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064-200-029
V NOTES RESIDENTIAL PERMIT NO. _ 064064�� _ 05-1080 GRESS, GAI: J=OK 0 = Not OK NotApplic Not Ready able 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 "ftJ P LPG MISCELLANEOUS Date 7. Well Clearance & Disconnect 8. Utility Clearance 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION "(Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector. 6. Water, MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval Date 8. Gas and Electricity Tagged Date 9. Tie Downs -Type -Installation Cert. Date 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 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 Date 8. Gas and Electricity Tagged Date 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. Frng.; 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 #'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 Vofts-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-Panelboards-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= Not OK - = Not Applicable RESIDENTIAL (Single & Duplex) = Not Ready f Date UNDER OR (Plans) OK except #'s 1. i Setbacks -Easements -Flood -Slope , Main; Soils-Elec. Grnd.-/JSP Ftg. Depth Ftg., Garage; Soils-Steel-Elec. Grnd.-/,/Zl" Ftg. Depth 4. Ft orches & Decks; Soils -Steel-/ /" Ftg. Depth - _ malls, Main; Steel-Blockouts-Wrapped Stemwalls, Garage; Steel-Blockouts-Wrapped old Downs and Special Anchors 7. lab, Steel -Wrapped ,O Piers -Fire lace Ft .-Steel ,p D.W.V.; Fall -Fitting -Test -2 Way C/O -S er Test UF, Gas Pipe; Size Anchoreard GV PipiLnb Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Qktric Underground ums & Ducts; Clearance -Material -Support -Ins. irders-Sills-Anchor Bolts-Joists-Vents-Crippies Access &Ventilation 16. Insulation Date (e -)S-OS Card B-1 D0�O 5 Date 7ffjs Card B-1 W k Date --1 ^pS Card B-1 , Date Card B-1 Date Pj,4KT1BING (Permit) OK except #'s (".Water Htr.; Vent -Access -Combustion Air Baffle eW Water Pipe; Test & Anchor -Nail Protection 1 0 D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Ast Tub & Shower, Second Floor -Tub Access Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test Date LT S Card B-1 ll,. _T Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) .OK except #'s 241 Wture & Transformer Clearance -Ins. Protection 2.VEjec. Receptacles Spacing -Lights & Switches at Doors 2 ize Boxes & No. of Conductors Stapled 2 mex Installed Close to Edge of Studs & C.J. 2 quip. Ground made up w/Mech Fasteners -Bond Gas & Water 29/4Appliance Circuits in Kitchen & Conductor Size GFI bfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or AI Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI jnsulated Neutral O Yes O No 3E. ervice-Riser Conductors & Ground Main Disconnect 32!ui . Clearances Panels-Motors-Mech. Equip. 3 lothes Closet Light -Shower Light -Spa Light 3 . Smoke Detector Date `���!-f Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace-Ve6t Access -Comb. Ait-Return Air Vent 115 Outlet Date 48: Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. (replace Ties or Type A Flue -Fireplace Throat Clearance 50. "c Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5 Bdrm. Windows or Exiting Doors -Sill Ht. & D' ions •� Ar—& ,( Curage Fire Protection Framin - C ne V '- 53:/Property Line Firewall & Openings 541 Ext. Doors -One T -Check Garage 3rd Story, 2 Exits 55. airs; Width -Headroom -Rise -Run -Landing -Fire Protection �ood on Roof Overhang -Attic Vents -Rafter Outriggers Siding -Nailing Veneer 58. Stsco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59!lazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. _Igsulation-Walls-Ceilings Infiltration -Walls -Windows Date tV -j L( -q Card B-1 j ti,�-_ Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL ns) OK except #'s teps-Door & Sidelight Protection -Landings 6 . Smo tector 6 rnace Vents -clearance -Comb, Air -Connector - Ir age; Above Floor-Ducts-Mech. Protection BT. Bedroom Exitino W-G.Fj. & Bath Fixtures & Tub Access -Spa. lec im & Subpanel, Br�a`k�r�Si5es 8 Labels s & Rails 7-1!Firepl ce or Stove, Clearance -Hearth e&. Outlets at Wood Panel, Int. & Ext. �2!Kxt. & Appliance; Ground -Air -Gap -Cooking Clearance 94! -F -I . Outlets & Receptacles at Kit. Counter Ye'Garage Fire Door, Swing -Landing -Closure 76. A�Duct in Garage -Damper 4*Y. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in G ge; Above Floor -Meth. Protection b Elec. & Mech. Equip. Listed for Location I eceptacles in Garage (F.F.I.)-Romex Protection &9. -Foam -Looked in Attic Gyard Rails & Deck Construction -Post Caps GB�Fdn. VBents & Crawl Hole Door Drainage & Wood Earth Clearance Looked under Floor es 83. Following InstldJDrive 0 Yes O NoMalks O Yes D No/Planters O Yes O No 84. Stucco Brown -Finish 85 -ICC -Unit Disconnect, Electrical -Plumbing tafi�Atrove Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing erior Elec. Trim, G.F.I. Receptacle -Underground 89,Xelitifation Throughout House 80--Eltfss Protection. S4-Gerrections from Previous Inspections 9R, Saes fest-Meters Tagged, Gas -Electric er & Sewer Connected -C/O to Grade -HD Approval 10 ergy Compliance Certificate -Other Certificates dress Posted 96. Fire Sprinkler Date4ao_14e Card B-1 SDate Card B-1 Date4 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: 40. Attic Access & Platform if Furnace in Attic Date 1j'� Card B-1 p Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 4K SiRs Proper Materials & Anchors 4z✓W&Ils Studs -Nailing Spacing & Braces -Plates -Sound 4$�gearing Walls over Girders & Floor