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Home My WebLink About063-050-018T.� 063-050-018 PERMITN95-2790 GARDNER, Walter & Marci Tippitoe Ln., Forest Ranch V11U Cont: Illumination Electric Ele for Well & Future Lot Development 063-050-018 06-0594 MCCRILLIS, DAVID 4909 TIPPITOE, FOREST RANCH, n CONT: JOHN MCCRILLIS //r✓�Y NSF (GAR, OPN, COV) � B' Mk 5 Butte County Department of Development Services. o" Te_ �aE✓. N O T E 7 County Center Drive, Oroville, CA 95965 (530) 538-7601 vn v.buttgcoiintyneyoos ,// O'K RESIDENTIAL 1APN: Permit No. Owner. 6 -050-018 06-0594 4 - 1 IMCCRILLIS, DAVID ., Site Address: 4909 TIPPITOE, FOREST RANCH z Contractor. ) CONT: JOHN MCCRILLIS NSF (GAR, OPN, COV) Type of Permit: (tl ` 7/17`04b . E. r r OFFICE COPiA.) �� I 4 Address _. GAS - i Meter By Date A ELECTRI I` Meter By Da�j Iry Grzf--,g-2ALD SPECIAL CONDITIONS [eS�A CHECKED BY ❑ FLOOD CERTIFICATE EQUIRED �~ O FIRE SPRINKLERS REQUIRED s ❑ SPECIAL INSPECTION ITEMS _ Q VERIFY ' Q USE PERMIT CONDITIONS 0 SUBSTANDARD HOUSING LETTER T ` Q ENCROACHMENT PERMIT 0 (� NSI I .�• r UtNVHl' •"OFFICE COPY- . {' O /J n� Address_ 41 t ( GAS Meter By Date G� ELECT r i Meter B / Date4—_6% DATE JOB FINALED: GRENATCJ4�'a OK = Not OK RESIDENTIAL (Single & Duple)o DATE 1UNDER FL00y/ DATE IpLIXOBING l _ �YCo' Setcks-Easements-Flood- bpe Q�Ftg in; Soils-Elec Grnd Ftg Dpth g Garage; Soils -Steel -Flet Grnd Ftg Dpth. 4 Ftg Porches/Decks; Soils -Steel Ftgl Dpth ' 5 -& mmwalls Main; Steel-Blockouts-Wrapped Pli4 _ ZSt�e walls Garage; Steel-Blockouts-Wrapped Fiold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test tl Wtr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd 13 Plenums & Ducts; Clrnc-MaterialSupport-Insultn 14 Girders -Sills-Anchr Bolts Joists-Vnts-Cripples 15 Acc & Vntltn 16. Insulation .� DATE F R" I N G 5jfls Proper Materials & Anchrs WWVV Its S ds -Nailing Spacing & Braces -Plates -Sound a g Walls over Girders & fir Nailing ft Stop in Walls (rat proof) F� Stops, Furred Ceilings -Stairs -Chasers -Tubs Y2'H�aders & Beams-Sz & Bearing 23'Hangers-Post Caps-Anchrs-Cnnctns 3�4�,�eeiling Joist-Rftr Ties -Purli n -Roof Brac-TrussShthg xYFrplc Ties or Type A Flue-Frplc Throat Clmc 2'8_'l`Cttic Acc; Sz & Rmx Prtctn-Draft Stop4ns Baffles 4�s Wndws or Exiting Doors -Sill Ht & Dimensions -� 28"Garage Fire Prtctn Framing -RC Channel 20A�j prty Line Firewall & Opngs 3g xt Doors -One 3' -Check Garage 3rd Story, 2 Exits 3#�tairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc S- lazing Area -Glass Prtctn-SkyLts-Plastic Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnls 38 Insultn-Walls-Ceilings 39 Infiltration -Walls -W ndws ._L� Il(rci�o s DATE ELFjCTRICAL 4 Fxtr & Tmsfrmr Clrnc4ns Prtctn 4VElec Rcptcls Spacing-Lts & Switches at Doors 42"Sz Boxes & No Of Cndctrs Stapled mex Installed Close to Edge of Studs & CJ Grnd made up w/Mech Fstnrs ndn lectrode Bond Gas & Wtr pinc Cires in Ktchn & Cndctr Sz GFI uWeed Wire Sz W ❑ CU or ❑AL AWire 9. ❑ CU or El AL ange Circrc A =7;! ga MCU or ❑AL Oven Circ ga CU or ❑ AL Insulated Neutral ❑Yes ❑No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 y( lothes Closet Lf-Shwr LtSpa Lt qSmoke Detector tr Htr, Vent-Acc-Cmbstn Air Baffle _ 5 tr Pip - es Anchr-Nail Prtctn 5 WV• st F' ' gs & Anchr Nail Prtctn OC g hw an; Test First flr-Tub Acc 57 TT st Tub & Shwr, 2nd flr - Tub. Acc 58 Gas ipe; Sz & Anchrs 59 F" a Sprinkler; Test 3 d Yard Gas Piping aL0.11,�f o'er m URIC IM Eg.-KAN I CAL &�4-'A'�C cts Insultn & Support 6�Vee Fan, Exhaust abv Insultn oDOensate Drain & Ovrflw, Sz & Grade 64 -Furnace -Vent Acc-Comb Air RtrnNent 115 Outlet 65 Attic Acc & Pltfrm J'f Furnace in attic o'er 0 p 0\ uAlt FIN S ps-Door & SideLt Prtctn-Landings oke Detector Furnace Vnts-Clrnc-Comb, Air-Cnnctr Ip�arage; abv-flr-Ducts-Mech Prtctn room Exiting G ath Fxtrs & Tub Acc-Spa Z+'G� rc Fault let m & Subpnl, Breaker Sts & Labels s, Guard/Handrails Fr or Stove, Clrnc-Hearth e utlets at Wood Pnl, Int & Ext 7 c xtr & Appinc; Grnd-Air-Gap-Cooking Clrnc I�utlets & Rcptcls at Ktchn Counter arage Fire Door, Swing -Landing -Closure 9 ACED t in Garage -Damper 8 4tr Htr; Vnts-Clrnc-Com Air Cnnctr-PRV; abv fir Mph Prtctn; LPG Appince Undr House 3" drain I�m� Elec & Mech Eqp Listed for Lottn 8�t&cRcptcls in Garage (GFI) Romex Prtctn Ins n -Foam -Looked in Attic uard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood-Eartt 86 Clrnc Drnge Planters ❑ Yes [::]No 87 Stu -Brown-Finish /C �n�tt Dscnnct, Elec Plmb 68'V v Roof, Plmb-Appinc-Frplc-Clrnc to Opngs JtyWell, Dscnnct, Elec, Plmb t Elec Trim, GFI Rcptcl-Undrgrnd 92 V n thru House I Prtctn UyG� coons from previous Inspctns Gas Test -Meters Tagged, Gas-Elec 96 W�Sewer Cnnctd-CIO to grade -HD Apprvl .WE�efgy Cmpinc Cert -Other Certs f -t. Address Posted 99. Fire r' kl ra�j. OK M-A:NUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION Lj SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap . Nat 0 or LPO Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cnfnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE D E C K S'C O V E R S`C A R P O R T S `GARAGE S 1 Zoning -Setbacks -Easements 2 Ftgs; Soils-Sz-DpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills -An chrs-Stu ds-Rftrs -Trusses 9 Siding; Nailing -Veneer -Stucco -lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls DATE IPOOLS 1 Setbacks -Easements 2 