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HomeMy WebLinkAbout064-190-016NOTES RESIDENTIAL { 064-190-016 03-1978 € PERS IT NO. LABARGE, DOUGLAS t BcQ LAFAYETTE CIRCLE, MAGffA��LIA Cont: RENOIR CONST. V NEW SINGLE FAMILY G moo( I i SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB-STANDARD HOUSING LETTER OFFICE COPY 1 ' Address N630 `R- AIA444 0 GAS Meter By Date ELECTRIC 9 11-01 Meter By a�✓� Date j� j JOB FINALED (Date) .� Signature 1Ck f �trn% < till J=OK 0 = Not OK . = NotReadyable 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-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utilitv Clearance Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date Date POOLS (Plans) OK except A's Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Soils; Compaction -Structure Stability 1. Zoning Requirements -Setbacks -Easements 4. 2. Footings; Size -Spacing -Marriage Line . Elec.; Pool Lighting; 15 Volts-GFI 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. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM -(ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test. 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office 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, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors ' Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except A's 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles.and Lighting, Distance-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. Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = NotOK Applicable = Not Applicable RESIDENTIAL . = Not Ready Date UND FLOOR (Plans) OK except #'s 1 ning-Setbacks- Easements- Flood -Slope 2 tg., Main; Soils-Elec. Gr .-/ )U" Ftg. Depth Ftg., Garage; Soils-Steel-Elec. Gr .-/ /" Ftg. Depth . Vg., Porches & Decks; Soils -St -/ /" Ftg. Depth S mwalls, Main; Steel-Blockouts-Wrapped emwalls, Garage; Steel- Blockouts-Wra ed 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 Y1 1. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. enums & Ducts; Clearance -Material -Support -Ins. 1. fdirders-Sills-Anchor Bolts-Joists-Vents-Crippies 14./Access & Ventilation 16. Insulation Date d1l Card B-1 Date Card B-1 Date =),1 ' a Card B-1 Date Card B-1 Date PLUMBING(Permit) OK except #'s LAO�Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 15�D.W.V.; Test Fittings & Anchor -Nail Protection Sho er Pan; Test, First Floor -Tub Access \ . rosYfub & Shower, Second Floor -Tub Access Gas Pipe; Sixe & Anchors - A&.—FfP€'Sprinkler; Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 (Single & Duplex) Date ELECT CAL (Permit) OK except #'s 2"ipttre & Transformer Clearance -Ins. Protection 26e-tjoeReceptacles Spacing -Lights & Switches at Doors 2 Boxes & No. of Conductors Stapled exstalled Close to Edge of Studs & C.J. ip. Ground made up w/Mech Fasteners -Bond Gas & Water W 2 Appliance Circuits in Kitchen & Conductor Size GFI 3. u e d Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 717 Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al In lated Neutral 0 Yes O No S e -Riser Conductors & Ground Main Disconnect 3 . � Clearances Panels-Motors-Mech. Equip. 34'Cl?jLws Closet Light -Shower Light -Spa Light moke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECH CAL (Permit) OK except #'s A.C. Ducts Insulation & Support 7. ee an, Exhaust above insulation Condensate Drain & Overflow, Size & Grade 38.-FarrrA%-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40; is Access & Platform if Furnace in Attic b Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRA (Permit) OK except #'s Si roper Materials & Anchors 4 Wal uds-Nailing Spacing & Braces -Plates -Sound e g Walls over Girders & Floor Nailing 4 Stop in Walls (rat proof) Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs Headers & Beams -Size & Bearing Date FRAMING (CCDMinued) 4�2f�g.-Joist-Rftr. Ties- Purl in -Roll Brac.-Truss-Shting.-Rtng. Fireplace Ties or Type A Flue -Fireplace Throat Clearance ," 51�. Windows or Exiting Doors -Sill Ht. &� ensions 5 . araFire Protection Framing -R nneI 1 � 5 roperty Line Firewall & Openings 5 xt. Doors -One 3' -Check Garage 3rd Story, 2 Exits Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 15ilywood on Roof Overhang -Attic Vents -Rafter Outriggers iding-Nailing Veneer 511-8ttfLo-Mesh-Drip Screed -Fd. Vents-Underflr. Access 5 lazing Area -Glass Protection -Skylights -Plastic. QV Shear Walls; Naili-Bglts-_..,/, ) 61. 