Nailing 4±1raft Stop in Walls (rat proof) 4VFire Stops, Furred Ceilings -Stairs -Chasers -Tubs 4 eaders & Beams -Sim Bearing i_ Date 48: Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. (replace Ties or Type A Flue -Fireplace Throat Clearance 50. "c Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5 Bdrm. Windows or Exiting Doors -Sill Ht. & D' ions •� Ar—& ,( Curage Fire Protection Framin - C ne V '- 53:/Property Line Firewall & Openings 541 Ext. Doors -One T -Check Garage 3rd Story, 2 Exits 55. airs; Width -Headroom -Rise -Run -Landing -Fire Protection �ood on Roof Overhang -Attic Vents -Rafter Outriggers Siding -Nailing Veneer 58. Stsco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59!lazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. _Igsulation-Walls-Ceilings Infiltration -Walls -Windows Date tV -j L( -q Card B-1 j ti,�-_ Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL ns) OK except #'s teps-Door & Sidelight Protection -Landings 6 . Smo tector 6 rnace Vents -clearance -Comb, Air -Connector - Ir age; Above Floor-Ducts-Mech. Protection BT. Bedroom Exitino W-G.Fj. & Bath Fixtures & Tub Access -Spa. lec im & Subpanel, Br�a`k�r�Si5es 8 Labels s & Rails 7-1!Firepl ce or Stove, Clearance -Hearth e&. Outlets at Wood Panel, Int. & Ext. �2!Kxt. & Appliance; Ground -Air -Gap -Cooking Clearance 94! -F -I . Outlets & Receptacles at Kit. Counter Ye'Garage Fire Door, Swing -Landing -Closure 76. A�Duct in Garage -Damper 4*Y. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in G ge; Above Floor -Meth. Protection b Elec. & Mech. Equip. Listed for Location I eceptacles in Garage (F.F.I.)-Romex Protection &9. -Foam -Looked in Attic Gyard Rails & Deck Construction -Post Caps GB�Fdn. VBents & Crawl Hole Door Drainage & Wood Earth Clearance Looked under Floor es 83. Following InstldJDrive 0 Yes O NoMalks O Yes D No/Planters O Yes O No 84. Stucco Brown -Finish 85 -ICC -Unit Disconnect, Electrical -Plumbing tafi�Atrove Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing erior Elec. Trim, G.F.I. Receptacle -Underground 89,Xelitifation Throughout House 80--Eltfss Protection. S4-Gerrections from Previous Inspections 9R, Saes fest-Meters Tagged, Gas -Electric er & Sewer Connected -C/O to Grade -HD Approval 10 ergy Compliance Certificate -Other Certificates dress Posted 96. Fire Sprinkler Date4ao_14e Card B-1 SDate Card B-1 Date4 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: COUNTY OF BUTTE ....... BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE ` IZESS 05-- 10&O 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 have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. \S R bEC IL R M % <�TA ( 2 t At STA! ( M -Tic) Af 0 ti p Pit lc a Fog ,6� SAL ALC Q\Y) PpoU(D& S-_ncP=) Fnt2 Nx-)2 FRaw %FlC2AGE 4.. _T0 I I(aca SE 0\�. r- t4 rr -m SAL A (Zcx f til p L n /9T f L�X�l2 Date /0-1 3 -US Inspector , '—IkP— A N KaYj f L tow S REV 4/05 Phone # 3 3-2 Z FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 4.ra-a^•'-'�7'R �'r1�.t:��i. ;z'. �.l .riy. �t �... �''T-n1 . . . . .. . . . . �-- COUNTY OF BUTTE - BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE a,<-- IoB0 OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at :s 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 ssjindicated below. z t S%- t— r -�- l r i r -,z V o J L -3 rvvf,d A,,_ f . �9d �� o� u -r cA4-- r i . w. i r V J �, X C- t' %.r e U �ro rocs r-0C--C . f, (r.1Ss mac/•— Gun Date S_ Inspector T °d 6 Cr-�� 1-*- k�i REV 4/05 Phone # ��R.. (.0'g �� ' 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 i CORRECTION NOTICE w vrvlmcn rtnmi i rvv. - - 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. �1 nS4" ( O r� ( r. OCG v — • J- )sale, 1 L k=1 ne,41 A M %r Date Inspector REV 4/05 Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 e Y �y.v22:+� � �s�++L.wyt�"" ...`L.� �--A .• a:� i+�` .. J _ �ti + COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE OWNER /o 'P% 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. . r Date Inspector ✓t 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 C-,(zC-SS 6s-686 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 have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. Date ( — '7 S Inspector b68Cl2 r44 REV 4/05 Phone # S 38' 6 S Z Z FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 11 Certa'InTeedW CertaffeedBld@ ® Statement InsnlSafe°4 �` �Fiber Glass Blowing . Insulation mic 1-lornpowner Name / Jabsite Name cj� Addres. installer/Contractor (sign] Company Name Date Buiider (sign)-- — — Company Name Date Inspected By (sign if required) Date THERMAL PERFORMANCE—ATTIC BLOWING APPLICATION': • In accordance with the chart above, you mtlst install the ,ninimurn number of bays per 1,000 sq. ft of nes area for each R -Value listed. • The maximum net coverage must not exceed that Specified for each R -Value. • The installed insulation must be at or above the specified minimum thickness for each R -Value. • Failure to install the required minimum. weight per sq. it of insulation at or above the minimum thickness will result in reduced R -Value. • This product should not be mixed with other blown insulations or the thermal claims will become invalid. DANGER: RECESSED LIGHT FIXTURES --7:1 PREVENT OVfiv.Ea@RFATING., DD NOT INSULATE ON TOP DR WITHIN 3" OF SUCH DEVICES. DOES NOT APPLY TO TYPE IC LIGHT FIXTURES OR T€3 FLUORESCENT FIXTURES WITH THERMALLY PROTECTED BALLASTS. 