Soils; CompactionStructure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Encisrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Egp-Htr 8 Elec Grndng; Eqp w/S' Crcltng Eqp-Pool Ightg Bokes-Enclsrs=pnlboards4risultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide 40, 0 Pool Drawing BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (630) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. License Class: License Number: Date: Contractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its Issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Protesslons Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than rive hundred dollars ($500).): d1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If however, the building or Improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or Improve for the purpose of sale.). PERMIT NO. BP060594 Issued Date: 06/05/2006 APN: 063-050-018-000 Site Address: 4909 TIPPITOE LN FRN Map Index: Description: nsf (2794), gar (512), cov (400), open (640) Owner: MCCRILLIS, DAVID AND LISA PO BOX 243 FOREST RANCH, CA. 95942 530-343-5530 Applicant: MCCRILLIS, DAVID AND LISA PO BOX 243 FOREST RANCH, CA. 95942 530-343-5530 O I, as owner of the property, am , exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business _ and Professions Code. The Contractors' Stale License Law does Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). O 1 am Exempt under Article 3 of the B�isss/aanndd Professions Code Date: l.?�(��Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penally 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. O 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is Issued. My workers' compensation Insurance carrier and policy number are: License #: Architect: PIETZ, GREGORY A. Engineer: Carrier: Total Square Ft: 4346 S.F. Valuation: $206,698.00 Policy #: Census Code: (jr I certify that in the performance of the work for which this permit Is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued (Sec 3097 Civ.) Name: Address: x.54 Iq SgCp #�� 455Co2�1 �-S-OCc 'mit Is hereby issued under the applicable provisions of the Butte County Code and/or Ions to do work Indicated above for which fees have been paid. Dale: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification In accordance with Section 19827.5 of California Health & Safety Code Is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above Information Is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and. state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. thereby authorize repr@seehhtattiives of Butte lCounty tno enter upon 1the above mentioned property for inspection pu\\ - c Print Name: 1 �/iu-J Li U"l�L-�, ll"� Signature: ) Date: O Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit u1 -Ib -u4 pg i BUTTE INTER -DEPART'MENT'AL, MEMORANDUM COUNTY JUL 18 2006 TO: BUILDING DIV SION, OVILLE DEVEr.OrriErr7 SERVICES FROM: � i , ENVIR. HEALTH, CHICO DATE: _ RELEASE ENV. HEALTH HOLT) ON BUILDING FINAL FOR: O IC-NAlVIE: - �i�� l S __SEPTIC': r��WELL: AP#: ADDRESS/LOCATION: Comments: GUmemos/eeleasehold CORRECTION NOTICE PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. z FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 COUNTY OF BUTTE ; BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. z FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 . . . . . . . . . . . . . . ...rv` COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive - Oroville, CA - (530) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. " A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. Ify have�a'ny questions pertaining to this matter, or need additional �. explanation, please co ct the/Building Inspector as indicated below. I � IJ Y• r i=q Date � t Inspector REV 4/05 Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive - Oroville, CA - (530) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you h ve a questions p aming to this matter, or need additional explanation, please cont tht 'ng InspectorAsindicategf below. I'' Date 20-0-7 Inspector ' (� REV 4/05 Phone it FOR RE-INSPECTIONCALL: 538-7636 OR 891-2834 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive - Oroville, CA - (530) 538-7541 CORRECTION NOTICE ffll��916 /S 06-(")5 C/ OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is complete)1. If you have any questions pertaining to this matter, or need additional explanation, ple,Ose contact the Building Inspector as indicated below. /2-7 _5/WA2 .. �%�/ �-� .✓l, i ' �% _ /1_ _ r_ i.n� //yS//!G 14.5/.0 U I/ L= 6111 0217 zG Date" l d ( Inspector REV 4/05 Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 I AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2006®0028515 Recorded I Official Records I County of I Butte I CAIrm J. GRLIBB5 1 County Clerk-Recorderl I I 010:14AN 05 -Jun -M I REC FEE 13.00 CW Page 1 of 3 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: �Irr A 44---YeI' t -d Date State of California County of `-bLk PROPERTYzCERS: . � e L i s a known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s)'(/are subscribed to the within instrument and acknowledged to me that *sWIthey executed the same in WIS 4/their authorized capacity(ies), and that by K/fWr/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature Seal:NBtrCYlAAON Cortm*don 0 0 D kft cow* NO" PUlft - 00Wft A.P. a lam! 63 - 0,5-0 — lly E Camm.Ad17. l BY .Mid-Valley.Tide .& .Escrow Corn any. ::AND-VJHEN-REC-ORDED-MM--T,0: David- C--McQi111s-and-,Usa.A.