63. Infiltration -Walls -Wind ws Date ard B-1 _ Date Card B-1 Date Card B- Date Card B-1 Date FINAL (Plans) OK except #'s Ext. Steps -Door & Sidelight Protection -Landings .Smoke Detector Furnace Vents -clearance -Comb, Air-Connector- Jn Garage; Above Floor-Ducts-Mech. Protection 60. X.Fl. & Bath Fixtures & Tub Access -Spa 6 ,iElec. Trim & Subpanel, Breaker Sizes & Labels 7,6./Stairs & Rails Fireplace or Stove, Clearance -Hearth Elec. Outlets at Wood Panel, Int. & Ext. Zq�(Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 4. Elec. Outlets & Receptacles at Kit. Counter 7 . Garage Fire Door; Swing -Landing -Closure 766:A.C. Duct in Garage -Damper Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection llb.; Elec. & Mech. Equip. Listed for Location Elec. Receptacles in Garage (F.F.I.)-Romex Protection 86. JKsulation- Foam- Looked in Attic 8 .. Guard Rails & Deck Construction -Post Caps 2. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No 84. tucco Brown -Finish K. j,C. Unit Disconnect, Electrical -Plumbing Wr Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 89. Exterior Elec. Trim, G.F.I. Receptacle -Underground Ventilation Throughout House Glass Protection 91. Corrections from Previous Inspections 9k. -Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates Address Posted 96. Fire Sprinkler Dates 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: Insulation Certificate BUILDn1G,PERMIT #: BUILDING OWNER: BUILDING LOCATION: Description of installation ROOF H Brand Name Maw Thermal )s Thickness (inches) CEILING Brand Name Batt or BlanketTypeValue) Thickness (inches) � 0"1 Thermal Resistance. (R - Brand Name Loose Fill Type lb Minimum thickness inches Contractor's minimum installed weightlft — Value) Manufacturer's installed weight per square foot to acheive Thermal Resistance (R - EXTERIOR WALL�-P/1S � Brand Name Maw Thermal Resistance (R -Value) _ Thickness Cinches)' � RAISED FLOOR A Material i Thickness (inches) SLAB FLOOR Material Thickness (inches) Width (inches) Brand Name Thermal Resistance (R -Value) _ Brand Name Thermal Resistance (R -Value) FOUNDATION WALL Brand Name Material -7'�;ermal Resistance (R -Value) Thickness (inches) 3-19778 Declaration I he certify that the above insulation was installed in new�reresidential builde building at ings contained n Title 24 ofabove location in ftthe with Y Efficiency Standards for the current Building Energy Y California Administrative Code. -7')'S 1.60 .Q .: License Number C a ;��K (Builder) (Build Date 11 cc) signature and Title License Number sub -Contractor (Insulation Installer) Date Signature and Tide THIS CERTIFICATE MUST .BE PROVIDED TO THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED ANLN 1T 93 AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2003-00Es7065 Recorded Official Records CountyBUTTE f CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 11:39AM 25 -Sep -2003 REC FEE 7.00 CONFORM 1.00 Travis Page 1 of 1 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: tru e C®L, r<� , Cal ; r. OA 5LAINI , i ; Sook OJ' pages 37, 3$ I�', � a�aQ X11 Date '7 SSI PROPERTY OWNERS: State of Californip n 1 County ofSa, On -7/cp��/0 3 before me, personallyearedLDm4q\as La62ano,FL � _T:a,nna Dc&, Ua6c''Q3� +ecsena* 4inewa-to-me (or proved to me on the basis of satisfactoryevidence) 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 ­hisff /their authorized capacity(ies), and that by•hisflrer/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 I Seal: TOMMY JACKSON Comm. # 1380902 iA N A.P. #M4490 "0I 6 IF NOTARY fY0UC-CALIFOAN A Sam Civa County .+ ely Comm. Eapiraa oct.2o�8 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville,-Califo(nia 95965 • Telephone (530) 538-7541 (Rev. 12/96) APPLICATION AND PERMIT 7 79 ASSESSOR PARCEL NUMBER 064-190-016 ZONING R-1 BUILDING PERMIT OWNER La Barge,Douglas 408-377-8345 TELEPHONE SO. FT, OCC. BUILDING VALUATION 1830 R 98 800.00 . OWNERS MAILING ADDRESS 1412 RQiQ CQurt San JoseCa 117 C. 1921-00 CONTRACTOR'S NAME TELEPHONE 120 11 1260-00 CONTRACTORS MAILING ADDRESS PO Rox 1165) Magalia CA 95994 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace 1900-00 Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 689-00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 93-00 BUILDING ADDRESS 1940,220 Lafayette Circle Ma alfa Energy Plan Checking Fee $ $ PERMIT FEE $ 728.00 LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 63.00 Solar or heat pump water heater 23.00 Water Water piping 15.0015.00 as water heater or vent 15.0019-00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Unities ❑ Installation ❑ Other ❑ Describe Work: NSF t��T�(—ga�aoe Master -97-4-9 Gas piping system 1 - 5 outlets 15.00 15-00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ 143.00 ELECTRICAL PERMIT Fling Fee 20.00 Main Service "ooOA Ov OR LESS zoR IESS 23.00 3.00 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 fo ce as qffect. License Class ic. No.SUID �� 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 IOOOA 46,00NEW CONST. DWELLINUP. G OCC OR ADDNS. ( a ACC. S. SO 3.50FT 1.9 4 NEW CONST. MULTI -OUTLET NON-RESID. C 97.50 POWER APPARATUS 8 SINGLE Our. CIR. Ex. Occup. OUTLET OR FIXTURES zo @ ,.w SAL @ .SO Ex. Occup. our>Eris .a.DFR.a 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 124-94 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 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 w ers' compensation provisions of section 3700 of the Labor Code, I shall frt with co ply those provisions. t X Date _� o� �3 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 Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEI= $ Mobile Home Installation Fee $ Energy Inspection Fee $ cc . TYPE OTAL F E$ 07.44 HAZ. I D. FE IMPFftnJ, --- c F PARCEL PD HD ,SSU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above r whi h fees have been paid. By Dat PERMIT EXPIRES ONITE-D.D.S.-B.D. ate rReceiptNo. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT .. .� r .. r .r � T _ ._ � • • --� .. .-- � .-�vn-c--.t.,.,.-",.�.,��,ny."'P�lrl`1'�S11�s11� COUNTY OF BUTTE -DEPARTMENT OF DEV LOM T 0V/CE1aZFNG DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER ASSESSOR PARCEL NUM13ER Proposed Building Use: 1)45 Counter Technician: l/u Date: 7-1�1 Wp uired in order to apply for a permit. All boxes MUST be checked R marked NA in order to apply. lans, 3 or 4 sets, signedXy the preparer of the plans. 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be indexed and returned to the plan review line-up when required items are received. - Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot 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 ..................................... 4 2. Hazardous NlateriafF rm ..... .... ..� ................................................... 13. Other 5 Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) fI Fees as shown on the attached Schedule of Fees Due Sheet ...................................... . Statement of Intent for Non -heated and A/C Buildings ............................ ...Sanitation and plot plan approval from the Environmental Health Departmentin City of Chico Plumbing permit ................................................... . ..... California Department of Forestry plan approval paid. Sent_ by: Planning approval for (A) Use: (B)Parking: (C) P rcel Check: 0. Contact Land Development about ❑ Improvements, ❑ Drainage': 1. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).(T�' 22. Pre -Inspection for required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ..............:.............................. ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... 6. Letter of Signature authorization.................................................................... 7. Recorded copy of Agricultural Acknowledgment Statement .................................... 28. Manufactured home utility clearance............................................................... ❑ 29., Existing violations and/or expired permits......................................................... ❑ 30.:.,0 Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from I!egal Owner, ❑ Check to H.C.D ❑ 31. Other:I When issued Telephone f and hold for pickup. I have been informed of theabove items and requirements for obtaining a building permit. Applicant:�\ ate: �- 03 A 1. Index permit application for the above items numbered: 2. Additional items required Contractor, designer, owner, was advised cf the above data by Contractor, designer, owner, was advised of the above data by Plans reviewed by: Date: Structural reviewed by: Date: Note transfer by: Date: e Plan Check Letter phone\❑ mail, ❑ counter, by Date: phone, ❑ mail, ❑ counter, by Date: Plans.approved by: Date: _Structural approved by: Dat . Yellow: Building Division E.H. USE ONLY t. Plat Man Attachad" 1 Roar Wan AttaCAad sant to 8.0. TO: Building Department &*Vie FROM: Environmental Health SUBJECT: Sanitation Clearance 'R car&,Qf a5 F c DGO-jo-d . L OwnerLocation AP# . Plan Approved fo . Sewage Disposal, ter upply: Public Private Well Clearance foelling,, Othgr Hold final for: Final clearance O.K. for: NOTE: x,30, a3o No /0� Enviro menial Health Spe ialist Date 8/96 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 HEDULE OF RECEIPT OF FEES OWNER-k.A.P. # PROPROSED BUILDING USE ' DATE RECEIPT # DATE REC. 1. BUILDING PERMIT FEES --- Balance Due ..................... $ Additional Fees Due........... $ / /Revised Plan Checking Fee.... 2.,8'CHOOL DISTRICif FEE'S 3. ShiRIFF FEES (paid at Building Division) �j� 2 Residential........... X $360.00 =$ LJ 0 Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Fig. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES 510.00 (paid at Building Division) FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) 8. WATER TENDER FEES BATTALION #, $200.00 (paid. at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... X = $ Sq. Ftg. Amt. 10. OTHER At time of permit may be changed ( APPLICANT I was advised the above fees are required to be paid prior to issuance of the permit. These fees process. DATE -%ka-'xj Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District A.P. Number O Property Owner Property Location/Address Subdivision Residential Development No of Living Mobile Home Addition/ 'Supplemental to Units Installation Conversion Permit # *(No foundation inspection): .......................................................................................................I............ (Floor Plans reviewed by School District Personnel) I Sq. Footage /K-360 (Group R) Sq. Footage (Including Exterior Roofed Areas) 7/ Dat District Identification No. 8. AST School District certifies that__/ % - (Applicant) -Address) Le has complied with the requirements of Resolution No. y repre e ng � square feet. Representative Paid by Check # Remarks: A (Phone Number) (State) (Zip Code) by payment of $ AB 2926 $ FULL MITIGATION $ 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 660201a), 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 Ischool district) feeformAs (10/98)dmm 12196) ' MER COUNTY OF BUTTE - DEPARTM9.NT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive ° Oroville, California 95965 ° Telephone (530) 538-7541 P R APPLICATION AND PERMIT ",ems/w ! ^ / &1 � v A I �n Z° BUILDING PERMIT 0 i Mefm MG MDII_= D+mmm Damm" wwNG ADORESs T 6UBDN6IONS NONE USEOFSI ZDuplex 0 Mobpehome 0. Other lew Jb AdcFfkn 0 lescribe Work TYPE OF WORK . --- P9 {-.A- --`4S_ L S r y o -1-i 1-04::4 i --::>r 2o!,� 76 25 FL,cr-Db > XJ 0 Li 0-0C— Total Valuation S - PERMIT FEE -- Filing Fee S 2D.00 Permit Fee S 2D+ TO +ot" Plan Chackina Fee S'023 OR ADUM Energy Plan Checking Fee S . S PERMIT FEE S PLUMBINGPERMIT Filing Fee 20.00 __.._il--...._._.. -- ------ t Eaeh Trap - -- -,7."00 Solar or heat pump water heater 23.00 Water piping I S.DO ^ Each gas water heater or vent 15.00 ^ Gas piping qystam t - 5 outlets i 5.00 Bulfing sewer t 5.00 MobBe Home I S I G I W 020.00 L�� g Fee 20.00 PERMIT FEE ELECTRICAL PERMIT Main Service on ED7.5D xo°Ya Main Service 2D+ TO +ot" Haw DOMI: OVIELUNO Docup. OR ADUM A A=. IV M g Fee 20.00 23.DD 46.00 90. / ED7.5D Er_ Oecu . ovnET OR FXTURB 0 -W ! Ex- Dc= . ro ° 5.0D Temporary Service 23.DD I Mobile Home Fenlides 2D.DD I '�cIrY�1t'�- �bt�o►� V=. Wring pFifingFee S1k x PERMIT FEE S 60 MECHANICAL PERMIT 2D.DD f) THeating O Hoo rmg Hoodd 6.5D I Ventilation PERMIT FEt S �— Nbbile Home Installation Fee S Energy Inspection Fee S Af� Tm;wed "` COQ �" TOT L EE $ • D. F'c6 IMP D P-.- PD i 65 JE ��� This permlt is hereby issued nder the applicable provisions of the Butte County Code and/or Resolutions to do work indtcalad above for which fees have been paid. E 8y Date ---- PERMIT EXPIRES ON AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 COPY of Document Recorded 25 -Sep -2003 2003-0067065 Has not been compared with original BUTTE COUNTY RECORDER 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: La-Z �'1533 , Qt> Show'-\ an 44 cerlre: r T'A4 p &44-A41 1, P*x,,e Q. -se -1P: i co( i � �\e 0 cc 4� `fie C� e).- �e CONn� , Ca1;-�f�•.�4' , p r� ��� 151 I �-? I , r'n 1300k 3� , ore fngP51 q4- pages , 3$ , 34, q•�Q y , Date "7,� 3 I State of Californi ) County of5c�.,- c.-Iar2.C- ) On 171.- c),3 before me, personally eared Iis �OLu2 . i __:C)60a - � .LZ, knew&4a-me (or proved tome on the basis of satisfactory evidence) to be the person(s) whose names) is/are subscribed to the within instrument and acknowledged to me that be she/they executed the same in 46sfher/their authorized capacity(ies), and that by-hisfher/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: TOMMY JACKSON Comm. 11380902 N S MWART 1UGW'-UAWVnU A.P. k R o Mr cum. Elpim Oa.20, 7AOi 1U National Pollutant Discharge Elimination System (NPDES) Phase II Construction Stormwater Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement Project Title: Lo & ne ALtse By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs more than 1 acre of land requires a Construction Stor n Water Permit from the State Water Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP) and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit if my project disturbs more than 1 acre of land. I, further, certify that this project will not disturb more than 1 acre of land. I am aware that submitting false and/or inaccurate