30-24-233 Builders Statement A Saint-Gobain Company @2003 CertainTeed corporation 10!03 r �Y R -VALUE BAf9S PER MAXIMUM MINIMUM WEIGHT- 1 BATT6iRULLS 7 CEILINGS INSTALLED R-VALIIE I 7000 SQ. FT. SQ. FT. PER BAG POUNDS PEH SQ. FT, I MINIMUM THICKNESS To ob.ain a Bags per Contents of bag Weight per sq. ft. of -- ----- ! — Should ;tut be Thermal Resisrance 1000 sq. ft should not cover installed insui3tion should --�- -- --1— = less than: (R) of: I of net area: ' more than: (sq. ft) not be less than: Obs.) fin ) -- Ei) 36.5 -- 27 — 0.981- .981 49 -- _ 49 34 0.800 -- •-- 44 --- _29.6 26.4 38 _ 0.712 - I •— 16'h ----- - 38 --- 22.8 �- 44 -----0.615--- --- 30 ---- - •------I --_ 18.0 56-0.465 - ..-.. ---_t 26 15.5_ 65 0.418 22 — - 13.1 77 0.353--- -- - 19 i i .1 90 - - ?„ �. 19 ------ 7.7 129 _0.301 --- 0.209 -----�-•----- 53� --.— --- 1,1 ------ --- 6.E 151 . i ----- 9.173--•--.-.— -- 43,4 •----- THERMAL PERFORMANCE—ATTIC BLOWING APPLICATION': • In accordance with the chart above, you mtlst install the ,ninimurn number of bays per 1,000 sq. ft of nes area for each R -Value listed. • The maximum net coverage must not exceed that Specified for each R -Value. • The installed insulation must be at or above the specified minimum thickness for each R -Value. • Failure to install the required minimum. weight per sq. it of insulation at or above the minimum thickness will result in reduced R -Value. • This product should not be mixed with other blown insulations or the thermal claims will become invalid. DANGER: RECESSED LIGHT FIXTURES --7:1 PREVENT OVfiv.Ea@RFATING., DD NOT INSULATE ON TOP DR WITHIN 3" OF SUCH DEVICES. DOES NOT APPLY TO TYPE IC LIGHT FIXTURES OR T€3 FLUORESCENT FIXTURES WITH THERMALLY PROTECTED BALLASTS. 30-24-233 Builders Statement A Saint-Gobain Company @2003 CertainTeed corporation 10!03 r �Y R -VALUE THICKNESS ARFp (SQ. FL) fNSULSAFE 4' BAGS U7 1 BATT6iRULLS 7 CEILINGS V 3/4 l-7 ---- i - ------i- -- _--__—�.----- - WALLS % ?-glib i ----- - - - ---�-- - - 1 -- -_ SI&,b --�- -- --1— = FLOORS - --r—— ----j---- ---- -- THERMAL PERFORMANCE—ATTIC BLOWING APPLICATION': • In accordance with the chart above, you mtlst install the ,ninimurn number of bays per 1,000 sq. ft of nes area for each R -Value listed. • The maximum net coverage must not exceed that Specified for each R -Value. • The installed insulation must be at or above the specified minimum thickness for each R -Value. • Failure to install the required minimum. weight per sq. it of insulation at or above the minimum thickness will result in reduced R -Value. • This product should not be mixed with other blown insulations or the thermal claims will become invalid. DANGER: RECESSED LIGHT FIXTURES --7:1 PREVENT OVfiv.Ea@RFATING., DD NOT INSULATE ON TOP DR WITHIN 3" OF SUCH DEVICES. DOES NOT APPLY TO TYPE IC LIGHT FIXTURES OR T€3 FLUORESCENT FIXTURES WITH THERMALLY PROTECTED BALLASTS. 30-24-233 Builders Statement A Saint-Gobain Company @2003 CertainTeed corporation 10!03 r �Y Manufacturer Insulation Fact Sheet This is CertainTeed Corporation l nsu Sae 4 Fiber Glass Blowing Insulation CertainTeed Corporation P.O. Box 860 Valley Forge, PA 19482 THERMAL PERFORMANCE—HORIZONTAL OPEN BLOW CertainTeed C11 The following thermal performances are achieved at weights and coverages specified when insulation is installed with pneumatic equipment in a horizontal open blow application: R -VALUE BAGS PER 1000 SQ. FT. MAXIMUM SQ. FT. PER BAG MINIMUM WEIGHT- POUNDS PER SQ. FT. MINIMUM THICKNESS To obtain a Thermal Resistance (R) of: Bags per 1000 sq. ft. of net area: Contents of bag should not cover more than: (sq. ft.) Weight per sq. ft. of installed insulation should not be less than: (Ibs.) Should not be less than: (in.) 60 36.5 27 0.986 22 49 29.6 34 0.800 18'2 44 26.4 38 0.712 163/4 38 22.8 44 0.615 143/4 30 18.0 56 0.485 12 26 15.5 65 0.418 1072 22 13.1 77 0.353 9 19 11.1 90 0.301 73/4 13 7.7 129 , 0.209 5'2 11 6.6 151 0.179 4 3/4 R -values are determined in accordance with ASTM C 687 and 518. Complies with ASTM C 764 as Type 1 insulation. THERMAL PERFORMANCE—SIDEWALL RETROFIT APPLICATION When inst6ljW8-,with pneumatic equipment in sidewalls, the following thermal performances are achieved at the thicknesses"weights and coverages specified. Based on a•design density of 1.6 pcf/25.6 Kg/m3. R -VALUE BAGS PER 1000 SQ. FT. MAXIMUM SQ. FT. PER BAG MINIMUM WEIGHT- POUNDS PER SQ. FT. MINIMUM THICKNESS To obtain aBags Thermal Resistance (R) of: per 1000 sq. ft. of net area: Contents of bag should not cover more than: (sq. ft.) Weight per sq. ft. of installe insulation should not be less than: (Ibs.) Should not be less than: (in.) 29 35.8 28 0.967 71/4 22 27.2 37 0.733 512 16 19.8 51 0.533 4 15 1 17.9 56 0.483 31/8 14 17.3 58 0.467 31/2 READ THIS BEFORE YOU BUY What you should know about R -Values. The chart shows the R -Value of this insulation. R means resistance to heat flow. The higher the R - Value, the greater the insulating power. Compare insulation R -Values before you buy. There are other factors to consider. The amount of insulation you need depends mainly on the climate you live in. Also, your fuel savings from insulation will depend upon the climate, the type and size of your house, the amount of insulation already in your house, and your fuel use patterns and family size. If you buy too much insulation,, it,will cost you more than what you'll save on fuel. To get the marked R -Value, it is essential that this insulation be installed properly. 0 �.j r.�., � ��.