- McCriffis -P.O.;--BOX-243 +0rest"Ranchi-C-A-95942 I -Recorded . Official Records CountWTy Of TE --CWDAM J. -61%m ,Recorder RUSEVARY DICKSIM Assistant 091WM 05-11ay-M A .. RM,FEE Ala I TAX 143.00 I &W*va 'I'Page'l of 3 ..A.PiN.*...,063-050-018-.:.Oo0 8je,No.:.,04Q1-183295.0.(DH) GRANT DEED 11w urwasignkitrantm(i) DmWi(sy'WMMWMY'YRMgER'rArlIL4"0,:CMIR" FRTarr $0.8% 'x "W"Putm! an the cormeridoirwftd-v&eefpmpertycomW4, OR U=PuW of the considwallm orhl) vakmIess value orlim muter erKun*anm remmrdnq at time d,sde, j x unW=Mmtedam. ( ) CftV8f,and -FOR-A-m-E•-E, CONSIDERATION,. receipt of-whic-h-4s;.hereby--ackriowledged,-Manfie-M....Gar�dner,•a,marrW 'Woman astervale 8nd-SeParate.:PrapertVry ft.-acqulmdAftas Mw.g'e,44.,Gardner,-.as!-herseparate -wvperty hereby GRANTS to DaVld C. McCdll!S aril Use A. McChWar'"hus6and and miffe asjdint e -the.1blJowing.descr1b d propert e yinthe. unfricoMorated area of, County oflguttip State of ffa f Cal mla -PARCEL-1: L -BEING-LO.'1;-As.HDWG ON --THAT.--CER*.AZ.N,PARcEL.mAp,.;.RECGRDW...,;NTHE,OFFIC-E, OF TW -R' ECO RDER,eF4-H9- -QUAftTER-OF�%EC-Tj[ ' PA -E(4)-23dMD'ZEING-A: ORTION-OFTHEWUMWEST ON -3, T-OWNSHM 23'NORTH, RMGE'--3--EASr,-M-D,;9.-& f4,--0E1-NG- MORE FOUOW&- Mail Tax-SWments To: SAME AS ABOVE P3V.: 063-050-018-000 Grant -Deed - continued -FIe:No.:0401-1832958 -(DK) __. -pate:=04/13-/2005 • BEGINNINGS-ATTHE-NORTHWF..ST-CORNERt;OF SAID•LO.T1;:THENCE FOLLOWING,ALONG-THE -.WESTERLY-BOUNDARY LINE.OF.SAID-LOT.I,-ALONG-.THErENTERtiNE=OF.A.60:FOOT..ROAD AND PUBLIC UTILXTY=EASEMENT, SOUTHERLY -ALONG -THE -ARC OFA 300,FOOT•RADIUS EURVE; C®NCAVE 4O THE WEST,THROUGH A CENTRAL -ANGLE -OF 1G -DEG. -3V,03", -FOR --AN -ARC-DM- ANCE OF-55:42°FEETTO•THE-END OF:SAID CURVE; THENCE -SOUTH 25-DEG:52'.#04" -WEST, fOR-A-DISTANCE,OF 139:67 -FEET TO-THESOUT}fWEST~CORNER OFSID•L-OT-1; YHENCE-FOi�OWING AiONG THE-50UTHERLY-BOUNDARY-LINE -OF,SAID,tOT '12, NORT'H•78 -DEG., 56' 21"'EAST,'FOR 756.07-FEET-TO'A 3/4INCH-IRON-PIPE TAGGED Li& 3634; THENCE 'CONTINUING,NORTH 78 -DEG. 56' 21".EAST'ALONG THE SOUTHERLY BOUNDARY°LIE-OF 'SAID' LOT 1'FORt33,25.,FEET -TO'*POINT'LOCATFD IN'TH>E'CENTERLINE-OF-A-SMALL CREEK `AND'AL'ONG-THE`EASTERLY'9OU`NDARY LINE --OF THE' LAND-DESCRIBED-INTHEZEED TO WIL•LTAM'E.-FITZGERALD,`ET UiC;-DA7EDFEBRUARYT2,-1971'AND'RIECOROED`MARCH-2, `1974;114 `BOOK -1650,' "PAGE-700i "CREEK CENTERLINE'AND THE•EASTERLY'BOUNDARY-OF"SAID'FMGERALD-PARCEL, 'NORTHERLYT6THE`NORTHEAST'CO•RNEROF SAID'LOTS,-SAM'POINT'BEINGTAGGED- S. '3634,'AS.SHOWNON-SAID'PARCEL-f4AP THENCEFOLLOWINGALONG'THE*NORTHERLY -BOUNDARY"LIN'E'dFSAID-LOT Y,'SOUTH'WtiEO.'79'"23"WEST,"FOR"942:3,tFEET TO THE TRUE POINT OF BEGINNING. PARCEL II: A RIGHT OF WAY FOR ROAD AND UTILITY PURPOSES OVER A STRIP OF LAND 60 FEET IN WIDTH, THE CENTERLINE OF WHICH IS DESCRIBED AS FOLLOWS: COMMENCING AT THE NORTHWEST CORNER OF THE SOUTHWEST QUARTER OF SECTION 5, TOWNSHIP 23 NORTH, RANGE 3 EAST, M.D.B. & M.; THENCE SOUTH 0 DEG. 21' 39" EAST, ALONG THE WEST LINE OF SAID SECTION 5, A DISTANCE OF 1,073.41 FEET; THENCE SOUTH 68 DEG. 05'42" EAST A DISTANCE OF 743.85 FEET TO'THE POINT OF BEGINNING FOR SAID CENTERLINE; THENCE NORTH 25 DEG. j52'040 EAST.,, 609.67 FEET; THENCE ON A CURVE TO THE.LEFT.WITKAMADIUS OF_300;F.EET,THROUGH.A CENTRAL ANGLE OF 86 DEG. 33' 21 Aft .ARC.DISTANCE-OF.453.21,EE M THENCE N.ORTN-60..OEG. ,.41':17" WEST, 623.91 FEET TO A..POINT.OM:_.TliE;EAS[ERLX_$OtJA1DARY LINE.OF.TJFiE.LAND..QESCRZOEMIN.THE_DEED TO XRE .000NTY.OF.bUT_.E,.RECOitDEDS EMBER,20,..1961,..IN.BOOX.1139, PAGE.453,-OFFICIAL _RECORDS, AND.THE..END..OF.SAID:.CENTERLINE. ,EXCEPTING THEREF tOM.ALL THAT•PORTION-LYING.WSTHIN-T.HE.,BOUNDS OF;PARCEL.I, - DESCRIBED:HEREIN. Dated: 0WIT12085 MargiGardner BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 638-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. License Class: License Number: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): dI, as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). PERMIT NO. BP060594 Issued Date: 06/05/2006 APN: 063-050-018-000 Site Address: 4909 TIPPITOE LN FRN Map Index: Description: nsf (2794), gar (512), cov (400), open (640) Owner: MCCRILLIS, DAVID AND LISA PO BOX 243 FOREST RANCH, CA. 95942 530-343-5530 Applicant: MCCRILLIS, DAVID AND LISA PO BOX 243 FOREST RANCH, CA. 95942 530-343-5530 O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project.(Sec. 7044, Business and Professions Code. The Contractors' State License Law does - Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Busi /s/s and Professions Code /, Date: i P�LL_(f Owner: � i� ' ! ^; WORKERS' COMPENSATION DECLARATION I 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 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Policy fdr I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply wwiiitth� those provisions. Date: '/ Q c Applicant: WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. License #: Architect: PIETZ, GREGORY A. Engineer: otal Square Ft: 4346 S.F. Valuation: $206,698.00 Census Code: 3�1f�-OCA �C�2y3.33 #� 4 5r�Co2�i CONSTRUCTION LENDING AGENCY This I hereby affirm that there is a construction lending agency for the Res performance of the work for which this permit is issued (Sec 3097 Civ.) By: Name: Address: is hereby issued under the applicable provisions of the Butte County Code and/or to do work indicated above for which fees have been paid. IRES ON: O 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. O Attached are copies of the required E.P.A. notification forms. 