svin.A Contractor ❑ Agent` An OSHA permit is require or 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 $ Occu P. CONST.TIP[ ISCHOOLIFL00111PAIICELI Po I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY 0Fr3t111T CN019-- -. the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. 61 3 W/, I I ......--_- - — , ..,... .__-____ -._ . .- . __ 3694-87 PERMIT NO. 1015-89B, E PERMIT EXPIRES OWNER CHARLDT REEFER CONTR. owner 62-51-56 ASSESSOR PARCEL 200 Bald Rock Rd, BC LOCATION t. 4 . y E Temp. Power Pole ! Celled PG&E Temp. Elec. Service Celled PG&E j Temp. Gas Service Called PG&E JOB FINALED (Date) .r. Signature = OK 0 = Not OK = Not Readyable MOBILE HOMES Av - MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DE S, COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements rOning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch gof Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Sewer; Location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- 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. Cgports; Windows -Doors 7. Utility Clearance le r , Sills-Anchors-Studs-Rftrs-Trusses g; Nailing -Veneer -Stucco -Mesh Card -81 Date Card -131 Date . Ro , Shthg-Roofing Card -131 Date Card -B1 Date t.; Steps -Doors -Landings _ Date MOBILEHOME INSTALLATION (Plans) OK except #'s -14 1. Zoning Requirements -Setbacks -Easements Card -BIW Date and -B1 Date 2. Footings; Size -Spacing -Marriage Line Card -B1 Dat Card -131 Date 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date POOLS.(.Plans) OK except #'s 5. Drain; MH Test -Fall -Flex Connector 1. Setbacks -Easements 6. Water; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability 7. Water and Sewer Connected -C/O to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool L tg. Boxes=Enclosures-Panel boards- Ins. to Main in Condui Card -61 Date Card -B1 Date Card -B1 Date Card -B1 Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -61 Date Card -131 Date Card -81 Date Card -81 Date 91 Q ra ptec s�4 1C,a— = uK 0 = NotOK RRESIDENTIAL (Single and Duplex) - =Not Applicable = Not Ready Date UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continued) 1. Zoning -Setbacks; -Easements -Flood -Slope 45. Hangers -Post Caps -Anchors -Connectors 2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 46. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth 47. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main; Steel- Bloc kouts-Wrapped 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 50. Garage Fire Protection Framing 7. Slab; Steel -Wrapped 51. Property Line Firewall & Openings 8. Piers -Fireplace Ftg.-Steel 52. Ext. Doors -One T -Check Garage -3rd story, 2 exits 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 10. Gas Pipe; Size -Anchors 54. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test 55. Siding -Nailing Veneer 12. Electric; Underground 56. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 57. Glazing Area -Glass Protection -Skylights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 58. Shear Walls; Nailing -Bolts 15. Insulation 59. Insulation-Walls-Clg. 60. Infiltration-Walls-Wndws Card -131 Date Card -131 Date Card -131 Date Card -131 Date Card -131 Date Card -131 Date Card -81 Date Card -131 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchors -Nail Protection 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors Card -131 Date Card -131 Date Card -131 Date Card -131 Date Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/G.F.I. 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Card -131 Date Card -131 Date Card -131 Date Card -B1 Date Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation-& Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnace in Attic Card -81 Date Card -131 Date Card -81 Date Card -131 Date Date FRAMING (Plans) OK except #'s 39. Sills, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Header & Beam -Size & Bearing Date FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes -Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 75. Plb., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81, Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation throughout House 87. Glass Protection 88. Corrections from Previous Inpections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates 92. Roofing Certificate Card -81 Date Card -131 Date Card -B1 Date Card -131 Date Card -131 Date Card -131 Date Comments at Final: (NOTE: An entry must be made each time You visit iob site) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS P RM T NO �, 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541. APPLICATION AND PERMIT vv ASSESSgRaARCEE_L1^Mg J ZO7` BUILDING PERMIT owNE�(D_ TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRA�SNAM TELEPH NE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION VN OWN Total Valuation is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER \ LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 o�Dv ��� ��G l 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 STRUCT{U� Ehh /' SF ❑ Duplex❑ Mobilehome❑ Other/ `g�'�-� SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 ea TYPE OF WORK New -K Addition[] Remodel❑ Utilities[] Installation❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 00V OR LESS J 00 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury p y p l y (Check one): El am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.y) , OR ADDNS, l ACC. BLDGS. �20sq ft NEW CONSTR. I.OUTLET NON-RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. ) Ex. OccupOUTLETS OR FIXTURES .00030 NS. OR Ex. OCCUp. OUTLETS FIXED P(RESID )REA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 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. ❑ 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. )ZFYI shall not employ any person in any manner so as to become subject e"�N 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 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in conseque ce of the granting of this permi X Date 7 (Y 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 P 'AMIT FEE $ ��, occu P. c rPE (J r scllooL vLo PARC!' PD Is3 ! This permit is hereby issued under sions of the Butte County Code and/or work indicated above for hic EcTOR , PUBLIC BY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS —I Dae /♦ VWHITE-D.P.W.. Receipt No. YELLOW-A3e 0330 R. PI K-INSP lCTOR, GOLDENROD -APPLICANT J V COUNTY OF BUTTE - DEPARTMENT ,OF.P,, LIC WORKS -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 e PERMIT APPLUTION DATA SHEET -Permit No. OWNER. A. P. No. f' Proposed'Building Use, ��',�r �' �-'lf Building Inspector n4hP� Date t At time of'Permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4., Complete engineered plans and calcs, with wet signature on plans . . 5. Energy Design Compliance and supporting documentation .......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ..................................................... 12. School District fees paid ................. 13. Sanitation approval from 4�-_ �r4 e_ % —_ Health Department ... 14. City of Chico plumbing. permit ..................................... . 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre -Inspection for required ...... Pre-Inspec. request to Building Inspector 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature authorization ...................................... 25. 26. ,;r1 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 Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone---jnaiI—counter by date Contractor, designer, owner, was advised of above required data by —phone _maII—counter by date Plans checked by Date (-/ 3251 Plans approved byDate Sets of plans on hold in File cabinet AP folder Copy—DPW TO Buildina Department FROM: Environmental Health SUBJECT: Sanitation Clearance (�jj - ve -, -� - -- P-,/ Owner. Location AP# Plan Approved for: Sewage Disposal p p _ Water Supply Hold final for: Water Supply Final clearance O.R. for: (/ J. Water Supply Clearance for -Other�✓�CC— NOTE * * * Sanitarian