�. Orr • .. R� WESTERNWOODS EWP ENGINEEREID WOOD SYSTEMS 7�. PAGE 01/01 Certificate of .Conformance Certificate 054086 THIS IS TO CERTIFY that the glued laminated timber products identified with a collective mark of Engineered Wood Systems (EWS) were manufactured. In accordance with the applicable standards and associated specifications indicated below: ANSI Standard A190.1-1992, For Wood Products — Structural Glued Laminated Timber ` NER-486 Glued. Laminated TIrnber Combinations And "GAP" Computer Program For Determining Design Stresses AITC 117-93 - Manufacturing — Standard Specifications For Structural Glued Laminated Timber Of Softwood Species IT IS HEREBY CERTIFIED that the MAPA EWS trademarked structural glued laminated timber members were produced in a manufacturing facility subject to regular audits in accordance with the Engineered Woad Systems (EWS) Quality'Assurance Program. Routine audits include inspection of the manufacturing process and evaluation of the in -plant QA program with adequate sampling to verify ;onformance to industry standards for lumber grade and glueline bond quality. �• t�,Q' �lP 0 tr V10 Cz as SEAL iu+ ao� `y'N' b.y �— Thomas G. Williamson Executive Vice President ENGINEERED WOOD SYSTEMS Is a related corporation of ARA — THE ENGINEERED WOOD ASSOCIATION 7011 South 19th 6V*ot • P.O. Box 11700 • Taooma, WA 98411.0700 Telephone; (253) 586.81300 • Fax Number: (253) 585-7285 •;a <'1' •. AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2005-0032654 Recorded 1 REC FEE 7.90 Official Records 1 County of I COPIES 2.00 Butte I CROACE J. GRlIBBS 1 County Clerk -Recorder! I I SA 01:09PM 08 -Jun -2005 I Page 1 of 1 Illlilllliillllllllllllllillllllll 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: P,¢2cE1 -T-1A.1 ,4-7- rnAF>6W7'i�r0r I�Rr�D�S�r ,407-�.i3 /fs �'h�aw�v C14 i''"p7a w i9 -S /QG�'c_o2D t D i .✓ 77f E ,Ulr /.57 �9 % ,N /3O o /C � of rn,�i'S Date D.3 PROPERTY OWNER State of California _ ) County of On J(.�i/1 C ZOOS before me, C111 LrU ( E. �� �5- , �b T" -L> (i C personally appeared e.nr1G"WL Qin r J r • JJJ personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official FOOA4b CilRMC E. MttlrfOMl Signature Seal: CoBlftow, # 1860507 MobY NO1C - Cc/loilib Oou1dY Cot�m.0lipUMMar2�. A.P. # n (oti-')- .:.f � ani t b�tna�4l ?tfs'3 l�re�ro�eA-tltiei? �inuo� I �I - t �e i sgsG I 'c5,-•+ru:-Si K,'Q�9:t14 llff�ffllf �ll�l{lfl�f�f�iflf#�lffl • 2ift•.,� no ban � �nrs3 .1 - t BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP051080 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 06/08/2005 APN: 064-200-029-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: . Site Address: 14626 CARNEGIE RD MAG �r (' � S� ( Map Index: Date: Contractor: _n nsf Description: DescrP (1752), g ar ( 517 ), cov (64) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate 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 Owner: GRESS GARY M & JUDY L to its issuance, also requires the applicant for such permit to file a 512 PAULA DR signed statement that he or she is licensed pursuant to the provisions of SUISUN CITY, CA 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 94585-2729 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).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: KB CONSTRUCTION PP Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does PO BOX 117 such work himself or herself or through his or her own employees, PARADISE, CA provided that such improvements are not intended or offered for 95969 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 530-872-9006 proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: KB CONSTRUCTION and who contracts for such projects with a contractor(s) licensed PO BOX 117 pursuant to the Contractors' State License Law.). PARADISE, CA ❑ I am Exempt under Article 3 of the Business and Professions Code 95969 530-872-9006 Date: Owner: License #: 707423 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penally 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 Architect: is issued. Engineer: 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: Total Square Ft: 2333 S.F. Policy#: \� Valuation: $127,312.00 I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and -agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith omply with those provisions. Date: G Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one /� y� Z �� F�)Q hundred thousand dollars ($100,000), in addition to the cost of for in Section 3706 the Labor compensation, damages as provided of code, interest, and attorney's fees. �v') /� t �/� /, CONSTRUCTION LENDING AGENCY This permit is h/here !)rued under the applicable provisions of the Butte County Code and/or !)rued I hereby affirm that there is a construction lending agency for the is issued 3097 Civ.) Resolutions t'd w d above for which fees have been paid. ��, Q performance of the work for which this permit (Sec By Date: Name: �' % PERMIT EXPIRES 0 D ( . Address: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or documen f Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpose Print Name: rn IT Signature: Date:2� ❑ Owner ❑ Contractor ❑ Agent for Owner Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 1Q OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" 1 tl f CONTRACTOR OWNER Last Name �5 Address l First Name Address67 A-, City ` Fax L �o g7? .5�Co StateC. _ ZipQtls�s Phone Fax Fax E-mail CONTRACTOR Name Name Address l City lo, tate Zip wa Phone z e,6L Fax L �o g7? .5�Co E-mail Lic. #,.071-C73 7 Z Clan, Fax E-mail GPtit ARCHITECTIENGINEEPoti`) -� 0P LOCATION AP# �6 1V - Z©v-O Z 9' Cross Street Policy Number Carrier PERMIT NO. P05_/d BIN #,O/_ (I City 4A _ , d WORKER'S COMPENSATION If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. 