1 hereby certify that I have read this application, that the above information Is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and. state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize repr$sehtatives of Butte lCounty �tgo enter upon the above mentioned property for inspection pu Print Name: /� J . LL U"l.�(� c. I l"� Signature: Date: 6-5--o v5 --o ❑ Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 r 1 �OTTF BUTTE COUNTY O O DEPARTMENT OF DEVELOPMENT SERVICES O i 0 BUILDING PERMIT APPLICATION O O AND SUBMITTAL REQUIREMENTS p _ r p 24 HOUR INSPECTIONM OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 O OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION COtf IN Website: www.buttecounty.nettdds "PLEASE PRINT CLEARLY" OWNER Last Name fi�nn^^ YI' G Cr j �1' S irst Name ave Address ��e i t—Z, City G S r State C Zip 5 Phone 3'505-A0' 530 Fax E-mail APPICANTVG44TURE X � For office use only: CONTRACTOR Name �-1►'e O r' ��e i t—Z, Address —7- Address PO City 0 !ao City Phone State , Zip g Phone ¢:k 6C State License Number M¢� G2(2�C E-mail °<' Lic. # D Class APPICANTVG44TURE X � For office use only: ARCHITECT/ENGINEER Name �-1►'e O r' ��e i t—Z, Address —7- /� j 1'\ t U L, ,Cl o A,, City : co State C-,,. zp -, r, q2 � Phone 9 4, .% 1 Fax 19 9 4 E-mail re ¢:k 6C State License Number M¢� G2(2�C APPICANTVG44TURE X � For office use only: APPLICANT NAME Name n �Jav;cl Address 0 o aye City Yes Staten Zp 6 Type Const.' �-1 g 2 Phone 3 _ 5 - Fax 3e/3 — ,$_ 32 E-mail °<' Date Approved: A) APPICANTVG44TURE X � For office use only: AP#0& _0 01 Zoning City l=creta iia Flood Zone WORKER'S COMPENSATION SRA Yes No Occ. Name Type Const.' Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS k'APr1R1%AC1R1 in nitjr2 Fr)RMS\R1doAnn1SuhRamtc.doc PERMIT NO. -�q LOCATION AP#0& _0 01 Property Address D 9 ) ; e City l=creta iia Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit. issuance. LENDING AGENCY Name Address Paoe 1 of 2 Description or Scope of Work: 2/y 279v sit an��(6 yam) Sq. Footage ❑ Structure Built without Permits ❑ Proposed .Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received b Amount: / Bldg L q ,�Q� � — SRA Receipt #�pi7 ' Sheriff SMIP bV '0Other Total REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxesl ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bidgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate: (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only).. Remaining items needed to issue the permit. Additional items may required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ .11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538.7541. EXPIRATION OF APPLICATION —.�- Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made. if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSMILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA .95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: �`''/ S ASSESSOR PARCEL NUMBER 06 3�(✓37n rO/V8 Proposed Building Use: / Y Permit Technician: Date: 3-16-06 Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. IN 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. I N 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. Ki 3. Engineered plans, 3 or 4 sets; with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl \moi / 5. Letter from Engineer or Architect for truss design review. ' f r4 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Hazardous Material Form ❑ 12. Acknowledgement of building permit application without required clearances. ❑ 13. Other \ Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) I A) 14. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 15. Fire Sprinklers............................................................................................ ❑ 16. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... ❑t � Erosion Control Plan Required........................................................................ �j 19. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ . City of Chico Plumbing permit........................................................................ \ ❑ 21. Site plan and business license approval from the City of Biggs ......................... 22. California Department of Forestry plan approv4_QT9id`Sent bySr_f1_14T ............. 23. Planning approval for (A) Use: (B) Parking: (C) Parcel Check:........... ❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 25. Fire Marshall Review (commercial projects only). Sent by:.. ...................... 'Ot Al 26. NPDES Form............................................................................................. �727. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... \ ❑ .29. Worker's Compensation Carrier and Policy Number .......................................... X71 t4 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ Letter of Signature authorization.................................................................... 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... _ .❑. 