information may result in revocation of grading and/or other permits or other sanctions provides by law. Signed: 4Q)XJ. Title: on Date: 7 C�L 10 3 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Stormwater Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement Project Title: By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs more than 1 acre of land requires a Construction Storm Water Permit from the State Water Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP) and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit if my project disturbs more than 1 acre of land. I, further, certify that this project will not disturb more than 1 acre of land. I am aware that submitting false and/or inaccurate information may result in revocation of grading and/or other permits or other sanctions provides by law. Signed: Title: Date: NPDES & SWPPP Non -Compliance Certification Butte County Storm Water Management Plan Revised 5/22/03 • • SITE PLAN REVIEW APPLICATION Date: ::2 AP# Permit Number (if applicable) APPLICANT INFORMATION Parcel Size: Owners Name: Owners Address: Telephone No.: Situs Address: Proposed Use: Residential IF 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 Oter Septic ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel DO NOT WRITE BELOW THIS LINE DEVELOPMENT SER VICES INFORMATION (For Staff Use) M Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: Snow Load Area: ? �rO 2�� • ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ 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: • Flood Panel No.: O Lj fTDe Index Date: c ❑ 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) 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: J C — 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 �- 3 Side Street Rear , p 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 Applicable Development Fees: Standard Fees Amount • ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ Other Subdivision Map Special Fees El Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) Formula * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. is Parcel Created By F-1 Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 Subdivision Map/Parcel Map: l �v � ( P)rju S ? Map Date of Recording: -7-15--71 Lot: ZS -3 ❑ Use Permit/Minor Use Permit Permit Number: Book: 3 Date of Approval: Page. ,Z� Li • Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: 0 Ij G ❑ 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 P must be prepared by a registered civil engineer or other qualified professional and Oeo 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 roa 0 Page 4 of 5 • J BUTTE COUNTY • AGRICULTURAL BUFFER NOTIFICATION AND/OR UNUSUAL CIRCUMSTANCES REQUEST • Butte County requires a 300 foot buffer between neighboring agricultural operations and a residence. This dimension is based on environmental assessments and studies. The Agricultural Commissioner may identify unusual circumstances where the 300 foot buffer cannot be met on existing parcels. This exception is not available for lots being created, divided or subdivided. Owner or Authorized Agent must complete the following and return with the required site plan to: Development Services Department, 7 County Center Drive, Oroville, CA (530) 538-7601 Name: 00 <4 QeQo !' Phone: <V � � q0 Mailing Address: R )3foS E -Mail address Q:'y2 Assessor's Parcel Number: OtA- - 19 © - o u b Reason. you believe you qualify for the unusual circumstances exception: �c� � des � U' ►e,�-�,� ���, Date UNUSUAL CIRCUMSTANCES DEFINITION: An exceptional or extraordinary condition where the existing lot size or shape or an existing improvement (well, septic systems, structures etc.) does not allow for the standard condition of a 300 -foot buffer zone. SITE PLAN REQUIREMENT: submit 4 copies with this form Refer to the Site Plan Submittal handout for specific requirements ....................................... Internal Dept. Contact Info: q_Env. Health ❑ Planning [IBuilding. ❑ Other ontact Person: Phone: FORWARD THIS FORM TO LARRY IN DEVELOPMENT SERVICES FOR PROCESSING ......................................................................................................................................................................................... For Agricultural Commissioner office use only: (to be completed after submittal ) DISCRETIONARY PERMITS (Planning) MINISTERIAL PERMITS (Building) a Exception Recommended ❑ Exception Granted with the ❑ Exception NOT Recommended following conditions: Reason/Conditions/Specific•setbacks from adjacent agricultural operations: • �JO AG. � 1souES Agricultural Department Signature: �Je A -v\ �2 Date: i - (9— Ll YMC UA3