0�o LENDING AGENCY 05" P Name X00" GP��O �ti Description or Scope of Work: Address A/5 7 52 b /� City State C,o`� �Sq. Footage C 0 V Phone Fax ❑ Structure Built without Permits E-mail State License Number ❑ Proposed Change of Occupancy (Note previous use): PPI,(/C44PPI,(/C44 T IGNATURE X For office use only: APPLICANT NAME Name � L•e w/ Address Occ. City Subdivision Name State Zip Phone Planner Fax E-mail PPI,(/C44PPI,(/C44 T IGNATURE X For office use only: Zoning — , Flood Zone I A I SRA LYe I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 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 required. 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: G0�7 Receipt #: � 2, V \,R` Date: 0 z i a 8 Bldg Sheriff SMIP Other Total REV 2-24-05 4 . 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 faxes! ❑ 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 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. ❑ 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 be 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 h'as been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 O co O 1 LO (D utte County Department of Development Services )NNE CHRISTOPHER, DIRECTOR County Center Drive roville, CA 95965 ;30) 538.7601 Telephone 1301538-7785 Facsimile TO: FROM: QSUBJECT: Z DATE: WILLDAN Scott Rutherford (530) 538-7160 srutherford(ftuttecouniy.net Plans Transmittal For Review Per Contract 4/2712005 Applicant: Gress, Gary Permit No: 05-1080 Project Type: NSF/Gar/Cov APN: 064-200-029 100% 70% Plan Check Fees $ 1.,085.26 $ 759.68 $ 1,085.26 $ 759.68 WILLDAN Fee $ 759.68 Copies Attached: Qty Chk Application Site Plan Review FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other ' v R� r .. ..- _: -_w-. '... -: - .. r: � ,..-�.. ,;... , _ .�._ _.... ♦.. � __..,.. vti..+.+w.n- s-....t-.:..uriv'F. - .- r. -_ .. e n g>OS /0 �b 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: ASSESSOR PARCEL NUMBER Proposed Building Use: / — Permit Technician: / Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. \/A' 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. I Aj 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. �p ja 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. / r j 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. r ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form SEI 113. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remainin Rems needed to issue the permit. (May require additional plan review upon receipt of the following items.) i nitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable&7_ < G U 55 5 ❑ Fire Sprinklers........................................................................................... ❑ 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... ❑ Erosion Control Plan Required........................................................................�� (� ` 20_'Pees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 1. City of Chico Plumbing permit........................................................................ ❑ 22. Site plan and business license approval from the Ci Biggs .............................. VV 23 California Department of Forestry Ian approval � paid. S�yi'tfbyY'f anning approval for (A) Use: (B)Parking: (C) Parcel Check:....!!..... 2 �S ❑ Contact Land Development about _ Improvements, _ Drainage ........................ NPDES Form............................................................................................. 6. 427. Encroachment Permit for driveway from the Public Works Dept ........................... Contractor's license information. (Number, Name Style, Classification) ................... ,O 29. Worker's Compensation Carrier and Policy Number .......................................... 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) .................. ter ofSignature authorization.......................................f�Oe(�3�et corded copy of Agricultural Acknowledgment Statement...- '1 r. nib?/ Agisting 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 TelephoneJ�f�'�" 72 9006 and hold for pickup.I 14 I have been informe�he bo��v it fns and requirements for obtaining a building permit. e J Applicant: Date: 1. Index permitpp ica itit on for the above it umbered: Plan Check Letter items requiredesigner, owner, was advised of the above da a by phone, ❑ mail, ❑ counter, by Date:esigner, owner, was advised of the above data by Prac*toor, phone, ❑ mail, B -counter, by Date: h . -()S esigner, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed b : Date: Structural approved by: Date: Note transfer by: Date: , Yellow: Building Division COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE (530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds /9 OWNER (/ PROPROSED BUILDING USE " 1. BUILDING PERMIT FEES --- Balance Due ..................... Ki "u-i'M �_ --- FEMA Flood elevation review ... $ A.P. # DATE RECEIPTT#DATEREC. 99 �C ►tional plan checking Fee.... $ _ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units o ercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) //}} 7k5. RESIDENTIAL DEVELOPMENT IMPACT -FEES � 971P COUNTY WIDE (per dwelling) $ 1/,016 CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per. dwelling) Zoning A FIR INSPECTION AND PLAN CHECK FEE $204.98 ( id at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) a �7 8. SMIP 9. OTHER 7,G . 