36. Other: ❑ 37. Other: When issued Telephone y �- S�3O and hold for pickup. I have been informed of the a , ve items and req ifements for obtaining a building permit. Applicant: r ' f Date: l �' � l o �` OC.n 1. Index permit application for the above items numbered: A r0 Plan Check etter 2. Additional ' res quired / Contractor, esign, o ner was advised of the above data by ❑ phone, mail, ❑counter, by Date: Contractor, esigner, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date. Structural approved by: Date: Note transfer by: Date: Yellow: Building Division K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 www.buttecounty.net/dds PHONE (530) 538-7541 FAX 538-2140 RECEIPT OF FEES SCHEDULE - RESIDENTIAL Owner me crillis Application Date 3/16/2006 1 2 3 4 5 6 7 7a 8 9 10 APN No: 063-050-018 Permit No: BP 06 0594 BUILDING PERMIT FEES ESTIMATED AT APPLICATION $3,376.32 Plan Check portion of Permit Fee ~ $1,350.53 FEMA Y FI d EI t;IR $109 98 0 Permit Type: nsf $2,025.79 Balance of Building Permit Fee oo eva on evlew SRA* x es Yes Fire Plan Check - Non -Refundable $95.00 $95.00 _ (State Responsibility Area) Building Inspection $109.98 $109.98 - $204.98 NON-REFUNDABLE portion of fees due at application $1,445.53 FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION FEES (BELOW) DUE PRIOR TO ISSUANCE OF PERMIT Balance of Building Permit Fees (from No. 1 above) SMIP* - Strong Motion Instrumentation Program (Enter amount from permit system) Additional Plan Check Fees (NON-REFUNDABLE) Other*: Other*: IMPACT FEES - RESIDENTIAL* Applications After 2/14/05 u Per Dwelling SFD Per Dwelling MFD Per County 1 4096.871 3071.14 Chico Urban Area 5372.091 3995.45 EI Medio Fire District 3128.311 2297.77 North Chico Specific Plan SR -1, SR -3, SR-1/PD 7938 .531 6757.08 �c R-1 0 o R-2 R-3 8031.53 6850.08 7541.531 6360.08 6780.531 5599.08 Processing Fee is automatically added to impact fee total 1 WATER TENDER FEE (Not collected when impact Fees Applicable) Enter Bat.# DRAINAGE FEES* CHICO STORM DRAINAGE MASTER PLAN 770 Butte Creek 771 Comanche Creek New construction, vacant land, on 1 acre or less - Enter 1 or less acre value 772 Little Chico Creek 773 Big Chico Creek 774 Lindo Channel 775 SUDAD Ditch 776 Mud -Sycamore Creek 777 PV Ditch MH 3117 $9?555`.51 RECEIPT DATE Tech/Asst $2,025.79+a g cn '&0& k "$20.67 X(�. 6475.49 RECEIPT DATE Tech/Asst $100.00 $4,196.871 5G,2� 6; -S -0t4 6, $200.00I Kourtni 10a More than 1 acre, existing buildings - fees to be assessed by Public Works Fee Determination Sheet Needed - Enter amount determined by PW 11 THERMALITO DRAINAGE AREA 1 $652 Maximum Per each new living unit on existing lots where full drainage fees have not been paid 11a Temporary Dwelling 1 $130 At time of building permit $130 annual renewal fee for first 4 renewals. Not to exceed $652. PROOF OF PAYMENT OF FEES (BELOW) MUST BE RECEIVED PRIOR TO is completed for applicant to take to respective district office. 12 SCHOOL DISTRICT FEES*Ghico-Unified-Sdfool=DlStrICt=062 12a RECREATION DISTRICT FEES* $8,069 $8,792 $6,596 $8,139 $6,975 $6,070 RECEIPT DATE Tech/Asst $8,603 OF PERMIT. Forms will be prepared after plan check At the time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. Applicant: Date: --s—/6-06 Pursuant to Govern men code Section 66020, you are he4otfie=d=those Items followed by an " " may have been imposed on your project. You have 90 days from the date of approval of the porject or from the impostion of the above referenced items during which you may protest. The requirements for a protest are specified in Goverment Code Section 66020(a). K:/Building/Forms/Schedule of Receipt Fees Residential 121205 � pftTMEIyT O� r/ < SP 17— o��\, Department of Public Works C o u m y o f B u t t e ° ° ' J. Michael Crump, LAND DEVELOPMENT DIVISION p '/ Storm Water Management Program /V Director 7 County Center Drive "c"a-177- `l�C� 5 Oroville, CA 95965 v@Wov` (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE1 Project Description:i S Y Project Location and/or Parcel Number: y ` oP 17,/�oi P 'Ta ,- Z_Y1 0(O By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when' combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law Signed: Title: e - Date: -S Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 OWNER -BUILDER VERIFICATION Attention Property Owner. - SP41 a&_ &s9,�r An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: YES.[ ><] NO [ ]. 2. I HAVE [ j( ] HAVE NOT [ ] signed an application for a building permit for the proposed work. 3. I have -contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: c PROPERTY OWNER: DATE: 1-- /6 — O 6 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. Butte County Department of Development Services uTr ADMINISTRATION 'BUILDING* GIS *PLANNING 0,Wz 7 County Center Drive ° Oroville, CA 95965 (530) 538-7541 Telephone CD (530) 538-2140 Facsimile U OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or. through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Scott Rutherford Chief Building Inspector NOTE: This Owner -Builder Information is required by Section 19830 of the Califomia Health and Safety Code. AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2006-0028515 Recorded I Official Records 1 County of I Butte I CANDACE J, 5RIBSS I County Clerh-Recorderl 1 I 010:14M 05 -Jun -2006 I KC IEEE 13.001 C!d Pape 1 of AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: �'te 4 44aelt t -J o2�—Q Date l PROPERTY�OWNERS: S a State of California County of Zi k On before personally aj)peared UI' W -d [T1CUyi (I iS 0Lf1Gi personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s)'K/are subscribed to the within instrument and acknowledged to me that WsjLe/they executed the same in WlWr/their authorized capacity(ies), and that by K/f*/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature Seal: C.onu 1 0 1431027 �r � - caftnft ff f cY MVComm. Eq *es 17. zoo� A.P. # J > _>0 ra'�' BUTTE COUNTY SCHOOLS IMPACT,FEE CERTIFICATION FORM (One form per Building) School Districtn9 Sy Buildi Department. No. • y / � A.P. Number k "1' U�y • �/� Jurisdiction: Q City County Property Owner C�- MCI ��( ) , ``, S Property Location/Address U 0-e • Fyfe GY1c Subdivision Lot No. Residential Development Q Sq. Footage 1 No of Living Mobile Home Addition/ 'Supplemental to (Group. R) Units Installation Conversion Permit # '• :........................................................................................ *(No foundation inspection) Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial 0 0 New Addition Building Department Representative . District Identification No._i School District certifies that Sq. Footage (Including Exterior Roofed Areas) 5.31 • �C� Date (Applicant) (Street Address) (Phone Number) (City) (State) (Zip Code) - has complied with therequirementsof Resolution No. representing pC 1 square feet. School District Paid by Check # Remarks: Q� • v by payment of $ B 2926 $ ULL MITIGATION $ Date / /YoHa: You may protest the Imposition of the fees Identified above by submitting a written protest.to the District. In compllana with Government Cods Section 66020(a), within 90 days from the date fees ars paid. Failure to submit a timely written protest will prohibit you from challenging the Imposition of the face In any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fes Certification Form, tin School District is notified by the applicable Local Planning Agency that this project Is be" reMswed under the California Environmental Quality Act (CEQA), this project may be subject to additional school ties to futiy ntdp% Its Impact on the school districts schools. White (school district), Yellow (building department), Pink (applicant) mor nift (3M5 SITE PLAN REVIEW APPLICATION Date:-C�/�� AP#' Permit Number (if applicable) Bin Number APPLICANT INFORMATION Parcel Size: Id 1)9 �7 Owners Name: ,D�y Owners Address: �o.%i �`�--moi i" �✓f��%>, �C� Telephone No.: 'Email: Email: Situs Address: IeI40 9 Proposed Use: Residential New Single Family Residential ❑ Single Family Addition ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition ®tljer ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel Septic ❑ Well Agricultural Exempt'Building ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A ❑ Other: Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SER VICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Site P n Stampe Approved i By Date ,WtV . too ?off Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑Nitrate Action Plan (See Environmental Health for standards) r—, Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) SRA - (CDF to determine specific requirements) 100 -Year Flood Plain: (See attached) • Flood Zone: x • Flood Panel No.:. Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) ❑ Oroville Enterprise Zone Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance --------------------------------------------------------------------------------------------------------------- ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: TIM{- rj �- 7-iz Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA'setbacks. Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front (. . Side Lo' Side Street Rear Height Waterway N/A N/A - N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA'setbacks. Page 2 of 5 Js Subdivision Map/Parcel Map: Map Date of Recording:=,Cg 1 �iZ2 Lot: 1 ❑ Use Permit/Minor Use Permit Permit Number: Book: L% / Page: `Z 3 Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ A«ached ❑ None ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. 7 Page 4 of 5 -.4 nh 4 +1,4, rJ �7 I=� I R/M For RAberl Tob AlAll Soo140 Page 75 f8 I rt ' 1 __j sT s1 Le Galen neo � 1 •Ie 9q! H Fd 43 it n pipe Ls 36 0 N6ga'�I•� L 0 T I 5.5 Ac. 101 per:. PRA. Far Robert Taboloff 81.40 Pp 73 30 LOT 2 3.3 Ac. 1.4 3/f I10N rlr[ LOT 3 3.6 Ac. NB 1814 LOT 4 5.1 Ac. iJVA'7S'q it or IO9.B6 \ I N33034W 130.99 SURVEYOR'S CERTIFICATE This map ess prepared by me or ander my direction and .a I I compiled from record data and is Detects upon A Nei° surrey in I� I 11 3 0624 W ' J COn/ormpnce .itn Me repYlremems a, Ind Suoolvgian M.A Act 0l • Ind request el Nino M EfAeie Outina Jarvorr. 1972 I fervor c"Iffy Id.01 .1 N 17'1602M 11 94.17 1 that 11 tonlorma riff IA< Approved Tantolfve Map And in. conolli— of iN 2B OS ofi w 't- ..3.40 panow thereof. That provisions of Applicable Slat° La. and Is X Iran pipe local Ordinances 'hare DAM campiied .ifh. 'W Ls 3634 c 634 rlrL 4LL11'lee / COUNTY ENGINEER'S CERTIFICATE 1 1 m.ona.r uh. dere This map nos been As ;nod this /'7dor of F :a IAT cl..ure Any Sc01e WOO' I 19u, for con form once .Nh the at Section 11375 of 1 the Subdivision Mop Act. I' Nq 2622E 110'2. �nl� 7 O4 clot Caca led A. G E. 1x224 INrxror Public Works I / of l \ ( RECORDER'S CERTIFICATE filed his .2.3 da7 ofi., 1972 / / In BA01 01 Parcel Ma AI pad 23 at the / 40'40'331 request a/Zt oe:e % �t Sen Al V. (ry r� N 2t08'I5E Luube KfuAnder NOTE $ Ball. County Recorder A •`'f Basis of Beorings Wly Bdy of SW 1/4 /N l 2e'je 7 E of Sec. 5 -as per P/M bk 40 pg. 75 or DePuy I : O -Denotes 'set COE 3✓4"iron pipe LS 3634 • - �"0enoles found Cor as shown •INj� II..... NO'os lsE n •-Denotes found IxIhub. r 1 • \ I N33034W 130.99 As I I I� I 11 3 0624 W ' J I�.NeA. ♦M N 27'48'5" Id.01 .1 N 17'1602M 11 94.17 1 iN 2B OS ofi w 't- ..3.40 \ 'W �+— 16.43 rlrL 4LL11'lee PARCEL MAP FOR NINA M.• CHOATE Being o portion of the S.W. 1/4 of Sec 5—T.23N-R3E. M. D B.81 M. Forest Ranch Butte CO. California January 1972 TNIEL E. 1111 "10TT GARY T. ""I" OI'1 LO neo L3 1134 LI LE NSED LAND S&:URV EY ORS I dILLEROAD P.0 BOx671 PARADISE. CALIFORNIA 93969, 72029 - r ;* - . . .r r .� ;y-_ :.a.; ..� ..,.., .._.. ..* s ..' "};"-'�. .. , �R;( .,�"_9' ..4� �y',.w �.• a'+.!CC}'�.'��»"�i..wli'..e 063-'050-018" GARD , ?PERMIT#95-2790 ;f t r:_ NER` `Walter &, Marcie'-. .7 TiPP'itoe Ln.' Forest Ranch �? Cont: Illumination Electric Elelfor Well & Future Lot, Development, j Y' I I )COUNTY OF BUTTE - DEPARTMENT OI; DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive-'Oroville, California 95965 - Telephone (916) 538-754 PERMIT NO. APPLICATION AND PERMIT, � ERMIT,�7qn ASSESSOR PARCEL NUMBER 083-'050-018 ZONING TM5 BUILDING PERMIT WALTER & MARCI GARDNER T 22N-2878 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 727 S LING DR COVINA CA CONTRACTOR'S NAME ILLUMINATION ELEC TELEPHONE 873-0122 CONTRACTORS MAILING ADDRESS 14590 CENTER VILLE RD Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Fling Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS TIPPITOE LN, ]'ORE ST RANCH PERMITFEE $ PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other ELEC FOR WELL SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Of Installation ❑ Other ❑ Describe Work: — Mobile Home S I GI W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 2 0:0 0 Main ServiceEOOV OR LESS ( 200A OR LESS ) 23.00 23#00 Main Service ( 200A TO ,000A ) 46.00 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 e'/ V Lic. No. CJ/ t!% 1 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 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BLDS. ) SO. 3.52 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APOUPTARATUS ) 8 SINGLE LET CIR. Ex. Occup. (OUTLET OR FD(TURES) BA2L Q 1.00 so0 FIXED Ex. Occup. (OUTLETS(RESO.)EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PRE INSP 123.00 PERMITFEE S 66.00 Contractor 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 MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor 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.) �7 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 co ly with those provisions. //r —2.�- — X (�-L�� Date � Signature ,of ' pplicant - ❑ O er ❑ Contractor ❑ Agent An OSHA permit is 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 Is occ CONST. TYPE I TOTAL FEE $ 66.00 HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL PD HD ISSU This permit is hereby issued under the in the Butte County Code and/or indicated above for which fees have B �/� _ iJD" y �l �iN/tll�l�� PERMIT EXPIRES ON //r/2 applicable provisions Resolutions to do work been paid. % l /� ate /� %/nn � %1r �(Dwe) Receipt No. /x 6 302— WHITE-D.D.S.-E.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7- CoU* Center Drive - Oroville, California 95965 - Telephone (916) 538-754tq PEIT NO. APPLICATION AND PERMIT �2 :zIn ASSESSOR PARCEL NUMBER 063-050-018 ZONING TM5 BUILDING PERMI OWNER WALTER & MARCI GARDNER TELEPHONE 322-2878 SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 727 S MIDHURST DR COVINA CA CONTRACTOR'S NAME ILLUMINATION ELEC TELEPHONE 873-0122 CONTRACTORS MAILING ADDRESS 14590 CENTER VILLE RD Fireplace CONSTRUCTION LENDER UNIwOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS TIPPITOE LN FORE ST RANCH PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LAT No. SUBDN510N'S NAME PARCEL MAP Solar Or heat pump water heater 23,00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other ELEC FOR WELL SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities IR Installation ❑ Other ❑ Describe Work: Mobile Home I S I GI W @20.00 PERMITFEE g Contractor ELECTRICAL PERMIT Filino Fee 20:00 Main Service ( Zoon OOR mss ) 23.00 23.00 Main Service ( 200A TO 1000A ) 46.00 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,POWER and m license is in full f rce and effect. License Class G' / Lic. No. la �� OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ 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 I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for 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 NEW CONST. DWELLING OCCUP. OR ADONS. ( 8 ACC. BLAS. ) so 3.5¢ Fr. NEW CONST. / MULTI -OUTLET NON-RESID. \ BRANCH CIRCUITS ) 97.50 APPARATUS (8 SINGLE OUTLET CIR. ) Ex. Occup. (ourLET OR FIXTURES ) 20 0 +.50 BAL SO Ex. Occup. ouTUEDTs RES o.°eA ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PRE INSP 23.00 PERMITFEE s 66. n0 Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number I(t�he above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I hethat 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 co ly with those pr visions. )/of e'> r- X _ Date _ Signature f pplicant - ❑ Owner ❑ Contractor ❑ Agent n OSHA permit is required for excavations over 5'0" deep and demolition or construction Aof structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 66.00 HAZ. D. FEES IMP FLOOD CDF PARCEL PO HD Issu This permit is hereby issued under the applicable provisions the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. (� BY ate �� / � PERMITEXPIRESON 2�' (Date) ReceiptNo. 1,61,66,302-n %,3O WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT .. ..w .. . .,. .'y+•+y...YT:i;�t-r... ��Kt��?*^rpt..:.:+^r�b��`^-ri^�r?i'I+*,�1(r%•'�..'rnr[v-Y',� �"rSi`R={',:��-.°..i �'�''.°r"1.. ."(.-.•'�,r. �.. - .. ' J COUNTYOF BUTTE - DEPARTMENTOF DEVELC PMENTSERVICES -BUILDING DIVISION ti 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916)538-i541 PERMIT APPLICATION DATASHEET �- OWNER W - l., a vel !N -v -A. P. No. 4.Proposed Building Use & 6-- W c 0 Building Inspector Date / At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . ................... 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ ' 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construc ' n�approval required prior to occupancy). .. . . P�a"�egI°" �e 20. Pre -inspection for LX- required. . to Building Inspector (Date) for 21. Contractor's license in -formation. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner . .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ....................................... . 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... ' 27. Letter of intent on building use . ..............:......................... . 28. Mobilehome utility clearance . ........................................... 29. Documentation of legal access . ..................... 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . .............. . 'Al Existing violations/expired permits . ................... :.................. kitsl�..........................:..................... 34. When you issue the permit, process as follows: Mail to owner.Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation 14� Acreage Applicant Date' Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date .}tea 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. 1.2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works t COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7-Ci5unty Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSORPARCELNUMBER 69-05— /F GJ//�i//��/ ! Zo 1p BUILDING PERMIT /� / ? //�y�(�///��' /C�Jq OWNER (/V � 1. l � "' / ' t/V�O�//N/'�C/ /'� E7�-/y7f(�'] ALN` aQf/ SO. FT. OCC. BUILDING VALUATION /N/"'� OW!TU ADDRE COMRACTOR'S NAME^ , •(/^'CQ'L/1 �` TELEPHONE CONTRACTO S UNG ESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee _$ ARCHITECT OR ENGINEERS MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS ^ /!J PERMITFEE S PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LAT NO. SUBONISIONSNAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE �" SF ❑ Duplex ❑ Mobilehome ❑ Other �� 6!1:-r_o� 106- SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Mobile Home IS I GI W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service600v OR LESS ( 200A OR LESS ) 23.00 9 �� Main Service ( 200A TO /000A ) 46.00 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 1DECLARATION 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 NEW CONST, DWELLING OCCUP. OR ADDNS. ( & ACC. BLDS. ) SO. 3.5¢ FT. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS (d SINGLE OUTLET CIR. ) Ex. Occup. ( OUTLET OR FDTTURES ) 20 Q 1.00 BAL .SO Ex. OCCU FIXED APPLNS. OR p (OUTLETS (RESID.) EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE a. :3 CA $ Contractor dQ 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 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 Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 50" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE S Contractor Mobile Home Installation Fee Is Energy Inspection Fee Is Occ CONST. TYPE TOTAL FEE $ HAZ. D. FEES I IMTTT=i CDF PARCEL PD HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRES ON applicable provisions Resolutions to do work been paid. Date (Date) Receipt No. WHITE -D.D.S.-B.D CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT OWNER: PRE -INSPECTION FOR: irm N DATE: A.P.#: ZONING: t DATE TO INSPECTOR ff PERMIT HISTORY: ONE 1 ]AS FOLLOWS: TYPE OF OCCUPANCY: BUILDING INSPECTOR'S REPORT uilding Description: C-csU [ ] • C ommerciavusa e: _ [ ] Residential/* of Units: [ J Currently Occupied. I [ ] AbandonedNacant. r Electric: [ ] Yes L>4 No _ . _... Electric is currently :[ ] On �.ffO Condition of electrical? Natural [ ] Propane[ ' ] None[ ] Mobile Home: Yes[ ] Currently On[ ] Off -/j,. Obvious problems: v tion: Plumbing working Yes[' ] NqK Well: Yes No[ ] Potable water: Yes[ ] No[ ] 9 Obvious Sewage Problems: Recommended: [ ]Issue >qHold for: Spector: ky W� No[ Date: It -R- QS- 0 0 - ,.•, L' •-'/�•4 N BS°11'J!'E ?02P 61" %l«+4 �� i �C• /37.9=i ; -ES.:- �, 4�r..,�J q,-; -- IV CN ly \ti209 .1c rf.46AC. ;sow �4,y ►1 ��, m , 61'9 f I , \ • �`A\ �� l t a 30 .� yx E \ 3. ac 2.50 � QQ �\�\�n Y3, E `JAI%•' � i �� ,Lh .Z` °o Y9 O L 0 T 0 3.53 AC. 7.0 d //Ac } S. ; 4C 1�a . �/ —_-,, z 9 / i a r - LI ) 'S� F Pfd Q' ✓ s � .4 , n - , 1 �� • 1 1 i 759 tea 3q3?g 9ooa �, y/, Y9Z� 1/6 LOT 34 .3.6 4(' so ••1 ss / / X33 A Al y 5 3 /►., 23 P,y4,-`V' �5 LOT 41'4 `. of '- 96 aC 4.06 AC to P .9?�. 5.1 4c m' i /4) e LAS SCALE: 1"= 100' 0 GREGORY A. P E I T Z for: David & Lisa McCrillis �`� C° ®`� SITE PLAN: L O T PO BOX 243 ARCHITECT Forest Ranch, California 9s9a2 Portion of the S.W.1/4 of 383 Rio Undo Ave. Chico, CA. 95926 (530) 894-s719 Sec. 5-T.23n-R3E. M.D.B.S.M.