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062-700-004
a 91-4332 FULLER `( HOWARD 7co"00� CONTR : ' UNKNOWN BALD"ROCK RD,;'BERRY CREEK.; ,T;RAVEL • TRA I LER f .UT I L "` 3-2-93 — J-1 62-700-004 PERMIT#98-0921 JOHNSON, Robert E. ,Pam R Ln.., Berry 'Creek Mobilehome Utilities ELECTRIC_ 0 GAS No I � t �f COMPACTION TEST :REQ- g O -SUPPORT STRUCTURE REQ d 062-70-0-004 98-2028 RUNGE, Henry 'J z �R 5 Pam R Lane, Oroville In (transfer 98-0921)mh util 062-700-004 PERMIT#98-0953 ' JOHNSON, Robert E: �'. Pam R Ln. Berry Creek Mobilehome�t2'nstallation_ - 062-70-0-004 98-2029 RUNGE ZHenry 5 Pam R Lane, Oroville (transfer 98-0953) MHI), . Gfll � 1� O � Record at the Request of e 'Mid Valley Title & Escrow Company Order No. BU -166340-3 MAM Escrow No. 166340 BUTTE COUN1Y RECORDER '4 SERIAL NO. 9-1 Dy,9 Loan No. .. RECORDED ATTHE REQUEST OR WHEN RECORDED MAIL TO: MID VALLETITLECOM PfAN�f DATE RECORDED: S-/ -., ROBERT E. JOHNSON TIME: q. -do u,rv1 ROBIN JOHNSON 2540 DOMINIC DRIVE CHICO, CA 95928 MAIL TAX STATEMENTS TO: 4 SAME AS ABOVE ORO—C 062-500-136 SPACE ABOVE THIS LINE FOR RECORDER'S USE DOCUMENTARY TRANSFER TAX $11 00 Computed on the consideration or value of property conveyed; OR X Computed on the consideration or value less Gens or encumbrances remaining at time of sale. The undersigned (,rantnr dPnlarPs Signature of Declarant or Agent determining tax'- Firm Name GRANT DEED FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, HENRY T. RUNGE, SR. and BONITA M. RUNGE, husband and wife hereby GRANT(S) to JOHNSON JOHNSON ROBERT E. dC1 S1t and ROBIN 2QtL52N, husband and wife, as Joirit Tenants the real property in the City of Unincorporated Area County of BUTTE State of California, described as PARCEL 2, AS SHOWN ON THAT CERTAIN PARCEL MAP RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON NOVEMBER 27, 1972, IN BOOK 44 OF MAPS, AT PAGE(S) 64. Dated Mav 8 1 qqR } STATE OF CALIFORNIA COUNTY OF Butte } On May 11, 1998 before me, Michelle A. Miller, Notary Public personally appeared Henry T. Runge, Sr. 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 m and ofricia I. Signature 'i BONITA M. i � MICHELLE A. MILLER ° Commisslon to 178414 Mtr CP51 Notary Public —eti Butte County. California My Commisslo n Exp. APR. 3, 2002 LAND DEVELOPMENT BUILDING / ENVIRONMENTAL HEALTH - PERMIT CLEARANCE Building Permit No. OWNERS I 11 }! A.P.-10 /— NAME:hI'iSO�'i ���✓e- L� NUMBER: (No P --' PRINT LAST NAME FIRST COUNTY ZONING�7 DESIGNATION: �' FLOOD ZONE: FLOOD MAP: APPROVED: CONDITIONALLY APPROVED: RESOLVE PROBLE PRIOR TO APPROVAL: PARCEL CREATION BY DEEDS OR MAP DEED INFORMATION: DATE OF CREATION: LEGAL ACCESS PROVIDED: YES NO DEED REFERENCE: LEGAL ACCESS REQUIRED: - 'YES "' NO COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: YES NO COMMENTS/CONDITIONS: MAP INFORMATION: . . DATE OF RECORDING III 7 %2 LOT Z BOOK ��- PAGE COMPLIANCE WITH OLD SUBDIVI ON LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT PAGE 23): YES V NO . IF YES, MARK APPROPRIATE ITEM(S) BELOW: - A. Construct road to B. Meet parcel size required by zone. C. Meet current E.H.D. requirements. CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BE PAID TO THE BUILDING DIVISION UNLESS OTHERW/SENOTED. 1. Maintain a 50 ft. building setback from centerline of road. _ 2. Maintain a - ft.building setback from right-of-way/centerline of _ 3. Comply with Zoning code for building setback from road. 4. Maintain a 100 ft. leachfield setback from all existing wells. 5. Maintain a ft. leachfield setback from 6. Pay water tender fees in the amount of $ to Battalion Number of the Butte County Fire Department. _ 7. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290. 8. Connect to a public water supply. 9. Connect to a public sewer system. _ 10. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National Fire Protection Association Standard for the installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet Fire Department specifications, serves the parcel. _ 11. Pay T.D.D. (Thermalito Drainage District) fee in the amount of $ _ 12. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See phone number below) _ 13. Obtain approval from the Department of Fish and Game for vegetation removal. Contact Fish & Game at 916-35.5-7010. 14. A traffic mitigation fee for each new or additional living unit shall be paid. Pay the amount of $ as stated in the Oroville Area Traffic Mitigation Fee Agreement. ftymant to be made to the iAWN20,q Dh sian. _ 15. All new residential buildings shall be constructed to comply with the requirements of the Uniform Building Code for seismic safety. Mobile homes shall be constructed on a permanent foundation system which complies with the Seismic Zone 3 requirements of the Uniform Building Code. _ 16. Deer Mitigation fees are to be paid, if, such fees have been adopted by the Butte County Board of Supervisors. X 17. Pay school impact mitigation fees. X 18. A development impact fee for sheriff facilities shall be paid pursuant to the provisions of Chapter 3, Article II of the Butte County Code. _ 19. Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988 as amended. ` 20. If any cultural resources are encountered during ground disturbing activities, all work shall cease in the area of the find pending examination of the site by a professional archaeologist. This person Would then be able to assess the site significance and suggest appropriate mitigation measures. 21. 22. , 23. 24 25. 26. LD 7/96 CAWP51 TORMS.KIBLDGPERM.CLR LAND DEVELOPMENT BUILDING / ENVIRONMENTAL HEALTH - PERMIT CLEARANCE Builomg Permit No. 91- 04 a-/ n7 H u;tP OWNERS 1,�! A.P. NAME: NUMBER: PRINT LAST NAME FIRST COUNTY ZONING DESIGNATION: FLOOD ZONE: FLOOD MAP: APPROVED: CONDITIONALLY APPROVED: RESOLVE PR•OK PRIOR TO APPROVAL: PARCEL CREATION BY DEEDS OR MAP V DEED INFORMATION: DATE OF CREATION: DEED REFERENCE: LEGAL ACCESS PROVIDED: YES NO LEGAL ACCESS REQUIRED: YES NO COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: YES COMMENTS/CONDITIONS: MAP INFORMATION: DATE OF RECORDING 7Z-72 LOT Z BOOK PAGE COMPLIANCE WITH OLD SUBDIVI N LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT PAGE 23): YES NO . IF YES, MARK APPROPRIATE ITEM(S) BELOW: - - A. Construct road to B. Meet parcel size required by zone. C. Meet current E.H.D. requirements. CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BE PAID TO THE BU/LD/NO DMS/ON UNLESS OTHERMSENOTED. 1. Maintain a 50 ft. building setback from centerline of road. _ .gay 2. Maintain a ft.building setback from right-of-way/centerline of . 9 re ' 7 cOU��oville,�a _ 3. Comply with Zoning code for building setback from road. O 4. Maintain a 100 ft. leachfield setback from all existing wells. 5. Maintain a ft. leachfield setback from _ 6. Pay water tender fees in the amount of $ to Battalion Number of the Butte County Fire Department. _ 7. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290. 8. Connect to a public water supply. _ 9. Connect to a public sewer system. _ 10. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National Fire Protection Association Standard for the installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet Fire Department specifications, serves the parcel. _ 11. Pay T.D.D. (Thermalito Drainage District) fee in the amount of $ 12. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See phone number below) _ 13. Obtain approval from the Department of Fish and Game for vegetation removal. Contact Fish & Game at 916-35.5-7010. _ 14. A traffic mitigation fee for each new or additional living unit shall be paid. Pay the amount of $ as stated in the Oroville Area Traffic Mitigation Fee Agreement. Payment to be made to the Pl wwft DAdskn- _ 15. All new residential buildings shall be constructed to comply with the requirements of the Uniform Building Code for seismic safety. Mobile homes shall be constructed on a permanent foundation system which complies with the Seismic Zone 3 requirements of the Uniform Building Code. _ 16. Deer Mitigation fees are to be paid, if such fees have been adopted by the Butte County Board of Supervisors. X 17. Pay school impact mitigation fees. X 18. A development impact fee for sheriff facilities shall be paid pursuant to the provisions of Chapter 3, Article 11 of the Butte County Code. _ 19. Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988 as amended. 20. If any cultural resources are encountered during ground disturbing activities, all work shall cease in the area of the find pending examination of the site by a professional archaeologist. This person would then be able to assess the site significance and suggest appropriate mitigation measures. 21. 22. 23.- 24. " 25. 26. LD 7/96 C:\WP51 \FORMS.K\BLDGPERM.CLR t RESIDENTIAL 062-700-004 HNSON,RVert ERMIT#98-0921v; JOHNSON, RSam R Ly Creek PERMIT NO. _ Mobilehome es's r �� PERMIT EXPIRES 062-70-0-004-, 98-2028 OWNER RUNGE, Henry i 5 Pam R Lane, Oroville CONTR. (transfer 98-0921)mh util ASSESSOR PA. iLOCATION b- x r , I. CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS r VERIFY OFFICE COPY Address Mty— Date ELECTRIC Meter By Date/L,L���" Called PG&E JOB FINALED (Date) Signature Aa, Vl.�f Af V=bK O = Not OKNot - '=NotReady MOBILE HOMES MISCELLANEOUS Date MOBIL OM MUTIES(Plans) OK except #'s Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s nin equirements - Setbacks - Easements 1. Zoning Requirements -Setbacks -Easements S' I M Support Sketch 2. Footings; Soils-Size-DepthSpacing-Connectors-Steel Test Fall�/O�oncrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails A�oWatetion-Test-Easement Need Sketch) 4. Wood Awn.; Posts-Beams-Rttrs.-Connectors ectricity; Location -Clearances - Amp -Concrete Shthg.-Rfg: Bracing a s' L -'-fie^-Tait i._ p 1 'r 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures %/Nat. or/ tLYt./ /LPG %V 6. Carports; Windows -Doors T Well CI nce & Disde4liect 7. Electric _�' Wil rty Clearance 8. Fnng.; Sils-AnchorsStuds-Rftrs-Trusses 9. Siding; Nailing VeneerStucoo-Mesh 10. Roof; Shthg-Roofing Date Card B-1 AW Date Card B-1 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 X&IL 12. Braced Wall Panels Date If MOBILE HOME INSTALLATION(Plans) OK except #'s LX-Zoping Requirements Setbacks Easements Date Card B-1 Date Card B-1 tings• SiaeSpacng-Marriage Line t Date Card B-1 Date Card B-1 est-DemandValve-Connector Date POOLS (Plans) OK except #'s lec ' ; MH Test -Crossovers -Breakers -Clearances i 1. Setbacks -Easements rain; MH Test Fall -Flex Connector 2. Soils; Compaction -Structure Stability ajcrj-MH Test -Regulator -Connector 3. Pool Structure; Steel -Connections -Thickness ater and Sewer Connected -C/O to Grade -HD Approval Dead Men -lining city Tagged 4. Elec.; Receptacles and Lighting, Distance -GA e D s -Ty do a 5. Elec.; Pool Lighting; 15 Volts-GFI i s .Sketch 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed ert of Occupancy 7. Elec.; Bonding; Metal w/5 -Circulating Equip. -Heater 12. Permanent Foundation Only: License Decal 8. Elec.; Grounding; Equip. w/S Circulating Equip. -Pod Lghtq. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit Date Card B-1 Date Card B-1 # 9. Health Department Approval Date Card B-1 Date Card B-1 10. Plumb.; Cir. TesbWater Supply Test f 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ✓ = OK O = Not OK - = Not Applica = Not Ready Date UNDERFLOOR (Plans) OK except #s 1. ZoningSetbacks-Easments-FloodSlope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth 3. Ftg. Garage; Soils-Steel-Elec. Gmd/ p Ftg. Depth 4. Ftg. Porches & Decks; Soils -Steel-/ J' Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts- Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 23. Fixture & Transformer Clearance -Ins. Protection 24. Elec. R eptacles Spacing -Lights & Switches at Doors 25. Size Bo s & No. of Conductors Stapled 26. Romex Installed Close to Edge of Studs & C.J. 27. Equip. Ground made up w/Mech Fastners-Bond Gas & Water 28. 2 Appliance Circuts in Kitchen & Conductor Size GFI 29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or AI 30. Range Circ. / / ga Cu or "van Circ. / / ga Cu or Al Insulated Neutral 0 Yes 0 No 31. Service -Riser Conductors & Ground -Main Disconect 32. Equip. Clearances Panels-Motors-Mech. Epuip. 33. Clothes Closet Light -Shower Light -Spa Light 34. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 35. A.C. Ducts Insulation & Support 36. Vent Fan, Exhaust above insulation 37. Condensate Drain & Overflow, Size & Grade 38. Fumance-Vent Access -Comb. Air -Return Air Vent 115 outlet 39. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 40. Sits Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 45. Headers & Beams -Size & Bearing RESIDENTIAL (Single & Duplex) �� Y Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties-Purtin-roff Brac.-Truss-Shting.-Ring. 48. Fireplace Ties or Type A Flue -Fireplace Throat clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdnn. Windows or Exiting Doors -Sill Hgt. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3 -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior / Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ext Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace; Vents -Clearance -Comb, Air-Conector- In Garage; Above Floor-Ducts-Mech. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixt. & Appliance; Ground. -Air Gap -Cooking Clearance 73. Elec. Outlets & Recepticales at Kit. Counter 74. Garage Fire Door; Swing -Landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. In Garage; Above Floor -Meth. Protection 77. Plb., Elec. & Mach. Equip. Listed for Location 78. Elec. Receptacles in Garage (G.FI.)-Ramex Protection 79. Insulation -Foam -Looked in Attic 80. Guard rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 82. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No 83. Stucco Brown -Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throught House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES/ - 411 MainStreet, Chico, CA - (916) 891-2751 ' A 7 County Center Drive, Oroville, CA - (916) 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 notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. a /Al Je D/ D A 1Z fA �i r..✓ o i� Ve." r 4 -�u a e -f .o;�.�- MA 4A Date Inspector!S REV 10/92 COUNTY OF BUTTE BUILDING DIVISION ' DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE F.-1 -z04- PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be,e6rrected. Please notice this office when correction of work is completed. If yo�offiimmediately. uestions pertaining to this matter, or need additional explanation, ?please contact t � r d s�'Ala- &3 i� Date Inspector -IM REV 10/92 COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION + 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 K ®� E! Tl NO. (Rev. 12/9;) APPLICATION AND PERMIT I ASSESSOR PARCEL NUMBER 2-70-0-004 ZONING BUILDING PERMIT OWNER ROBERT E SON TELEPHONE 342-5700 SO. FT. OCC. BUILDING VALUATION GWNE2t1nbNGffiMIC DRIVE, CHICO 95926 CONTRACTOR'S NAME OWNER TELEPHONE ' CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS ' Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.0 Permit Fee $ 23.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS pAM R LAME BERRY CREEK Energy Plan Checking Fee $ $ , PERMIT FEE $ 3.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome EX Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK y New ❑ Addition ❑ Remodel ❑ Unities ❑ Installation Other ❑ Describe Work: MHI/98-0921 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 800OR LESS Main Service 200AORLESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter with Section 7000) of Division 3 of the Business and Professions Code, 9 (commencing w and my license is in full force and effect. License Class LIC. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law/for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service ( 200A TO 1000A 46.00 NEW CONST. DWELLING UP. OR ADDNS. ( a Acc. BLOB. SO 3.5¢FT; NORESIDT AULCTI.ONE RCET N• 97,50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occu OUTLET OR FIXTURES SAL .5o Ex. Occup. OUIxTLE�DSPPUNS .OREA_ 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation sof California, and agree that if I should become subject to the IN ensation provisions of section 3700 of the Labor Code, I shall it mply with those pr Ions. X - Date % x Ign_ature ofan - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ 100.00 Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 143.00 HAZ. FEES ES IMP FLOOD cD� .v/ PARCEL PD HD IssuE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have in BY Q PERMIT EXPIRES ON C applicable provisions Resolutions to do work been paid. //�' /I D to o' 7 Dat Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT CO NTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION •7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: Jn 1A ASSESSOR PARCEL NUMBER: d O Proposed Building Use: Building Inspector: Date: At time of permit application, I was advised the following data must be submitted prior to permit p easing an or issuance: Date Received By ❑ 1. All items have been submitted. 02. Plot plans, 3/4 sets, signed by the preparer of plans.---------------------------------------------------- 03. --------------------------------------------------- ❑3. Complete plans, 3/4 sets, signed by the preparer of plans. --------------------------------------------- 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! --------- 06. Energy Design Compliance and supporting documentation. ------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ------------------------------------------------ ❑ 8. Hazardous Material Form.--------------------------------------------------------------------------------- ❑9. Manufactured Home data and installation instructions including Tie Down Specifications ------------------- ill'. ------------------ ❑ 1 . Fee -of $ ------------------------------------- ------ ----- ------------------------------ / Impact fees as shown on the attached schedule. --5 1California as of Forestry plan approvaUfee s. ----------------------------=---------------------- ❑ 13. Flood elevation certificate. --------------------------------------------- ❑ 14. Sanitation and plot plan approval Health Department. ❑ 15. City of Chico plumbing permit. --------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. --- ❑ 17. Planning approval for (A) Use: (B) Parking: ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------------- ❑ 1.9. Encroachment Permit for driveway (construction approval prior to occupancy). ---------------------------- ❑ 20. Pre -inspection for required Request to Building Inspector on 021. Contractor's license information. (Number, Name Style, Classification). ---------------------- =------------- ❑22. Workers' Compensation carrier and policy number. -------------------- E123. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). 024. Letter of signature authorization. -------------------------------------------------------------------------------- RRecorded copy of Agricultural Acknowledgment Statement. ------ : Letter of intent on building use. ----------------------------------------------------------------------------------- Manufactured Home utility clearance. --------------------------------------------------------------------------- V❑28. Existing'violations and/or expired permits. ---------------------------------------------------------------------- ❑�9. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ aa .,------------- 10. other: Ouumx kJ/GG ,rid► When you issue the permit, process as follows ❑ Mail to owner, ❑Mail to contractor. 91-44-18 (Date) PRA Iftelephone and hold for pickup at office. ❑ Deliver with inspector. Applicant: Date: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: Tr ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner,>vV advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: Date: 9-435-'7 8 Plans approved by: Date: Sets of plans on ho in ❑ Plan Cabinet, )"A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. i (Rev. 12/96)' COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Cehter Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. AS SESSOR PARCEL NUMBER BUILDING PERMIT OWNER IV 'ONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADORES S Fireplace Total Valuation S ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MMU DRESS Plan Checking Fee $ BUILDING ADDRESS 11-10, Energy Plan Checking Fee $ S PERMIT FEE S LAT No. SUBONISpNS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 :;'00'FUCTURE SF O Duplex ❑ Mobilehome Other SPECIE/ Each Trap 7.00 Solar or heat um water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ ❑ stalls' Other 10 Describe Work: OR Gas piping system 1 - 5 outlete 15.00 Building sewer is .00 Mobile Home I S I G I W @20.00 PERMIT FEE _ ELECTRICAL PERMIT Filing Fee 20.00 Main Service p0A Oq tLES. 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby'affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: O 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: O 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. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed 4 the permit is for work of a valuation of one hundred dollars ($100) or less.) O 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, arid 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. X Date _ Signature of Applicant - O Owner O Contractor O Agent An OSHA permit is required for excavations over 60' deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 6000A 48,00 NEW CONST. DWELLYIO CUP. SG ADONS. ( ACC. 3.5¢FT. NEW M L REr NON -REBID. CONS,T' @7.50 PO L APP=US a SINGLE DURET da Ex. Occup. OUTLET ORFwTuAEs SAL@ .500 Ex. Occu . ounEDTsAPPUNS io.OREw 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE _ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee b • ��% Energy Inspection Fee S OCC CONST. TYPE TOTAL FEE $ • 40% KAZ. I O FEES IMP n.00D CDF PARCEL Po HD ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By Date PERMIT EXPIRES ON provisions to do work paid. I• Receipt No. WHITE-D.D.S.-B. D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROO-APPLICANT BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM xok, ' (One form per Building) School District —or i I/ I le �j'I / S Building Department No. A.P. Number ��.- �a' �-- Ply Jurisdiction: City County Property OwnerR1,4"V7,re \0 --- Property Location/Address .� pGy /•17 L, /� pj l I ` , ,o J^ r (A VII -V01.4 NC Subdivision Lot No. Residential Development No of Living Mobile Home Addition Units Installation Commercial/Industrial Q New Addition Building Department (Floor Plans reviewed by School District Ffersbnnel) District Identification No. C) 9 O O 3 O �/41? 421 1(IfG School District certifies that . P/2 (41 (Appycant) Sq. Footage ,(Group R) Sq. Footage (Including Exterior Roofed Are 1" Data (Street Address) 42. has complied with the requirements of Resolution No. representing e square feet. District Representative Paid by Check # Remarks: J iatate) (Phone. Number) (Zip Code) by payment of $ / B 2926 $ VIbLL NUTIGATION $ Date Notice: You may protest the imposition of the fees Identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the Imposition of the fees in any' court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its Impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls (2/97)dmm Mobilehome Manufacturer: Manufacture Year: I i If other than single wide, furnish etup Model Number: Width: (ft.) Length: (o ft.) Tagalong or Expando Size (ft.) x (ft.) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets. FOOTINGS: Wood pressure treated or foundation grade[' Other: SUPPORTS: Concrete block[] Other: ,c oi�✓J ,t P Gid' Provide Tie Down Specifications for all Mobilehomes: Pier Footings Sizes and Location SINGLE WIDE MULTI -WIDE Line 1 JLUne 1 Line 2 ne 2 Main Beams Line2...................................................................................2 Line 1 ne 3 ne 2 ......................................................:............................Main Beams ne 2 ................................................................................ne 1 ............................................ ine s Tag or Triple e4 ine 1 Line 1 Piers: Size minimum: r 1 x Spacing maximum: 1 9` From ends-maximum:l &` Line 2 Piers: Size minimum: Jam] x 1301. Spacing maximum: y AK, 49,` From ends -maximum. ` Line 3 Roof Loads: Size minimum Location (from front): Line 5 Roof Loads: Size minimum: Location (from front): Line 1 Openings Size minimum: x [36]. Each side of openings with width over: ' I Ll` Line 4 Piers: Size minimum: x Spacing maximum: ` From ends -maximum ` oma, �j50953 FILE COPY b M.H.I.-2 1. Owner's Name: }Kd t)e (j P 2. Assessor's Parcel Number: a (.2- %d 0 - 0O 1 3. Installer's Name: 010 n Q -r- 4. ' Is the site currently under permit? Yes[„}' No[ ] Permit No. 5. Is the site an existing site? Yes[ ] No[ +� (If yes, fianish two plot plans). 6. What is the electrical rating of the mobilehome —LP Amperes. 7. What is the mobilehome site circuit breaker rating?' Amperes. ell �. 8. What is the electrical rating of the mobilehome site? a n o Amperes. 9. Is the main service remote from the mobilehome site? Yes[ ] No[)(] If it is, what is the rating? Amperes. 10. Is there any other electric load to be served by the mobilehome site electric service (i.e. well, garage etc.)? Yes[j] No[ ] If yes, please identify the load and size: a) The mobile home site: Load- GU e,l Amperes- b) The main service: Load- Amperes - 11. Type of gas service at mobilehome site: Natural[ ] . Propane[ ] None[j 12. Size of. gas pipe at the mobilehome site from the meter or tank: inches. 13. What is the gas pipe length from the meter or tank to the mobilehome? (ft.). 14. What is the mobilehome gas demand? B.T.U.* *(This information is not required if the pipe length is less tha , 6 feet on natural gas or less than 50 feet on propane). THE OTHER SIDE OF THIS FORM MUST BE COMPLETED IN ORDER TO PROCESS THIS PERMIT APPLICATION May 1995 8.5 ou 'gPPROVED �Ufte County . onvlrOnmenpad Health 4r.r Fg) A Zv- ou 'gPPROVED �Ufte County . onvlrOnmenpad Health 4r.r Fg) MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION --7 COUNTY CENTER DRIVE OROVILLE, CA 95965 ---PHONE (916) 538-7541 APN: PERMIT NO.: Owner's: Name: 4C9.r..- Owner's: A )r,` 5 03 � l.�-� �� C� Address: ✓� � r ;' Mobilehome / t TYearof / Manufacturer =t—/ r Manufacture: Serial number / 1 or V.I.N. i / 0 •� � V Insignia or HUD number: rCi Official approving installation: '" Date: /A If the mobilehome is moved or relocated, the mobilehome installation acceptance shall become invalid. This form shall not be used when the mobilehome is installed on a foundation system. 5138 White -Owner, Yellow -Installer, Pink -Bldg., Gold -Assessor. • CERTIFICATE OF ANCHOR INSTALLATION True 25 CCR MobIWOMe Parks Act Section 1326 (bK3) I certify those portions of the tiedown system installed below grade were ,not damaged prior to or as a result of the installation, were not modified :prib to or during the installation, and were installed in accordance with the manufacturer's installation instructions, :plans and specifications of the engineered tiedown system referenced on this certificate. •Tiedown System: , Manufacturer. �.✓� Cl Model: ''' l%_ + r• �� O- 12 Installed by:' ate: Cbntr./Owner _ ' Sr -License Ilio.: -J - 77 COUNTY OF BUTTE \' BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 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 notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, ` na>4 se contact this office immediately. '• f �- i1 S 4' c r o Y /� CZ -Ale - 1, re - Date R��V ` 0/92 ��_": T�7i• M l• �✓ COUNTY OF BUTTE- DEPARTMENT OF6EVELbPMENTSERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-75419 �PEWIT No. (Rev. 12/96) APPLICATION AND PERMIT j �! ASSESSOR PARCEL NUMBER 069-70-0-004 ZONING BUILDING PERMIT OWNER TELEPHONE 342-5700 SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 26 CONTRACTOR'S NAME TELEPHONE ' CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. AIV FilingFee $ Permit Fee $ 23.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS PAM Energy Plan Checking Fee $ PERMIT FEE S23.00 LAT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee ' 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome X3 Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ff Installation ❑ Other ❑ Describe Work: MOBILEHOME UTILITIES Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S W @20.00 40.00 PERMIT FEE $ 60-00 _ ELECTRICAL PERMIT Fling Fee x20.00 0V LE Main Service ZDOA OR LESS 23.00 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter ii 9 (commencing wth Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.P License Class LIC. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Lawlor -the following reason: jo ET 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. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. so. OR ADDNS. ( d ACC. BUDS. 3.5¢FT. NEW CONST. MULTI -OUTLET NON -R0.1) ,c cl c 97.50 OWER APPARATUS a SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20@1.00 BAL @ .SO Ex. Occup. ..FIXEAESs) E 5.00 Tem oxer Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 ' PERMIT FEE $ 63.00 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) certify that in the performance of the work for which this permit is issued, I shall not employ any,person in any manner so as to become subject to workers' compe satio aws of California, and agree that if I should become subject to the w e pensation provisI of section 3700 of the Labor Code, I shall Itmpl with those isions. ___ Date 3 Si ature t - ❑ Owner ❑ Contractor ❑ Agent n OSH itis required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 146.00 HAZ. p, F IMP' FLOOD C %DFer OpN PD I HD SU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date 0 PERMIT EXPIRES ON Date Receipt No. tai WHITE-D.D.S.•B. D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I.,; ,PPROVy w Atte Go7% mmental Mea `t�S -- 152.56 UNTY 062--700-0oe-I 98-092t (g SU'L 'NC A P P s� _ r"ar 152.56 UNTY 062--700-0oe-I 98-092t (g 4 2- — 7 0 —a AP# CDF FIRE SAFE REQUIREMENTS PERMIT # NAME Under authority of PRC 4290, the following checked items are required by the Butte County Fire Department and are made a part of this permit. These requirements are minimums and will be superseded by Butte County local regulations which equal or exceed these standards. Field inspections will be made by the Butte County Building Department for compliance. [ 1272.00 Maintenance of Defensible Space. To ensure continued maintenance of properties in conformance with these standards and measures and to assure continued avail- ability, access and utilization of the defensible space provided for in these standards, annual maintenance must be provide for by the land owner. Driveway Standards [] 1273.02 Surface. All driveway surfaces and structures (bridges, '1 1273.07 culverts and other appurtenant structures which supple- ment the roadway bed cr shoulders) shall provide unob- structed access to conventional drive vehicles, includ- ing sedans and fire apparatus weighing up to 40,000 pounds. [ 1273.03 Grade. Not to exceed 16 percent unless paved. 1273.04 Driveway Radius 1. No roadway shall.have a horizontal inside radius of curvature of less than 50 feet and additional sur- face width of 4 feet shall be added to curves of 50- 100 feet radius; 2 feet to those from 100-200 feet. 2. The length of vertical curves in roadways exclusive of gutters, ditches and drainage structures designed to hold or divert water shall be not less than 100 feet. 1273.05 Turnarounds. If required, will have a minimum turning radius of 40 feet from the center of the road. [�] 1273.05 Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 foot taper on each end. [�} 1270.10 Width. All driveways shall provide a minimum 10 foot I traffic lane and unobstructed vertical clearance of 15 feet along its entire length. U E " UNTY Page 1 of ' BUILDING DEP TMEON' ' 62-'70 -o� ��'�-US 2/ �4n/Sa,4! 44bL-r- AP # PERMIT # NAME [ 1273.10 Turnouts. Driveways exceeding 150 feet in length, but less than 800 feet in length, shall provide a turnout near the midpoint of the driveway. Where a driveway exceeds 800 feet, turnouts shall be provided no more than 400 feet apart. [�C] 1273.10. Turnaround. A turnaround shall be provided at all building sites on driveways over 300 feet in length and shall be within 50 feet of the building. 1273.11 Gates 1. Gate entrances shall be at least two feet wider than the roadway it serves. 2. The gates must be located at least 30 feet from the I roadway and shall open to allow a vehicle to stop without obstructing traffic on that roadway. [ J 3. Where a one-way road with a single traffic lane provides entrance, a 50 foot turning radius shall be used. .Fuel Modification 1276.01 Setback for Structure Defensible Space. [ ] 1. All parcels 1 acre aid larger shall provide a mini- mum 30 foot setback for buildings and accessory buildings from ul] property lines and/or the center of the road. 2. For parcels less than 1 acre, local jurisdiction shall provide for the same practical effect. See Other Requirements below. [�] 1276.02 Disposal of Vegetation and Fuels. Disposal, including chipping, burying, burning or removal to a landfill site approved by the local jurisdiction, of flammable vegetation and fuels caused by site development and construction, road and driveway construction and fuel modification shall ba completed prior to completion of road construction )r fi.-ial inspection of a building permit. BUTTE COUR7V Page 2 of 3 �1 2 -7 o , o �/- 'ff - 07 z 1 Jo - 4j" 0 ,0 4X ,6& -r- AP # PERMIT # NAME Other Reauirements �I(Xj If Building Setback is 15 to 30 Feet: / - Class A or B roof - Enclosed eaves If Building Setback is Less Than 15 Feet Choose any 3 of the following: - Metal or no doors on side toward property line with insuffi- cient setback - Class A or B roof with enclosed eaves - Interior automatic sprinkler system per NFPA 13D - Glass area not to exceed _0% of wall area toward property line with insufficient setback - Siding from the following list: Stucco - 3 coat Hardi-Board or Plank Masonry Masonry veneer Metal Other Butte County Fire Department approved materials �� Date Signature�Q TTEC�U� TY Page 3 of 3 BUILDING DEPA T ENT - `COU NTY OF BUTTE DEPARTMENT OF DEFTiOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: , ASSESSOR PARCEL NUMBER: n 6 Z ^ 7 uil Proposed Bding Use: i,,t,4 /� « Building Inspector: Date: At time of permit application, I was advised the following data must be submitted prior to pe proesaing and/or issuance: Date Received By ❑ 1. All items have been submitted -------------------------------------------------------------------------------------- E12. Plot plans, sets, signed by the preparer of plans, ------------------------------------------------------------ ❑ 3. Complete plans, 3/4 sets, signed by the preparer of plans, ----------------------------------------------------- 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans, -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ 116. Energy Design Compliance and supporting documentation, ---------------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------------------------- 118. -------------------------------------------------------- ❑8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑9. Manufactured Home data and installation instructions including Tie Down Specifications.------------------ sk 0 10. Fees of $ ------------------------------------------------------------------------------------- + ❑ 1 1. Impact fees as shown on the attached schedule. -- -- ---- ---------------------------/--------------------- ; -California Department of Forestry plan approv -_ - ,{---------------------- �'tv-l�. San❑ 13� . Flood elevation certificate. ---------------------------------------------------------------------------------------- (,itation and plot plan approval n4 r�,_ Health Department.------------------------------------------- 1115. ------------------------------------------❑15. City of Chico plumbing permit.---------------------------------------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------------------------------- ❑�Planning approval for (A) Use: (B) Parking: -------------------------- Contact Land Development about Improvements, ❑ Drainage, Legal Parcel. ----------- NO].! Encroachment Permit for driveway (construction approval prior to occupancy). -�-�`-s=�------------ a CJZ0. Pre -inspection for required. Request to Building Inspector on (Date) ❑21. Contractor's license information. (Number, Name Style, Classification). ------------------------------------ 022. Workers' Compensation carrier and policy number. --------------------- 023. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). 1124. Letter of signature authorization. ----------- 25. Recorded copy of Agricultural Acknowledgment Statement, ----------- 026. Letter of intent on building use, -------------------------------------------- ❑27. Manufactured Home utility clearance. ------------------------------------- 1128. Existing violations and/or expired permits.---------------------------------------------------------------------- s• ❑2 . 243 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ • --------------- p/ ------- 5�I ` ther: l Pj"o .�- o'p- 01010'0 W �-i t r ri.� - S When you issue the permit, process as follows ❑ Mail to owner, ❑Mail to contractor. NTelephone 3&%,,5700 and hold for pickup at office. ❑Deliver with inspector. rYpplicant: Date: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designd-,owner as advised of the above required data by)phone, ❑ mail, ❑ Building Division counter, by Date: ,s?,4),g 11Contractor, designer, owner, was advised of the above required data by phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance W' jo Nno" 3- -D c�C E.H. USE ONLY- 1 Plot Plan Attached -� Floor Plan Attached Sent to B.D: - Owner /Location AP# Plan Approved for:�Sew�aggee Di po.sal l/ Water Supply: Public Private Well Clearance for . Other Hold inal Fina cleai NO E. :e 0. K. or: Environmental Health Specialist 0 071 0-n ie Date OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signatwe. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES NO 0 2. I HAYED . HAVE NOT 0 signed an application for a building permit for the proposed work, 3. I have contracted with the following person (firm) to provide the proposed construction:.. NAME: ' ADDRESS: - CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: CITY: 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 PROPERTYOWNER: SOCIAL SECURITY NUMBER: 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. OVER I OWNER BUILDER INFORMATION I Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible parry of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing thein own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various -trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractor`s` or subcontractors, then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you'are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State 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 contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contracgrs may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. r rely, Mic el C. Vi ira, C.B.O. M ger, Building Inspection NOTE: This Owner-Builder.Information is required by Section 19830 of the California Health and Safety Code OVER ,© V" (Rev. 12/96) It OJOUNTY OF BUTTE - DEPARTMENT OF pEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 - APPLICATION AND PERMIT PERMIT NO. -ASSESSOR PARCEL NUMBER 706_00y ZONING BUILDING PERMIT OWNER Jo�.A a TELEPHONE ;F112-70 SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESSp 12C1{ S YW i C r L d 1 CONTRACTOR'S NAME - TELEPHONE ' CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS ' Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan CheckingFee $ .a- 73 BULLDWGADDRESS9 Energy Plan Checking Fee $ $ Ai PERMIT FEE $ 2 Q LAT NO. SUBDIVISIONS NAME P CEL MAP PLUMBING PERMIT Filing Fee 20.00 r \ USEOFSTRUCTURE � SF ❑ Duplex ❑ Mobilehome KOther SPECIFY Each Trap 7.00 Solar or heatpump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities 1� Installation ❑ Other ❑ Describe Work: C� Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home @20.00 Q P PERMIT FEE 01,04 ELECTRICAL PERMIT Fling Fee 20.00 Main Service ponORLEss 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A To I000A 46.00NEW CONST. DWELUNG OCCUP. OR ADONS. ( 6 ACC. S. s0 3.5¢FT. � REOND. MULTI.OUTLET @7,50 POWER APATUS 8 SWGLE OUTPARLET CIR. EX. Occup. OUTLET OR FUTURES .00 SAL O I.50 LNS Ex. Occu . D TS q D°E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall em to an erson In an manner so as to become subject to workers' P Y Y P Y I compensation laws of California, and agree that if 1 should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X _ Date_ Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FES $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ 4CONST.TYPE TOTAL FEEnot FEES IMP FLOOD CDF PARCEL PO HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. o BY r -D d PERMIT EXPIRES O Te Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT CIbUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO Y (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 069-70-0-004 ZONING BUILDING PERMIT OWNER HENRY RUNGE TELEPHONE SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS 503, OROVIIIR 95965 CONTRACTOR'S NAME TELEPHONE MNOWN CONTAMYNTANAVILING ADD CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUIwIrTAs�EssR LANE, BERRY CREEK r 1�1 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑X Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other EX Describe Work: TRANSFER 98-0953 TO NEW OWNER Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W1 @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 a00R LESS Main Service 20MAORLESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ,E' I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to 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. X_ Date 9-i4 "" ( Si nature of App icant - ❑ Ow ❑ Contractor ❑ Agent An OSHA permit i required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service zooA To +Moog 46.00 NEW CONST. OWEWNG OCCUP. SO OR ADONS. a ACC. BLDs. 3.5¢FT: ONS =R.,.T. MULTI -OUTLET 97.50 PARATus INGLE APOUTLET US 6 SPSO OUTLET OR ForTURES Ex. Occup. B20 o +: o Ex. Occup. DFlunEDTs R DOEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 00 00 HAZ. D FEES IMP FLOOD COF PARCEL PD HD SSU This permit is herebx issued under of the Butte Coun Code and/or indi e for \ ich fees have By ERMIT EXPIRES ON I the applicable provisions Resolutions to do work been paid. Date y� �6 Datq Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I L1____ 1. . COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 PERMIT O. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 062-70-0-004 ZONING BUILDING PERMIT OWNER HENRY534-6004— TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE HAROLD CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER V t LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER _ LICENSE NO. f Fireplace Total Valuation $ Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ PERMIT FEE S LAT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑X Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other d Describe work: TRANSFER Ngi UTIL 98-0921 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service zoOA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class I No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, . will do the work, and the structure is not intended or offered for sale. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to 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. XWw Date C /40 Signature of A plicant - 13 Ov&br ❑ Contractor ❑ Alfent An OSHA permit Is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO t 46.00so NEW CONST. DWELLING OCCUP. SO U OR ADONS. ( a ACC. BIDS. 3.50FT. Np p�,pT MULTI -OUTLET @7.50 POWER APPARATUS a SwGLE OUTLET C R. OUTLET OR ORES Ex. Occup. BAL @ x.500 LNS Ex. Occu . ops AEsID OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD SSUE A This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON 5/26/99 the applicable provisions Resolutions to do work been paid. Date�� n /A� Date Receipt No.�SCIGS�Fi WHITE-D.D.S.-B.D. CANARY -A S SOR PINK -INSPECTOR GOLDENROD -APPLICANT AUGUST 12, 1998 RE: AP# 062-500-136 Q 4 - `J D -- D- 06 `I TO BUTTE COUNTY PUBLIC WORKS AND/OR BUILDING DEPARTMENT: THE UNDERSIGNED HEREBY ASSIGNS ALL INTEREST IN ANY PERMITS APPLIED FOR AND/OR FEES PAID, IN REGARDS TO THE ABOVE REFERENCED PROPERTY, TO HENRY T. RUNG., SR. l ROBERTi_E�JOHNSON X ROBIN ON 0 A. P. #'�%f� OWNERccri(�➢ L PERMIT # , — MH UTIL. CLEARANCE DATEell INSPECTOR/ ELECTRIC GAS SUPPORT STRUCTURE COMPACTION TEST REQ. SERVICE OTHER PIPE YES NO YES NO SIZE LOAD TYPE SIZE LENGTH BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM 0/— (One form per Building) School District r o v /e �� / t� Building Department No. A.P. Number 6. —// ( fq Jurisdiction: City County Property Owner Property Location/Address �j �a /'!7 % 1 Aj j' /7 .1 -eO r ►^ 6 Subdivision Lot No. Residential Development Commercial/Industrial New Addition Addition (Floor Plans reviewed by School District Personnel) District Identification No. 990030 06o& School District certifies that 01 5— (Street (Street Address) (State) Sq. Footage Q (Group R) Sq. Footage (Including Exterior Roofed Are 1 Date (Ap - ant) (Phone Number) (Zip Code) has complied with the requirements of Resolution No. to,5-- (J by payment of $ / representing (� square feet. lFWi212i6 $ ULL MITIGATION $ ��NnIW4 C zio ?00 chool District Representative Date Paid by Check # Remarks: Notice: You may protest the imposition of the fees Identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you. from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls (2/97)dmm 4� COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE CA' 95965 TELEPHONE (916) 538-7541 SCHEDULE OF FEES DUE OWNER 112, N to Oda S o L PROPOSED BUILDING USE j A 1. BUILDING PERMIT FEES -- Balance Due ................ $ . -- Additional Fees Due .......... $ -- Additional Fees Due ..... . ...... $ -- Revised Plan Checking Fee ....... $ (2 - )SCHOOL DISTRICT FEES (paid at District Office) VM .N T— HERIFF FEES (paid at Building Division) Res>dential ........ x $360.00 = $ Units Commercial (sq.ft.)... x $0.03 = $ Sq.Ft. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit) . x = $ #Units Amt. Commercial (sq,ft.) .. x =$ Sq.Ft. Amt. 5. RECREATION DISTRICT FEES (paid at District Office) 6. THERMALITO DRAINAGE DISTRICT FEES $425.00 (paid at Building Division) SRA FIRE INSPECTION AND PLAN CHECK 89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER A.P.# DATE 3. REC # DATE REC At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. APPLICANT DATE Original -Owner Copy -Building Div. (Rev. 12/96) :ya`�-----vr. r.�,..syy�"w- �,�—'�'q�r .^---• --...� yww..-�j+.. f. � �•� .s'""��~�ir' i I -e.---«..�.-.. �.. -�--. --,- • r AC—AL COUNTY' OF' BUTTE • DEPARTMENT.,OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, .OROVILLE CA -95965 TELEPHONE (916) 538-7541 i_ Al • 'SCHEDULE OF FEES DUE OWNER�!/ . A.P. # T PROPOSED BUILDING USE r M / `l" DATE r<Q REC # DATE REC .y 1. BUILDING PERMIT FEES -- Balance Due ................ $ -- Additional Fees Due ........... $ -- Additional Fees Due ........... $ -- Revised Plan Checking Fee ....... $ 414s • &1S OOL DISTRICT FEES (paid at District Office)—T / is r 'RIFF FEES (paid at Building Division) esidential ........ x $360.00 = $ Units Commercial (sq.ft.)... x $0.03 = $ Sq.Ft. 4. URBAN AREA FEES (paid at Building Division) �..� Residential (per unit).. x = $ c'- :, #Units Amt. Commercial (sq.ft.) .. x =$ , Sq.Ft. Amt. t 5. RECREATION DISTRICT FEES (paid at District Office) ' 6. THERMALITO DRAINAGE DISTRICT FEES $425.00 (paid at Building Division) SRA FIRE INSPECTION AND PLAN CHECK 89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. APPLICANT DATE Original -Owner Copy -Building Div. (Rev. 12/96) RESIDENTIAL 062-50-0-136 91-4332 FULLER, HOWARD CONTR: UNKNOWN BALD ROCK-RD, BERRY CREEK TRAVEL TRAILER UTIL -3- ol ee JOB FINALED (Date) Signature 4al 7 J=OK O = Not OK A Nott ReadyApplicMOBILE MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /"L -ft. / /"Nat. or/ /"L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card 6-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. _ Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK O=Not OK =Not Applicable ar...,,... 1 . - 'RESIDENTIAL (; = Not Ready Date UNDERFLOOR (Plans) OK except k's 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped t 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except a's -16. Water Htr.: Vent -Access -Combustion Air -Baffle ------------------ ----------------------------- 17. Water Pipe: Test & Anchor -Nail Protection -------------------- ----------------------------- 18. D.W.V.; Test -Fittings & Anchor -Nail Protection ----------------- ------------------ --- - -19. Shower Pan: Test. First Floor -Tub Access - ------------------------ 20. Test Tub & Shower, Second Floor -Tub Access - ----------=---------- ----- ----------- 21. Gas Pipe: Size & Anchors -------- ------ ----------------------------------------------- Date Card B-1 Date Card B-1 --------------------- --------------------- ----------------------- Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except q'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. Fastners-Bond Gas & Water --------------------- ------------------------------------------ 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI -------- ---- ---------------------------------- ---- ---- ------------- 28. Subfeed Wire Size / r ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI 29. Range Circ / i ga Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No ----------- ----------------------------------- 30. ----------- - ----- - 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 -------------------- ------------------------------------------- ------------------------------------- Date Card -6- t Date Card -B- 1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except w's 34. A.C. Ducts Insulation & Support --------------------------------------- 35. Vent Fan Exhaust above insulation ------------------------------------------------------ --- 36. Condensate Drain & Overflow: Size & Grade 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -215. outlet ---------------------------------------------------------------- 38. Attic Access & Platform if Furnance in Attic ----------------------------------- --- - -- - - ------------- ---------- -- -- ----- --- - Date Card B-1 Date, Card B-1 --- - -------------------------. --------------------------------- Date Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except N's 39. Sils. 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. Headers & Beam -Size & Bearing t 31 O = jingle & Duplex) Date FRAMING (Continued) - r. •.45. Hangers -Post Caps -Anchors -Connectors 46. Ong. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng. 47. Fir,place Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions _ 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings _ 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits _ 53. _Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows ' -------------- ---------- Date _ Card B-1 Date Card B-1 Date Card B-1 Dater Card B-1 Date FINAL (Plans) OK except N's _ 61. Ext. Steps -Door & Sidelight Protection -,Landings 62. Smoke Detector ----------------------------- 63. Furnace; Vents-Clearance-Comb!tAir-Connector- ------------------ --- - In Garage; Above Floor -Ducts -Meth. 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 -- ---- --- - - -- 7 1. 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 Protection 77. Insulation -Foam -Looked in Attic ❑ Yes ---------------------------------- 78. -Guard -Rails & Deck -Const ruction- 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-Fireplace.-Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing - ------------------------------- - 85. Exterior Elec. Trim: G.F.I. Receptacle -Underground ------------------ -- 86. Ventilation Throughout House ---------------------------------- 87. ------------ -------------------87. Glass Protection -.. -- ------- 88. - ----------- - 88. Corrections from Previous Inspections -------------------------------- ------------------- 89. Gas Test -Meters Tagged: Gas -Electric - --------------------------------- ------ ---------- 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates ------- -------------------------------- Date Card B-1 Date Card B-1 --------------------------------------- - - Date Card B-1 Date Card B-1 ------------------------------------------ Date Card B-1 Date Card B-1 Comments at Final: ------------------ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovllle, California 96985 - Telephone: 918,'538.7541 91-4332 APPLICATIQN AND, PERMIT 11 ASSESS R R NU _ 62-50-136 ZONING i] 11 BUILDING PERMIT OWNER Howard Fuller TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS ' General Deliver , Berry Creek 95916 CONTRACTOR'S NAME unonown TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ {QDC LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 20.00 G Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS #5 Pam R Ln. Berry Creek Permit fee PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. Z SUBDIVISION NAME PARCEL// AP 7 (O Water piping 7.00 Each pas water heater or vent 7.00 USE OF STRUCTURE cler SF ❑ Duplex ❑ Mobi lehome ❑ Other Travel Trailer Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home 06 @ 15.00 45.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities NY Installation❑ Other ❑ Describe work: travel trailer utilities _ Permit Fee $ C0.00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 18.501 18.50 Main service 200ATO1oo0A1 CONTRACTORS LICENSE LAW I declare under penalty of perjury (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 Fl 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) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.&\ OR ACDNS. 1 ACC. BLDGS. / _37.50 3.64sq.ft. NEW CONSTRULTI.OUTLET NON.RESID BRANCH CIRC ITS @ 5.00 (POWER APPARATUS e) SINGLE OUTLET CIR. EX. OCCUp(OUTLETS OR FIXTURES 20 X 76 AL_ AS FIXED APLNS. Ex. OCCUp. OUTLETS P(RESID )REA.1 I 3.00 Temporary service 1 15.00 Mobile Home Facilities 15-001 15.00 Misc. Wiring 15.00 Permit Fee $ 48.50 — 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. VI 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 15.00 Heating Cooling Hood 6.50 I 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 accrueHAz agai t s 'd Count) i cu�as�q� ranting of this permit. Date ,,Z gnature 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.D Mobile Home Installation Fee S J, Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 12 .50 F E IMP Fiyoo —i`-- coF PARCC PD Is u This permit is hereby issued under the sions of the Butte County Code and/or work indicated abgye for which fees R OF PUBLIC By E PE EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date 04-J. F i 103625 Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD-APPL I CANT 0�, oc Au - COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville. California 95965 - Telephone: 916.'538-7541 APPLICATION AND PERMIT PERMIT. NO. P1����z ASSESSOR PARCEL NUMBER �(�,.(, ZONING BUILDING PERMIT OWNER Gw TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 6&4j&� ae%'vete 6evr oe CONTRACTOR'S NAME U&rMWAJ TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER Al M-�AILING UNKNOWN Total Valuation $ Filing Fee $ 15.00 LENDER'S ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING AD ESS d!L aim Permit fee PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other %_T SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home @ 15.00 700O TYPE OF WORK NewU Addition❑ Remodel[] Utilities Installation[] Other[:] Describe work: —�— U $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600v OR LESS 200A OR LESS 18.50 Main service 20GATO t000AI 37.50 CONTRACTORS LICENSE LAW I declare under penaltyof perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification F-1 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) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST./ DWELLING OCCUP.s:\ DR ACDNS. l ACC. SLOGS. // 3.6C sq.ft. NEW RESID, BRANCH NON•R ESID BRANCH CIRC ITS @ 5.00 /POWER APPARATUS 6 I SINGLE OUTLET _ R. / OUTLETS OR FIXTURES EX. OCCUp\J. 20 76q FIXED \ EX. Occup. OUTLETS (RESID )REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 9 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. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling Hood 6.50 I Ventilation permit Fee $ L 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 consequence of the granting of this permit. X Date Si nature of Applicant — Owner g pp ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct - ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST TYPE TOTAL FEES 2 ✓� HAz 1 0 111 I IMP I FLOOD I COF I PARCEL PO Ho ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. J 'NHITE•O.P.W.. TELLOW-As r»OR_ PINK•INSPr ETOR_ an, nr.IRnn.APPLI CANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET • Permit No. OWNER _ f ow,41zl) ude A. P. No. Cs72 -SOD — � 3� Proposed Building Use Building Inspector F—'V Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. Sanitation approval from D/LUv, 'lam Health Department 2— z D -'9r 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... ZP18. Improvements may be required. Contact Land Development Section DPW 19 Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. equest to Building Inspector 21. Contractor's license information.(No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner o) ..... "LV24. Recorded copy of Agricultural Acknowledgment Statement ......... rZ12019r 25. Letter of signature authorization ................................... 26. 27. (Date) 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 Appl ican Date /-a- /g—rr'J Copy of !-.az-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By 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---inaiI—counter by Contractor, designer, owner, was advised of above required data by—phone —ma II—counter 4.0 Plans checked by Copy—DPW Date Plans approved by _Sets of plans on hold in File cabinet AP folder date date Date TO: Building Department FROM: Encroachment Permit Section RE: 'Diiveway Clearance �10 wG�✓� �c� ,r d owner location AP A Driveway permit !/LavtP Q ���� has been issued for the above property. n b e ,3; 6",-A date sign re 10 Buildinv Department 4FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved .for: Sewage Disposal x Water Supply Hold final for: Final clearance O.R. for: Clearance or, --_._ ro o e. NOTE *** Water Supply Water Supply Other /G{,% -p— anitarian Date t ,F. 1 f I , 1:+ APPROVED Butte County Env' men Health Da----- -------- a r, APPROVED Butte County Env' men Health Da----- -------- a .A, . satbaek of 8 f't. 8�o� tie co' ext' lines anda. setb&C er of Ei0 gt the road Of centerline aha31 be cle&er / etzv(jture8 or equipment eXOSPt 5 p .U�i to a ft. save overbw& R) VEvu 7 ti Thte eet of Plane and speoMoations W=tbe ADL OA the job at W Wines and it is unlawid to m"0 any ebWas or anemone on eatme without �' ofButtem tW �' est ofpupye NOTE: All Materials & WorkmanShip Shall Be In ACGOrd&nc8 with Recognized Good Practices and of a Quality Prescribed for the Speoifled use in the Uniform Building, Plumbing & McQbanlcat Codes and the National BlectMaed Code. C- dUILDING DEPARTMENT �PPPOVED Il -4 Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT 91-52410 FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement ,be recorded prior to issuance of a buildd:ng permit. The property described herein is adjacent 91-032410 1 Ree Fee to land or included within an area zoned 5.00 for agricultural purposes, and residents I CashRecorded I 5. 00' of this property may be subject to incon- Official Records ec veniences or discomfort arising from the County of I use of agricultural chemicals, including, but not limited to herbicides, pesticides, Butte 1 Candace J. GrubbsI and fertilizers; and from the pursuit of agricultural operations including, Recorder I but not limited to cultivation, plowing, 2:13pm 20 -Dec -91 I XX 1 spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All 'that real :property,_.situate in the County of Butte, State of California, desr_ribed as follows: - - PARCEL 2, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON NOVEMBER 27, 1972, IN BOOK 44 OF MAPS, AT PAGE 64. j Date: State of On this the day of2,,,,:& e. C , 19CII, before me, the SS. undersigned Notary Public, personally appeared County of`_j,-4J:-_f ) 14 r7 w c1.1a V1. V w 11 e e— a■■■■■a■■■■■S Personally known to me. M Proved to me on the basis ■ DONNA CROSBY ® of satisfactory evidence. °■ ;-�, NOTARY PUBLIC -CALIFORNIA :to be the person(s) whose name(s) Is ■ �,.- Butte County ■subscribed to the within instrument and acknowledged that _ S My Commission Expires Aug. 3, 1992 executed the same for the purposes therein contained. IN WITNESS ■■■■■sa■■■■■■■■■■■■■■■■■■WHEREOF, I hereunto set my hand and official seal. Present A.P. No.� Notary Public END OF DOCUMENT T, Date: State of On this the day of2,,,,:& e. C , 19CII, before me, the SS. undersigned Notary Public, personally appeared County of`_j,-4J:-_f ) 14 r7 w c1.1a V1. V w 11 e e— a■■■■■a■■■■■S Personally known to me. M Proved to me on the basis ■ DONNA CROSBY ® of satisfactory evidence. °■ ;-�, NOTARY PUBLIC -CALIFORNIA :to be the person(s) whose name(s) Is ■ �,.- Butte County ■subscribed to the within instrument and acknowledged that _ S My Commission Expires Aug. 3, 1992 executed the same for the purposes therein contained. IN WITNESS ■■■■■sa■■■■■■■■■■■■■■■■■■WHEREOF, I hereunto set my hand and official seal. Present A.P. No.� Notary Public END OF DOCUMENT "I'li i "') os 11, ;�,; - I C