70 10. OTHER 11. OTHER At time of permit application Lwas, advised t above ees are required to be paid prior to issuance of the permit. These fees may be changed during-flie plan checking p - cess. / APPLICANT DATE Pursuant to GovernalelCo ction 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. 3/05) � I I Butte County Department ofDe velopment Services ° eu r r ° 7 County Center Drive ° tl ' = ° Oroville, CA 95965 (530) 538-7601 Telephone ° (530) 538-7785 Facsimile WIN �y BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: • I need to submit applications for septic and/or well to Butte County Environmental Health immediately. • I an: required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained. • I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building_ permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not .limited to, verification the parcel was legally created, adherence to. all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: 'S12 e1-,7 C 4,✓ IL u r�?� Applicant Name: /�L!Z1U/GI�CsS APN: Z90/y-2,00 Building site address: t i Permit No.: I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above- #f1er ced building permit application and my signature below: � _0 S OF APPLICANT DATE Copy to Applicant/EH/File K:Forms/BldgPermitwithoutClearances 020705 T 7' l 1 ° �� 5 �CfC WC¢� Department .0 o u n t i J. Michael Crump, Director Public f B u t Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville. CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase 11 Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 9 ACRE1 Project Description: SF Project Location and/or Parcel Number: e_�_ 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: Date: Less than I Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 ri A W1 LLDAN Serving Public Agencies May 26, 2005 Scott Rutherford Butte County Building Department 7 County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX SUBJECT: COUNTY OF BUTTE PLAN REVIEW APPROVAL Jurisdiction Job No: 05-1080 Assessor's Parcel No: 064-200-029 Description: Gress - NSF/Gar/Cov Willdan Project No: 14353-1595-M Dear Mr. Rutherford: 117 C Street Marysville, California 95901 530/749.2.373 fax 530/749.2199 www.wilidan.com Willdan has completed a plan review of submitted plans and documents for the above referenced project and recommends your approval with the conditions noted 'on the 2nd page of this letter. The plans and documents provided for this review that have been found in compliance with the applicable codes are: ➢ Plans: Two (2) copies sheets 1 through 5, dated 10/04 by J.L. Randall & Associates ➢ Energy Calculations: Two (2) copies, dated 10/29/04, by Robert Mangrum ➢ Truss Calculations: Two (2) copies dated 11/03/04, by James Bourez, P.E. The plans have been stamped with the Willdan approval stamp and dated the date of this letter. According to our previous letters relating to this project, the superseded plans and documents will be discarded within 10 days unless we receive other instructions. On the pages to follow is the identification of the codes and standards applicable to the project, a code analysis, conditions -of -approval and identification of any deferred submittals. W I LLDAN Serving Public Agencies APPLICABLE CODES Unless noted otherwise, all comments are based on requirements of the 2001 California Building Standards Code found in the California Code of Regulations, Title 24: • Part 2, known as the California Building Code and abbreviated herein as CBC • Part 3, known as the California Electrical Code and abbreviated herein as CEC Part 4, known as the California Mechanical Code and abbreviated herein as CMC Part 5, known as the California Plumbing Code and abbreviated herein as CPC Part 6, known as the California Energy Code, and Energy Commission Standards, and abbreviated herein as CECS CODE ANALYSIS Our plan review revealed the following information regarding the occupancy designation, type of construction, and other pertinent features. This information is consistent with that shown on the plans and permit documentation. Specific Use Type of Occupancy Type of Construction Sprinklers Stories 1" Floor S Ft 2" Floor Sq Ft Total Sq Ft L Dwelling R-3 V -N No 1 1752 NA 1752 Garage I U-1 V -N No 1 517 NA 517 Porch I R-3 V -N No 1 64 NA 64 CONDITIONS OF APPROVAL 1. Approval is contingent upon the review, requirements and approval of other departments and/or agencies that have jurisdiction over this project. 2. Revisions and/or notes as red -lined on the plans. DEFERRED SUBMITTALS Our plan review reveals no deferred submittals noted at this time. SPECIAL INSPECTION NEEDS Our plan review reveals no special inspection needs pursuant to CBC 1701. Since y aac Kuster Plans Examiner Ce: Alice Mefford, E-mail: amefford@buttecounty.net Gary Gress, 512 Payla Drive, Suisun City, CA 94585 Page 2 of 2 County of Butte Permit Nurnber 05-1080 W illdan Project Number .14353-1595 Ju 09 05 01.23p Princess 5303424132 p.1 WWWWWWWWwwwom r-r- ENCROACHMNT PERMIT County Df Butte Department of Public Works 7 Count Center Drive Oroville. CA 95%5 Phone (530) 539-715712==6 Fax (530) 5384356 Download Forms: wwwbuttecount)r.nebpubtscwotltslfartns.html NOT�Y COUNTY 24 HOURS BEFORE WORK iS'TO BE DONE Photo 530) 538-7157 Eict. 2016 Permit N"°Der p:secr "PLICATION I l WE, the undersigned, bemby apply to 11C County ofBtdte form eucmaehmcnt permit to do the fa➢towiag work wade or over die County roads and hi all in accordme with County ordiu acs: and gricnil hm. All intotmatioo yumpt shmatum must be of lciably pritttod 1. Applicaar•s1a. Compnap Vamt- 2. Addn=,. D R i c7 3. Phone z- sod -1. Aftessor's Psrt:d Number. - S. istcetiotr a Woit w t ` t o . 6. Appliant's Sim 7' Date. CONTRACTOEVS INFORMATION g. Contnotarr Name ` h ji C e- 9-ABdresa CA- g5g3 10. Phone: a._ 11. Tate , r 2 12. Contractor's Licaese Number: . 13. Cvtificeft or/Tasunmac: Yes No: ❑ 14, Cattractoi'a 5igoanuc 14a. Dave Signed; J _ , C , Q� IS. Authorized Ageot TYPE• OF WORK TO BE DONE 16 PlwseChedc: Curb: -O Gutter, ❑ Sidewalk: ❑ 17.�Drivevray 13stTypc 19. Other Work - Drseraaw. 19. PLns Atraebed: D Yes ❑ No PERMIT GRANTED In compliance with the above requm and subject to all terms. 4oed+vms (indmding thowon pace 2 of is permit forte) and spvcW tsoriditiaa9 written bdDW.- esionis haft Vasial 2Q Condititms // Qp Und Service Alert .SA must be notified two WorkinS Drier to W.Zae. 4nV7-2600 21. O All work shall conform to ac companying: Derail ❑ Plans ❑ Sp lar Conditions ❑ 22. Date Issued 27. Srpirstioo Darr. 7h. Sunk: 25. Date Paid: 26. Amount Paid: 27. PEW By: 2tL ReodptM.: Mike Crump, Director of Public Waft By: 29. Firml hupccdoa Date: 30. [otpected By: ❑ Completed - OK ❑ Completed —Not OK D Additiotral CDmmente Art itched nuo.>r. ;i.Carameats: Ne.. It permits We raXtd to any number bMdet(530) 533-0356. Meyem be delayed up m Coe west. Page i of 2 AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2005®0032654 Recorded I REC FEE 7,00 Official Records I County of I COPIES 2,N Butte I CANDACE J. GRllBBS I County Clerk-Recorderl I 1 SA 01:69PN GB -Jun -M5 I Page 1 of 1 11111111111 IIID 1111111111111111111 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 Aescribed 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: vwm %�qi r►A P • En7T/i-Ze-Dr - _ v� 17' ^40 ,Y w rf�Cr� W ft -S r c0, 2BC D a/ TIfE p //ems ) /- �f iQC-C'R1)e& 0 ""- t' Co �lwJ ,y d lot,t 5771 r? off- _ice/Y/.� r O O K' �� O � 111 jc S f /4 Y p�'6J Date PROPERTY OWNER J6CIVIVc77K 19 3LA-"-T-6 rJ State of California ) County of On -J( nr- r7 2005 before me, CA, i E. personally appeared 1'1e,) I C -i1 l I a_ A r 6 Z71- personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official Cly E. �iSiOMI Signature Seal: Caffdrdmdon# 1560507 &ftftw r A.P. # OO- C116ar�2, BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM 0 FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) ❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD) R-frARADISE RECREATION AND PARK DISTRICT (PRPD) 0 DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) 2ze2!� Q Building Permit Number. 037^/6 Yo Property Owner (s) Project Location /Address Subdivision Name o�rne� �C 1. Assessable Sq. Ftjd Type of Residential Development (check one) V New Development Single Family -Detached Single Family -Attached Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling Mobile home Mobile home replacement verified by Assessor Department Demo Permit (datei#sued 4 ) r1 ' verified by Building Department Comments: 0 FRRPD ❑ CARD VPRPD ❑ DRPD certifies that: lan fi-2D .-�3("4, g9Da( Appli Number Mailing Address ICity State Zip Has complied with requirements of the Butte County Board of Supervisors Resolution No. 0 141(77 by Payment of - Dwelling Units @ $ . I per unit for a total of $ l 75a Square Feet @ $ per sq foot for a total of $ Remarks: C,r Paid y heck No: Paid by Cash: Receipt No: and Park District Representative KAFORMS\BUILDING FORMS\park-rec standard form rev Ldoc Date -770 8 g BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District r Building Department No. A.P. Number Property Owner County GDU� Property Location/Address Subdivision Lot No. Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) District Identification No. School District certifies that Address) (State) has complied with the requirements of Resolution No. representing S�uare feet. School District Representative Paid by Check # Remarks: Sq. Footage (Including Exterior - Roofed Areas) Date WAY, N, rV ME - W z1a P,17Z-- (Phone Number) (Zip by payment of $ 3ZZ2 Pee 2926 � FULL MfTIGATION $ Date Nofke: You may protest the Imposition of the fess Identified above by submilding a wrtlten protest to the District. In compliants with Government Code flection 66020(a), within 90 days from the data fees ane paid. Failure to submit a timely written protest will'prohiblt you from ehal"Ing the Imposition of the fees In any court acdaL N. subsequent to the School District Representatlw signing thisSutte County Schools Impact Fee Certification Form, the School District Is nod Md by tlw applicable Local Planning Agency that this project Is being ravlowad under the California Environmental Quality Act (CEQAh this pro)ea may be subject to additional school tees to fully fie. its Impact an the school dl bkft schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls (10/03)dmm Residential Development Q Q Q• Footage V 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) District Identification No. School District certifies that Address) (State) has complied with the requirements of Resolution No. representing S�uare feet. School District Representative Paid by Check # Remarks: Sq. Footage (Including Exterior - Roofed Areas) Date WAY, N, rV ME - W z1a P,17Z-- (Phone Number) (Zip by payment of $ 3ZZ2 Pee 2926 � FULL MfTIGATION $ Date Nofke: You may protest the Imposition of the fess Identified above by submilding a wrtlten protest to the District. In compliants with Government Code flection 66020(a), within 90 days from the data fees ane paid. Failure to submit a timely written protest will'prohiblt you from ehal"Ing the Imposition of the fees In any court acdaL N. subsequent to the School District Representatlw signing thisSutte County Schools Impact Fee Certification Form, the School District Is nod Md by tlw applicable Local Planning Agency that this project Is being ravlowad under the California Environmental Quality Act (CEQAh this pro)ea may be subject to additional school tees to fully fie. its Impact an the school dl bkft schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls (10/03)dmm r R i• SITE PLAN REVIEW APPLICATION Date: �� Z /©� AP# 067LZ —200 —0.2 --- Permit Number (if applicable) 0i(0 APPLICANT INFORMATION Parcel Size: Owners Name: Owners Address: Telephone No.: Situs Address: 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 Other ❑ Septic ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) 60 Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Site Plan Stamped Approved By Date (p Page 1 of 5 ALL ITEMS CHECKED 'APPLY TO THE PROPERTY 1 Parcel Is In: H . Snow Load Area: • a000 -AD X5-00 P f ❑ Land ConservationAct 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) w 001 SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: • Flood Panel No.: —CT(o-0CP7C OOG Index Date: �o ❑ Sacramento River Reclamation District (Approval must be obtained from the Calif rnia 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 ----------------------------- -------- ---------- -------------- ------------ --- ---7 ----------------- - ❑ Detached Building Use Form ❑ Encroachment -Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: GP- L - D2 Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 �s0 A& - Zoning Code Streets & Highways Fire Prevention Subdivision Map Front SideJr- D� ► / '_ Side Street Rear s - 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 �s0 A& - Applicable Development Fees: Standard Fees Amount Formula ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads 0 Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ Other ------------------------------------------------------------------------------------------------------------------------- Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) 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. Parcel Created By II 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: A-1 L/ Map Date of Recording: 7ikIZI Lot: ,2-13 ❑ Use Permit/Minor Use Permit Permit Number: Book: S� Page: 0' Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ 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 roa Page 4 of 5 ❑ x 0 Summary of Specific Requirements: This information provided in this summary is based on the application information and on the best available data at the time of review. CALarrys\Building Permit Site Plan Reviewl.doc Page 5 of 5 0 �IOP y �. �""r•,.-? _ r ! ,�i SEE S11EET ND. 3 — 2 QJ f? l��Fd°t I C F �N ' '• � ; .'. rOr AL dCPES /29.95/ — _- ., I [ S 90.113 &MDS zo. 91a S?E /7.791 Ts Ta . �0°.i• ,6 (•a.sa• ae `i4 ,°vC . °d „s. .'"a '!:N„„ars -�- .rr 9m. i:crro `' ' ti •�'tr _ a. �ti C �'• 4•- IS/ , `�'< SO '��b a�/ ?52 16���r� Q 0. a;,, �•, ,a\Zt sof cvEo t.S/�iE4 L/d AV6 A >! & °a A o 6 ca iA ' 2z/ �/� 06 0• ,w � tg zoos`' ��-..�.:�w - �� I � Amc4a.4 �0• d 0 ''� : 6r° J, 2ps t 69 a°%�'4 °°•� ?53 ,/ 8� '��+'�?t� 108 2p6 � • � � - 4 9 a - c^ :/, .\\`N i 1G B 1?p 1+ S ° m-' >• V/C/N/TY MAP $ i f•'--. '�:.- `,u4- [#�9 ? G Q .> � y. $ �. a- ? -fo`p' �C01 ddA ?O �_ n.� 0 .1 e: ,t .aGr,/ra - ° .::¢.re.>`c _____ ,•_ '.,.N ZSQ Z�k � 4. dd f ?/9 00 � �� �Oy.t �• !> 8. ��� t1 d�.1° 4' oit \,4 ISNFFTT I OB ' ' 4:c / �. 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Jb, • 1`�: 1' ' e? -1. ` �� zos�'�caU a:,.v" F d '''.'' t °� QJ 54 °0 2• g Z96 dj A4 L 211E CALIFORNIA COORDINATE SYSTEM LONE 2 ESTABLISHED QYI-� "•.v»,,>,��:�'+c•ry .l-•.77G°q .yY <�=-•'^rnN 1,/Lr, 170 �4g' h. /q/T+ 1' 1: FRO IA TRIANGULATION STATION SAWMILL 1X•2.124.255.90, i z',° AC 1y.?75 ;, ^>r� r e e i ' a/ e`M's�i�� Q y°• Y.781,fi4 98) TO TRIANGULATION STATION BALD MOUNTAIN r'@ •� , __ d0' -61 ,t../L Pe 1 t ?9!;�- !. �.. �, (X•2,145.390.63, Y•532. 9413. 421 BEARING N ].2.23' 29' E La I 3B': `•� �• �� 1° @ '7t,y 1° •os;`\" 14° t' bAP ' 1` AS SIIOWN ON THAT AMENDED RECORD OF SURVEY. FILED IN :lrA' g.� h ?7Q 'O: •'$�R..+`+ 1' G'1 1 BOOK 33 PAGES 95. 96, 97. 98. 8 99 BUTTE COUNTY /ao,2 I y D kti b r Sao Z ' -moo\ 1g' ZBJ / /SIG 4/� RECORDS. DISTANCES SHOWN HEREON APE GRID DISTANCES: IIS, !°: ✓/v-/s••F rei yg 277 ^'� `oq ' °` ?73 A. 77? pi •?1i �`Da`"''.- R' W� ,,, 4 0.(OAO 0� .... D°0 MULTIPLY QY 1.0001138 TO OBTAIN GROUND DISTANCES. ysro 37 . ,x%,. � ! : 'q ' _ o ` t � ? % $ zBG 'e g 0� /; '-.• �'^- V h' oy Q aa3 °°' ✓ :S`.`n' r rrc r i/• t /p �'!:` h - SUBDIVISION N0. _ x > , . o°'i✓i ^ p 's. °v- r°t �r Z [� ,..°. ,=s �,,y ,, E ;, ; a':... 7g =. �. D PARADISE PIN ES UNIT N0. 14 : PTN. SEC. 14 823 T. 23 N., R 3 E., M.D.M. BUTTE COUNTY, CALIFORNIA SCALE: I"= 100' FEBRUARY , 1970 MURRAY a M°CORMICK INC, CIVIL ENGINEERS LAND SURVEYORS 1912 F ST., SACRAMENTO, CALIFORNIA SEE 54EE7' NO. SEE faffT NO. 5 SHEET 4 OF 5 SHEETS Iii► I E.N. USE GAKY Piet Pian Attached t/ Flout, Plan Attached Sett to B.D. TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner. Location AP# Plan Approved for: Sewage Dispose! ✓ !Dater Supply: Public � Private ell Clearance for ✓dwelling. Other Hold final for: Final clearance O.K. for: NOTE- Environmental Heal pecialist to 8/96 -- �. e E.H. USE ONLY Pitot Man Att Floor Plan A Sant to 11.155E9/ 11 TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance 0 er Locationi AP# Plan Approved f Sewage Disposal W ter Suppl Public x Private Well Clearance fowelling. Other f"`� Hold final for: Final clearance O.K. for: