Loading...
HomeMy WebLinkAbout064-590-054`RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 X004-0063688 Recorded Official Records County Of BUTTE MACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 02:14PM 15 -Oct -2004 REC FEE 10.00 CONFORM 1.00 Mark Page 1 of 2 SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with ,California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit 2 described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. f LINDA A SAMMIS REAL PROPERTY OWNER/LESSOR 14705 BRIDGEPORT CIRCLE MAILING ADDRESS MAGALIA BUTTE CA 95954 CITY COUNTY STATE ZIP 6290 CHATHAM COURT INSTALLATION MAILING ADDRESS, IF DIFFERENT MAGALIA BUTTE CA 95954 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner. write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE . MAILING ADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 04-1485 530 538-7541 BUI IN PERMIT N TELE PF E 7DA(TEEE MB NATURE OF LOCAL AG Y OFFICIAL INTEGRITYHOMES' DEALER NAME (if not a dealer sale. write "NONE") 91563 DEALER LICENSE NO. a MARLETTE HOMES 2002 PACIFICA MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER H021470A/B/C 40'x48' ORE437623/24/25 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER AP# 064-590-054 HCD FORM 433(A) REV. 8/91 WHITE - County Recorder CANARY - HCD PINK -Applicant GOLDENROD- Building Dept. �y .,,r, .. .• v .:Y __ .1. M =j All that certain real property situate in the County of Butte, State of California, being more particularly described as follows: Lots 28 and 29, as shown on that certain map entitled "PARADISE PINES UNIT 11", filed in the office of the County Recorder of Butte County, California, on becember 17, 1970, in Book 38 of Maps, pages 17, 18 and 19.' EXCEPTING THEREFROM all minerals, oil, gas, asphaltum and other hydrocarbons substances with provision that any and all mining operations shall be done from orifices outside the surface area of the land herein described and that no damages shall be done to the surface of said land. AP No. 064-590-053 11, BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVIL'LE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class: License Number. Date: Contractor: OWNER -BUILDER DECLARATION� I hereby affirm under penalty of perjury that I a of from the Contractors' State License Law for the follow;,--, -c. 7031.5 Business and Professions Code: Any ctt%•% i _ lr���. <,quires a permit to construct, alter, improve, demi' _ ' 4l �,N07" .•e, prior to its issuance, also requires thr"-' '' ' 73 ',. 6L� ' Ole a signed statement that he or shy � �0 R w �5 F s of the Contractor's Slate Lice—", ' , Z l $ �I� icon r '�: Yrt Y l�C:e 7000) of Division 3 of,' i ' r� G 5• he or she is exempt thP•" 7 ..Obption. Any violation of S,_' ... tt, t fc y� �0 r gS�rt' subjects the applicant.' f nrr a :"x ed dollars ($500).): I1J I, as r 3f. 'al~�, c I j:,iployees with wages as their sole a - :-work, and the structure is not intendeG rr �^ .1' 0 �,oec. 7044, Business and Professions Code: Ti0LN-State License Law does not apply to an owner of pr,- QW, builds or Improves thereon, and who does such work hit. _.nf or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds'or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 'I am Exempt under Article 3 of the Business and Professions Code Date: ��� Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the -performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit Is Issued. My workers' compensation insurance carrier and policy number are: Carrier. Policy I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith -comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Sec 3097 Civ.) Address: PERMIT NO. BP042800 Issued Date: 01/10/2005 APN: 064-590-054-000 Site Address: 6290 CHATHAM CT MAG Map Index: Description: OPEN DECK(300) Owner: SAMMIS, LINDA 14705 BRIDGEPORT CIRCLE MAGALIA, CA 95954 Applicant: SAMMIS, LINDA 14705 BRIDGEPORT CIRCLE MAGALIA, CA 95954 Contractor: License #: Architect: Engineer: Total Square Ft: 300 S.F. Valuation: $3,000.00 Census Code: This permit is he issued der the applicable provisions of the BuHe County Code endlor Resolutions to �o d ted abo for which fees have been paid. By: Date: PERMIT EXPIRE ON: x to ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification In accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that'I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge It is unlawful to alter the substance of any official form or document of,Bulte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for Inspection purposes. Print Name: /A d4 � �� M ��✓ Signature: Date: �'/D'6!5; `Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor I BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTIONM OROVILLE: (530) 538-7636 - CIRCO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" OWNER Last Name' 6-< /W) it-; irst Name r Address ­20�� -LCIC r�T LnG City< f < < State City Phone7 ` , f 70 Fax E-mail APPLICANT NAME CONTRACTOR Name Address Address Crty �C �Lr City stat State Zip Phone Fax Fax E-mail Planner Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name Address Address Crty �C �Lr City stat State Zip Phone Fax Fax E-mail Planner State License Number APPLICANT NAME Name L jAdce 64 h-,^-�?�s Address Cross Street //� �4'Z=�T� ') r` -G Crty �C �Lr Yes stat Zip c�� Phone r 704 04 Subdivision Name Fax E-mail Lot APPLICANT SIGNATURE X For office use only: Zoning Properly Address Flood Zone Cross Street //� �4'Z=�T� ') r` -G SRA Yes No Occ. Type Const Subdivision Name Map Book Page Lot Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS Bpaga 8b al BIN # LOCATION AP# Properly Address City J Cross Street //� �4'Z=�T� ') r` -G WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Ct 6�7-lr /&Jg— Sq. Footage 30� ❑ Structure Built Wthout Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be 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 b0if"', Amount: 1 V Uy Bidg I I SRA Receipt #: �� Sheriff • C SMIP Date: Other Total t SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED,* ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxesl ❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Data sheets and 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). E39. 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). — ❑ 13. Sanitation and site plan approval from the Environmental Health Department. 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). 1-12. 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. O Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional information regarding this process, contact a Permit Application 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 merunos can only ee made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 r . 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: �� n/'�yY�-� ASSESSOR PARCEL NUMBER `/ �' - 5 qQ - Proposed Building Use: /��GCJLr�� Counter Technici Date: 3L6 Items required in order to appy for a permit. All boxes MUST be checked OR marked NA in order to apply. 1. Site plans, 3 or 4 sets, signed by 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. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or frld 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. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 20. Erosion Control Plan Required...................................................................."" ........ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of Fore try plan approval ❑ paid. Sent by. - 24. y:24. Planning approval (A) Use:(B)Parking: (C) Parcel Check:_ ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization......................................:............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ '35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone _ and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 9-.;2.3 - 0 1. Index permit appfication for the above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, ow^w advised of the a ve Hap0 phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: v`� Date: Plans approved by: Date Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division E.M. use ONLY Rat Plan Attachod Floor Man Anachad _ c^� 8an2 to'®.D. / TO: Building Department FROM:,- Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well Clearance for dwelling. Other Hold/final for: Final clearance O.K. for: NOTE: Environmental Health Specialist Date 8/96 Building Permit Number: 04- -900 Owner Name: Z Mi Residential Construction Requirements Il1I[PORTANT This set of plans and' specifications MUST be kept on the job site at all times and it is unlawful to make any changes or alterations on same without written permission from the Building Division, County of Butte. All materials and workmanship shall be in accordance with recognized good practices and of a quality prescribed for the specific use in the 2001 California Building Code (2001 U.B.C), 2000 California Plumbing Code ( 2000 U.P.C.), 2000 California Mechanical Code (2000 U.M.C.) and the 1999 California Electrical Code (1999 N.E.C.) COMPLY WITH ITEMS CHECKED BELOW. Your parcel lies within a designated 100 -year flood plain. Finish floor, electrical, H.V.A.C. equipment and services shall be a minimum of one foot above the elevation shown on the attached Flood Elevation Certificate. A Post Flood Elevation Certificate will also be required Note:, We will normally accept:the following as compliance with the flood elevation requirements: 1. Building is anchored to concrete stemwall system with conventional anchor bolts. 2. Building plate on top of stemwall to be one foot or more above the 100 -year flood elevation. (Plate height less than 24" above grade, or engineered design required). 3. Electrical, heating, ventilation, plumbing and air conditioning equipment and facilities located above the plate. 4. At least 2 openings in exterior walls, located on opposite or adjacent walls with a total net area of not less than 1 square inch for every square foot of enclosed area. 5. The bottom of the openings shall be no higher than 1 foot above grade. 6. The openings may be screened or covered with other devices that will permit automatic entry and exit of floodwater. Page 2of 2 Building Permit Number: 0q' Z8007 Owner Name: 5a,v nAllS Parcel lies within the State Responsibility Area (SRA). Comply with attached requirements. �5 ��. Fire sprinklers are required in this structure. IMThe following parcel map requirements shall be met: tKAll structures and equiDment including overhangs shall be clear of all easements. A setback ofOWWfrom. the side and2h -401�,T from the rear property lines and 20 feet (25 feet if Federal Aid Route) from the edge of the right of way shall be clear of structures and equipment except for a 2 foot overhang. IkExpansive soil may be encountered on this site. This condition may require the foundation to be designed by a California registered engineer or licensed architect. V. fi..., i{ G PLYWOOD CC EXT, X 2'x 12" STA( STRINGER. 48'ao. MAX. 7OF VIEW IlhLiV #UL- .NOT 5NOU1N FDR CLARITY. Z41 if U, DF"2 2"sV DECKING '(ALT)a GIRDERS .. ., .. � 9a' TiG PLYWOOD CC EKT. • q•,�q.• � , � ENVIRC� 9 . tmr'qL HEALTH MOBILE HOME OR DECK � M a SES' CH1CO3 Cp:i-r► _ 48" ' MTL. FRMU CLIP (EA. DE 4 r oc MAX APPR 4N V 9'M!u Cj Butte C a 4'x4' POST ' v rn t 2"x 12' — _ ro O GrUARD RAIL % " 2DF.� _ f� �a' X 2"x4" PRESWC rRFATCP OR i DECKI IJ G ' GlR�E V, ' 8 MIN.- � -DOLTS - -- -- RFD 11I.A76F S _ .• . r ... PRECAST 4,X,40 POST ADE4U4TE DIAGONAI. 8 Igo 6RACING. TYPICAL RE'SIDEOA T//JI_ (�• COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS �o� n%/fig 1F, ''MN. FOOTING 7 County Center Drive — Croville. CeNtornle 95985 T nl wnhnnn' p1n ter, Butte County Department of Development. Services YVONNE CHRISTOPHER, DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile ADMINISTRATION * BUILDING * GIS * PLANNING October 15, 2004 Linda Sammis 14705 Bridgeport Circle Magalia, CA 95954 "I Subject: APN — 064-590-054 Dear Mrs. Sammis: The Butte County Department of Development Services, Planning Department, has reviewed the submitted Building Permit Application 04-2800 and has found your application in compliance with the established planning criteria. The site plan you submitted meets the setback requirements for your zone as well as applicable map or use permit conditions. The Permit Application has now been forwarded to the Building Division for their consideration and action. If attached, please find a copy of any use permits, map notes and conditions for your property. We are providing this to your for your information and future reference. Should you have any questions please feel free to contact me between the hours of 8:00 a.m. and 4:00 p.m. Monday through Friday at (530) 538-7603. t elytt ..J Tolley Assistant Planner SITE PLAN REVIEW APPLICATION Date: -co 4-/ AP# P./.' q- �`l0 - (n Permit Number (if applicable) 29Ob Bin Number, r APPLICANT INFORMATION Parcel Size: Owners Name:"'`"`' S �'"��' Owners Address: Telephone No.: Situs Address: Proposed Use: Residential ❑ New Single Family Residential ❑ Single Family Addition ❑ Mobile Home Residential Accessory —4 (e-clK 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): .a ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) y� Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval ®Site P an Stam ed Approved By -' Date In - (S- 2o-OCi Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: Snow Load Area,QDQ ' — 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: X • Flood Panel No.: Index Date: 6 ❑ 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: 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 go Side Side Street Rear Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ®, CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Applicable Development Fees: Standard Fees ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other -------------------------------------- Subdivision Map Special Fees Amount _ Formula ❑ Water Tender ❑ Road Improvement F] 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 ❑ Deeds: Date of Creation: Legal Access Provided: ❑ No Deed of Reference: Legal Access Required ❑ No Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Yes ❑ Yes ❑ 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 11 0� Subdivision Map/Parcel Map: ;` // Map Date of Recording: l,2- -17 - / -2. 70 Lot: .26 ❑ Use Permit/Minor Use Permit Permit Number: Book: A8 Page: 2`Z 2-j 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 road maintenance, and stop sign maintenance. F Page 4 of 5 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. C:\Larrys\BuiWing Permit Site Plan Reviewl.doc Page 5 of 5 National Pollutant Discharge Elimination System (NPDES) Phase II .Construction Storm Water Permit. and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement BLESS THAN 1 ACRE1 Project Title: By signing below, I, the projectowner/owner's agent, certify.that I am aware that a construction . project that disturbs 1 acre or more 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 1 acre or more of land. I, further, certify that this project will not disturb 1 acre or, more of land. I amaware that submitting false and/or inaccurate information may result mi revocation of grading and/or other permits or other sanctions provided by law., Signed: Title: Date: 5 -a IVs/ RF,CORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 CCJP'Y of Document Recorded 15-Uct-2004 2004-0063688 Has not been compared with original BUTTE COUNTY RECORDER SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. LINDA A SAMMIS REAL PROPERTY OWNER/LESSOR 14705 BRIDGEPORT CIRCLE MAILING ADDRESS MAGALIA BUTTE CA 95954 CITY COUNTY STATE ZIP 6290 CHATHAM COURT INSTALLATION MAILING ADDRESS. IF DIFFERENT MAGALIA BUTTE CA 95954 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE . MAILING ADDRESS OROVILLE BUTTE, CA 95965 CITY COUNTY STATE ZIP 04-1485 530 538-7541 BUI M PEnMITN TELEPFjj]1�jE MB `/�� NATURE OF LOCAL AG Y 0 CIAL DATE INTEGRITY 90MES DEALER NAME (if not a dealer sale. write "NONE") 91563 DEALER LICENSE NO. MARLETTE HOMES 2002 PACIFICA MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMENUMBER H021470A/B/C 40'X48' ORE437623/24/25 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) SEE ATTACHED ASSESSOR'S PARCEL NUMBER AP# 064-590-054 HCD FORM 433(A) REV. 8/91 WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD- Building Dept. 1 All that certain real property situate in the County of Butte, State of California, being more particularly described as follows: Lots 28 and 29, as shown on that certain map entitled "PARADISE PINES UNIT 11", filed in the office of the County Recorder of Butte County, California, on December 17 , 1970, in Book 38 of Maps, pages 17, 18 and 19. EXCEPTING THEREFROM all minerals, oil, gas, asphaltum and other hydrocarbons substances with provision that any and all mining operations shall be done from orifices outside the surface area of the land herein described and that no damages shall be done to the surface of said land. AP No. 064-590-053 BUILDING PERMIT NUMBER: 04-1985 Address or location of unit: 6290 CHATHAM COURT, MAGALIA CA Legal Description of Real Property: AP#: 064-590-054 SEE ATTACHED (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: LINDA A. SAMMIS Owner's address: 14705 BRIDGEPORT CIRCLE, MAGALIA CA 95954 INSIGNIA OR HUD NUMBER: ORE437623/24/25 SERIAL NUMBER OR V.I.N.: H021470A/B/C MANUFACTURER'S NAME: MARLETTE HOMES YEAR:2002 OFFICIAL APPROVING INSTALLATION AVI DATE: () PHONE: (530) 538-7541 H.C.D. 513C :,-;r:.::: _;. STATE OF CALIFORNIA NUMBER: Q�,��•Etii OFy�G •+ BUSINESS, TRANSPORTATION AND HOUSING AGENCY 8688197.:=.:.: _. o` •i�' DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DIVISION OF CODES AND STANDARDS `.. a :.;.;.::.r::. -::'MANUFACTURED HOUSING PROGRAM MANUFACTURER CERTIFICATE OF ORIGIN . f 6:C_HECK IF THIS IS A DUPLICATE MCO -ENTER ORIGINAL MCO NO. MANUFACTURED HOME OR MULTI -UNIT MANUFACTURED HOUSING NUMBER OF ... .I SFD•(SINGLE FAMILY. DWELLING) MUMH (MULTI -UNIT MANUFACTURED HOUSING TRANSPORTABLE SECTIONS .COMMERCIAL COACFI:.. - - � :-.: •,- . .. . OCCUPANCY GROUP MANUFACTURER NAME:" ' '" MANUFACTURER LICENSE NUMBER: MARLETTE HOMES 1074923 MANUFACTURER ADDRESS: SUGGESTED RETAIL PRICE 400 W. ELM ST HERMISTON OR 97838 $95,696 (Street) (City) (State) (zip) MANUFACTURER TRADE NAME: MODEL NAME AND/OR NUMBER: DATE OF MANUFACTURE: MARLETTE BY SCHUL T PACIFICA 10-17-02 NAME OF DEALER OR.TRANSFEREE (OWNERSHIP TRANSFERRED TO): CALIF. DEALER NUMBER OR DATE OF TRANSFER: TRANSFEREE DESIGNATION: INttlHRIT`Y 'HbkES 91563 10-17-02 DEALER OR TRANSFEREE ADDRESS: (SUW40 FEATHER RIVER BLVD (City)OROVILLE (State) CA (zip) 95965 INVENTORY CREDITOR NAME: DEUTSCHE- FINANCIAL INVENTORY CREDITOR ADDRESS: AIM MARYVIL-LE"'C£NTER -DRIVE LOUIS MO 63141-5832 (COST. (state) (zip) SECTION MANUFACTURER SERIAL NUMBER HCD INSIGNIA OR HUD LABEL NUMBER LENGTH WIDTH WEIGHT . (1-8 INCHES INCHES - (POUNDS) . _h. .. H-021:470 ORE 437623 576 'in 480 in 23520 B H=021470 ORE 437624 576 in 480 in 23520 TRANSPORTER NAME TRANSPORTER ADDRESS::,:' •, »• _ , Street C' (State) (zip) DESTINATION FOR UNIT DESCRIBED ABOVE: .. . ntegri-tiy.`..Homim3:- -St. 17.40 FEATHER RIV BLVD OROVIL1;ae CA •95965 ) .. -a.•:: r --.�-.„•`::ilio! a y !+�� P nYoflferjury under;dw laws a'( Oe State a CerRomla that the above rads ere true awl correct _...,. _ _ _ ....----_ ._._ .__ ..... r _ ._ ' r•�j .t j "_ :5 _T,.t-::m d9 tc9,-.. Ri7 iy' ~L;iiT _,�Y+... ..C. ,:. to ��''•�'-.: :LK:t _":::,. .. _; •( ate :moi - '.,. ` ) _ SIGNATURE OF AUTHORIZED, G 3VITAT693c�UR '•�' `f;: �:. � �.' SIA .�I{�!�:j�l!}. `I ':,t: .:A'- - :Ai f. STRIBI)i1"�""AR(GMl1�(PINq?y fORINARDT0;7HEMVENTORYCREDfiOR$1NLESSTHERE-IS NONE THENFORWARD70�HEPURCt(ASER(UFALER r: COPYa1'tWwm. . - FORWARD TO.THE DEPARTMENT AT P.O: BOX -I B28: SACRAMENTO. CA tI5812-1828• WITHIN FIVE (5) GAYS OF RFLEAS r_ Y,4COPY (YELLOW) ._ DELIVER TO THE TRANSPORTER TO ACCOMPAN)f E UNIT TO ITS DESTINATION �, Y _COPY 3. GOLDENROD» `. TO BE RETAINED BY THE MANUFACTURER _F_ i OR TAA(;. STATE OF CALIFORNIA DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DIVISION OF CODES AND STANDARDS REGISTRATION AND TITLING SECTION STATEMENT OF FACTS This unit is a: Mobi.lehome Commerical Coach Floating Home Truck Camper Decal (License) No. (s) Trade Name r Serial No. (s) (0,,� i y 10 A l-1 C I/ We, the undersigned, hereby state that the unit described above: r� CUT '-bci 1"C'L r and lq7l cl-e l Affiant further agrees to indemnify and save harmless the Director of Housing and Community Development, State of California, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the above- described unit in California, of from issuance of a California certificate of title covering the same. I / We certify under penalty of perjury that the foregoing is true and correct. Executed on 3— I LI) Q L� at: Croville , California (Date) (City) (State) Signature of each affiant Printed name of each affiant I Address 1740 Feather River Blvd. City Oroville HCD 476.6 (Rev 11/86) chelle Freel, Office Manaaer . State California 5/24/2004 9:41 AM FROM: Fax TO: 821-5854 PAGE: 002 OF 003 Fax 5/24/2004 9:30 AM FROM: Fax TO: 921-5854 PAGE: 002 OF 002 Fax Lof a",.filed in:: the -a§*:sh-oWh-6ii:that certain # entitled, "Paradise' Pinibs Unit -N6. I... ..., . .. ... ... . .. .. . ... ... . ' .. California, "Paradise' . i` Unit -.1n County.Re,c& - Ai� tounty., C` I Dec . 1. � N'. office of. the de�: of Bu alif.ornia, or'i b'' 169�1 . 1 0. Qook:.38, of p at' %a g e. (s) EXCEwPT-N'-GTHtR--E'FR*0--M '11* minerals,. asp-halturn.- and:offier hyd.6&atpo substa-npe§�, w . ith pr.oyislon that any:-..-and:-.all..m-inin.g operations, -shall:.be. done: firqij! oeific:e-g outside; -t al I' h -farea ea of the-Ipnd,.0 e.s.Q.r i bed.. hereln,.'a od that -qQ - damage S.h.c. b' e dome to.the s , ..*a surface - surface a.ce of said iand. PARCEL B*' A no-ri"e.x.Q-1"Usiv.e..,.e.asem'ant.-o.ye.r Lots A.and B. (the eprnmon.,.are-as) of said Paradise Pines Unit.No. 11-1 4n.d..ihelois -.des:i'gnated.'-fckr..common and..recreatio-n-.areas.-aad.es-c.r.ibeid.*in- the Decla . ration . of Annexation for.'.0 n'itsA'V..Vj, Vill-.'X* HCl and X111. Assessor's. Parcel "N All that certain real property situate in the County of Butte, State of California, being more particularly described as follows: Lots 28 and 29, as shown on that certain map entitled "PARADISE PINES UNIT 11", filed in the office of the County Recorder of Butte County, California, on December 17, 1970, in Book 38 of Maps, pages 17, 18 and 19. EXCEPTING THEREFROM all minerals, oil, gas, asphaltum and other hydrocarbons substances with provision that any and all mining operations shall be done from orifices outside the surface area of the land herein described and that no damages shall be done to the surface of said land. AP No. 064-590-053 NOTES ` ` - RESIDENTIAL _ Q 04-148��5 'PERMIT NO. 064-590 054, _ SAMMIS, LINDA /^^/} CHATHAM CT, M.AGALIA W Cont: DUPAR & ANGEL r MH PERM FND NEW SITE THE HCD FORM 433A FOR THIS MH CANNOT BE .RECORDED UNTIL ONE OF THE FOLLOWING HAS 'BEEN TURNED IN TO THE BUILDING DIVISION: a (1) LICENSE PLATE(S) OR'DECAL (THE INSPECTOR MUST RETREIVE). (2) STATEMENT OF FACTS (ONLY ON NEW MH' S). YINSPECTOR TO VERIFY SERIAL & LABEL #'S. SPECIAL CONDITIONS SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER A. 7­� r- 5 � 2/ �20 )9/36 JOB FINALED (Date) Signature CHECKED BY J=OK 0 = Not OK •` =Not Applicable MOBILE -HOMES MISCELLANEOUS, '`" ' ` . =Not Ready MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK exce It #'s ncrrtic rnvccc ceocnorc f AGA!_CC 101-1 4. P 1. Zoning Requirements -Setbacks -Easements . 2. Soils; Special MH Support Sketch 7,/Water 3. Sewe -ocation-T t -Fall -C/0 -Concrete ` Vs and Electricity Tagged 9. Locatio est -Easement Needed (Sketch) ' 5. Elec �ty; Location-Clearances-Grnd-/ /Amp -Concrete erify #'s with Office Date as; Location -Test -Wrap;-/ jJ"L 'ft. / P Nat. or/ AP' L "ft./ 6-/ Date tCard 7. Well Clearance & Elisconnect Electric 8. Utility Clearance Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. 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 4 3. Gas; MH Test -Demand -Valve -Connector , POOLS (Plans) OK except #'s 4. Electricity; MH Test -Crossovers -Breakers -Clearances Setbacks -Easements 5. Drain; MH Test -Fall -Flex Connector Soils; Compaction -Structure Stability 6. Water; MH Test -Regulator -Connector Pool Structure;; Steel -Connections -Thickness Dead Men -Lining . 7. Water and Sewer Connected -C/O to Grade -HD Approval Elec.; Receptacles and Lighting, Distance-GFI 8. Gas and Electricity Tagged Elec.; Pool Lighting; 15 Volts-GFI 9. Tie Downs -Type -Installation Cert. Elec.; Enclosures; Conduit Entries -Terminals -Listed 10. Exits; Insp.-Sketch ` Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater - 11. t Cert. of Occupancy ,. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval , 10. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date 4PERMANENT END SYSTEM (ONLY) 7 i onin_g.Requirements-Setbacks-Easements _fit Z. otings; Size -Spacing -Marriage Line . , 4. __Po; MH Test -Demand -Valve !� 5. ectricity; MH Test e Water; MH Test 7,/Water and Sewer Connected 8. Vs and Electricity Tagged 9. xits 10. 'cense Decals 11 erify #'s with Office Date and B-1 Date Card B-1 Date tCard B-1 Date Card B-1 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 i 4 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 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-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 . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel- Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date 54. Card B-1 Date Card B-1 Date 55. Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 17. Water Htr.; Vent -Access -Combustion Air Baffle Siding -Nailing Veneer 18. Water Pipe; Test & Anchor -Nail Protection Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 19. D.W.V.; Test Fittings & Anchor -Nail Protection Glazing Area -Glass Protection -Skylights -Plastic 20. Shower Pan; Test, First Floor -Tub Access Shear Walls; Nailing -Bolts 21. Test Tub & Shower, Second Floor -Tub Access Brace Interior/Exterior Wall Panels 22. Gas Pipe; Sixe & Anchors Insulation -Walls -Ceilings 23. Fire Sprinkler; Test Infiltration -Walls -Windows Date Date Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Ext. Steps -Door & Sidelight Protection -Landings 24. Fixture & Transformer Clearance -Ins. Protection Smoke Detector 25. Elec. Receptacles Spacing -Lights & Switches at Doors Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 26. Size Boxes & No. of Conductors Stapled Bedroom Exiting 27. Romex Installed Close to Edge of Studs & C.J. G.F.I. & Bath Fixtures & Tub Access -Spa 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Elec. Trim & Subpanel, Breaker Sizes & Labels 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI Stairs & Rails 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or At Fireplace or Stove, Clearance -Hearth 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or At Insulated Neutral O Yes O No Elec. Outlets at Wood Panel, Int. & Ext. 32. Service -Riser Conductors & Ground Main Disconnect Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 33. Equip. Clearances Panels-Motors-Mech. Equip. Elec. Outlets & Receptacles at Kit. Counter 34. Clothes Closet Light -Shower Light -Spa Light Garage Fire Door; Swing -Landing -Closure 35. Smoke Detector A.C. Duct in Garage -Damper 77. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 80. 36. A.C. Ducts Insulation & Support 81. 37. Vent Fan, Exhaust above insulation 82. 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 83. 40. Attic Access & Platform if Furnace in Attic Date Stucco Brown -Finish Card B-1 Date Card B-1 Date A.C. Unit Disconnect, Electrical -Plumbing Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) _ 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FF.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes _ 83. Following Instld./Drive 0 Yes O No/Walks O Yes 0 No/Planters 0 Yes 0 No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netldds PERMIT NO. BP041485 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 06/16/2004 APN: 064-590-054-000 the Business and Professions Code, and my license is in full force and effect. l ' Cit IL License Class: License Number: Site Address: 6290 CHATHAM CT MAG Date.) Contractor: 1--)� C4S"Lit, Map Index: Description: MH PERM FND NEW SITE OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: SAUNDERS NORMAN F to its issuance, also requires the applicant for such permit to file a 14014 CRESTON RD signed statement that he or she is licensed pursuant to the provisions of CA the Contractor's State License Law (Chapter 9 commencing with Section MAGALIA, J 7000) of Division 3 of the Business and Professions Code) or that he or 95954 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 does to Applicant: DU PAR 8i ANGEL INC PP Code: The Contractors' State License Law not apply an owner of property who builds or improves thereon, and who does MICHELLE FREEL such work himself or herself or through his or her own employees, 2532 SANTA ROSH AVE provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one SANTA ROSA, CA 95404 year of completion, the owner -builder will have the burden of 530-821-5850 530-821-5854. (fax) proving that he or she did not build or improve for the purpose of Sale.). michellef88@sbcglobal.net ❑ 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: DU PAR 8r ANGEL INC and who contracts for such projects with a contractor(s) licensed MICHELLE FREEL pursuant to the Contractors' State License Law.). 2532 SANTA ROSA AVE ❑ 1 am Exempt under Article 3 of the Business and Professions Code SANTA ROSA, CA 95404. 530-821-5850 530-821-5854 (fax) Date: Owner: michellef88@sbcglobal.net License #• 457364 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: Cl I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insura�nc�e, carrier and policy number are: Carrier: Total Square Ft: 1904 S.F. ` L, �- ��� Policy #: \� ` Valuation: $123,760.00 ❑ 1 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 comply with those provisions. �1 \�Q r.Cl Date: A . Applicant:�� WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one J) Jn n 44 / n / q hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This p i is isions of the Mille County Coda anrVor I hereby affirm that there is a construction lending agency for the Reso do to ha a been paid. 2,Mffit performance of the work for which this permit is issued (Sec 3097 Civ.) BY Date: / D� Name: PERMIT EXPIRES ON: 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 document of Butte County. I hereby authorize representativesof Butte County to enter upon the above mentioned property for inspection purposes. Print Name: pr \— t e �Q— �� Signature: �_� X�� P �S (♦ l i Date: ❑ Owner "A�ntractor 0 Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.neAdds PERMIT NO. BP041485 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 06/16/2004 APN: 064-590-054-000 the Business and Professions Code, and my license is in full force and effect. License Class: � tiL License Number: Site Address: 6290 CHATHAM CT MAG , Date�ll Contractor. D44-\- \ Cu - i Map Index: Description: MH PERM FND NEW SITE OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: SAUNDERS NORMAN F to its issuance, also requires the applicant for such permit to file a 14014 CRESTON RD signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section MAGALIA, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95954 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 Code: The Contractors' State License Law does not apply to an Applicant: DU PAR &ANGEL INC pp owner of property who builds or improves thereon, and who does MICHELLE FREEL such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 2532 SANTA ROSA AVE sale. If however, the building or improvements are sold within one SANTA ROSA, CA 95404 year of completion, the owner -builder will have the burden of that he did build improve for the 530-821-5850 530-. 821- (fax) ( ) proving or she not or purpose of sale.). michellef88@sbcglobal.net ❑ 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: DU PAR & ANGEL INC and who contracts for such projects with a contractor(s) licensed MICHELLE FREEL pursuant to the Contractors' State License Law.). 2532 SANTA ROSA AVE ❑ 1 am Exempt under Article 3 of the Business and Professions Code SANTA ROSA, CA 95404 530-821-5850 530-821-5854 (fax) Date: owner: michellef88@sbcglobal.net License #: 457364 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self4nsure 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. lln�I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance policy number are: ecarrier ^and Carrier. �\� �' lLd Total Square Ft: 1904 S.F. ,����,� � a�`� Policy #:_ dU Valuation: $123,760.00 ❑ 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 comply with those provisions. �l-p Date: . Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of //J�J,/,+ compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This p is he is ued under t applicable provisions of the Butte Cnunty CodA and/or I hereby affirm that there is a construction lending agency for the Reso do to o w rl b f is fes ha a been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) / D Name: BY Date: PERMIT EXPIRES ON: Date Address: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: \ CVl-e Qq_ ��'�it Signature:`-' tc -k-,\ 0 X.l (j QQ�_ Date: 0 Owner ) 0-6 ntractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 OFFICE #: (530) 538-.7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION OWNER Name L{n&L_ ` nnlY\15 Address I O City to (?A Zip %Cj54 Phone 3 - $-t pc„ Fax E-mail APPLICANT NAME CONTRACTOR Name Ou'-par � ., Address n _4Z {_t- t t J City ul�c� ,� Fax State ; Zip Phone E-mail rn 2t Q��S� 5 c Lic. # c � � APPLICANT NAME ARC ECT/ENGINEER Name ., Address Zip City Fax State Zip Phone Fax E-mail State Ucense Number APPLICANT NAME Name 2 �S Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE C x O — C� For office use only: Zoning Flood Zone SRA Yes No Occ Type Const Subdivision Name Map tk Pa e � L2� Planner � Date Agprody vvcrt run Jut3lvllI IAL KLQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc W! PERMIT NO. BP o4 / BIN # LOCATION Pro e lice +am (.vur f- Mo Cross Street . , C re_L f r_� WORKER'S COMPENSATION Policy Number I.1Hcoq D- &663 Carrier �5+fc c rw- ld [11iringanyone other than license contractors, a certificate of worker's ompensation must be shown at the time of permit issuance. LENDING AGENCY Name n - Address A Description or Scope of Work: 1 5� rn Sq. Footage i G ❑ Structure Built without Per ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be re uired. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: �� Amount: }•95 - Bldg 15s �ItB SIVA Recei #'Q I Sheriff �(! / SMIP 40�,a�.o Date: 5/s+-�o¢ Other otal Page 1 of 2 RF\/ d-,An_nA al L' SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPERI ❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. 2 Engineered truss details and layouts' (if required) (NO FAXESI). ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to mobile or modular homes.) ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 8. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 9. Sanitation and site plan approval from the Environmental Health Department. ❑ 10. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ ; . 7: -2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting, documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11: Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541.. OVER FOR BUILDING PERMIT APPLICATION- KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04 i E.H. USE ONLY Piot EG. AttecMd Roo.,n Anschad 3an2 D. j TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal / -\-I- S pty: Public Private Well Clearance for 3 b dwelling. Other Hold final for: Final clearance O.K. for: NOTE: 8/96 IN I� ,y t lF�� 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: SA M ASSESSOR PARCEL NUMBER 5'10 • 054 Proposed Building Use: M N PE E2 r -I G til O I�J E: N 'S I Tf Counter Technician: Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1 1. Site plansor 4 sets, signed by the preparer of the plans. ❑ 2. Complete fans, 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. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. Ay 8. Manufactured homes:,() Data sheets and installation inst) Marriage line info,Floor Plan, 01 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.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. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner > ❑ 14. Hazardous Material Form 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by 19. Soils Report and/or Engineered Foundation required ........................................... ........ 20. Erosion Control Plan Required........................................................................ A ...... 21. Fees as shown on the attached Schedule of Fees Due Sheet .......Wh ...... 22. City of Chico Plumbing permit .............................................:.. 23. California Department of Forestry plan approval 2 paid. Sent by:24. Planning approval (A) Used (B)Parking: (C) Parcel ❑ 25. Contact Land Development about _'Improvements, ._ Drainage ......................... 26. NPDES Form ................................................./ AAS 27. Encroachment Permit for driveway from the Public Works Dept. .....!.6................ 28. Pre -Inspection for required....... ❑ �29. Contractor's license information. (Number, Name Style, Classification) ................... p/ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization ............ .... ......................:............................. It 33. Recorded copy of Agricultural Acknowledgment Statement ................................. 34. Manufactured home utility clearance............................................................... ❑ '35. Existing violations and/or expired permits .................................................. ❑ 36. Deed Restriction................................................................................. 0 37. Grant Deed, M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, k to H.C.D. $ 38. Other: ce-) ❑ 39. Other: When issued Telephone 8,�t I • S, and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 5 -Q y _Cq 1. Index permit application fort a above items numbered: Plan Check Letter 2. Additional items required rn Contractor, designer, owner, was advised of the above data by 6 phone, ❑ rhail, ❑ counter, by Date: Contractor, designer, owner, Was adxised of the ab ve data by phone, ❑mail, ❑counter, by Date: Plans reviewed by: C.� Date: I O Plans approved by: ffi C Date: 1 Structural reviewed by: 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 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER �A'MM 1:5 A.P. # �Iv4. 590 D54 PROPROSED BUILDING USE )JEW Mat Pee" F&iD r� ew S t' -M AUILDING PERMIT FEES 2 4.95 --- Balance Due ..................... $ --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ S HOOL DIST CT S �At SE t isOff e (f 1 er P TfVr S RIFF FEES (paid at Building Division) Residential............ X $360.00 =$ 36v Units Commercial (sq. ftg.)..... X $0.03 = $ DATE 904 - RECEIPT # DAW REC. ZMW sq.rrg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X # Units Amt. Commercial (Sq. Ftg.).... X = $ _ Sq. Ftg. Amt. 5. RECREATION DISTRICT FEES _ (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) ✓ 7. SRA FIRE INSPECTION AND PLAN CHECK FEE 689-.N aid at Building Division) 152.9$ 8. WATER TENDER FEES BATTALION # $200.00 (paid. at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone Zone X =$ # Units Amt. Commercial (sq. ftg.) ......... X = $ Sq. Ftg, Amt. 10. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT DATE S"0). `/--Q/ 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) I School District A.P. Number (/rte/ Property Owner ABUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (Or*4ri per Building) Building Department No. Q city County �4 /485 Property Location/Address Subdivision Lot No. n.............._........._......................:........................................ Foote Residential Development Q Q Q Sq. ge 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) co, me ial/Industrial Q Q Addition Building Department Representative t District Identification, No. IN School District certifies that (Street Address) . '0z=,A (City) (State) has complied with the requirements of Resolution No. representing / �U square feet. ko' 4-f A—_ School District Representative Paid by Check,# Remarks: Sq. Footage (Including Exterior j Roofed Areas)(£ Date (Applicant) (Phone Number) G r - (Zip Code) by payment of $ 2926 $ FULL MM $ /,6 Date ) Notice: You may protest the Imposition of the fess IdantMed above by submitting a written protest to the DN&W4 In compliance with Cwvwnmaht Cote Section 66020(a), whldn 90 days from the dats'fees are paid. Failure to submit a timely written protest wlll'prohibit ,you from challerglnp the Imposition of the fees In any court action. K, irr0sequsrt to the School District Representative sIgnhhg this Butte County Schools Impact Fee Certification Form, the &trool Disblct e notifed by the applicable Local Planning Agency that this project a being rwlawd under the Caiftmla EnvlromnerMal Quality Act (CEQA� thisproject may be subject to additional school fees to fully mitlpate.Its Impact on the school ftbkft schooii. White (applicant), Yellow (building department), Pink (school district) feetamxlo (10/03)dmm NOTICE TO ASSESSOR HCD 433(B) THIS FORM MUST BE COMPLETED BY THE OWN ER OF 4 MOBILEHOME OR COMMERCIAL COACH AND FORWARDEDATO THEACOUNTY HOME ASSESSOR UPON COMPLETION OF THE INSTALLATION OF THE UNIT ON A FOUNDATION SYSTEM PURSUANT TO SECTION 18551 HEALTH AND SAFETY CODE. ORIGINAL PURCHASE PRICE FOR: T- The Basic Unit 2. Ops -mg Equipmerrr i Upgredei 3. s,btow 4. Accessorin l Accessory Structures S. Othp (Specify) 6. Do* -,,y t korai tion 7. TOTAL SALES PRICE - S % f ----------- DOES THE BAST PRICE INCLUDE - The Terrber(s) YES ❑ NO lira d wAMb ❑ YES O WMebubc R Arks ❑ YESp UST NUMBER OF ROOMS; Bedroom DiniV Room BahtY Fornily Room Kkdwn _ tMiiilTr Room Uviq Roan �� Oslw Rooms Type of ERrerior won Covering: Trp. of Rent Gauping I wood, «c.) %Z ATL_ TTpe:PdJorced Air el, weed. Cenpovilia, (Me�erc.) ❑ Floor sr Well , Air Cendoionino, • ❑ YES �40 Eveporotive Ceokr: ;�rES Tens �•�_ . • ❑ NO swift -in co"P: Ytis iuih;n Oven: ❑ YES Buit1 in Dishrosher: ❑ YES Np ' b+ih-in WN Bar: ❑ YES •. Root OV*A ang (EtMi): ❑YES �y� 4�►rp '.1. Fsrnrflurr Included: ❑ YES • " inches 40 ; � Velve f Corport: ❑ Yes ❑ NO (LENGTH X WIDTH) Awing: ❑ YES ❑ No x Posh: ❑YES ❑ NO x aorogc: 13 YES X ❑ NO _ So -a" shed: ❑ YES X — ❑ NO Skirting: ng: ❑YES x ❑ NO LINEA FEET The sales price as shown does not include any amount for any in-place location. The Assessor's Parcel Number of the installation site is - (Signature) Address Telephone • e p SITE PLAN REVIEW APPLICATION Date: AP# t9 6�=S Permit Number (if applicable) 0H — I H 8 S Bin Number APPLICANT INFORMATION Parcel Size: Owners Name: L ��Ls Owners Address: Telephone No.: © Email: 11-1.1 C HZ�-�LF-1= 88 & S6C Edo r_tAL Situs Address: LOT Z 014A--T11 -A4(�'� NET Pror)osed Use: Redential New Single Family Residential ❑ Single Family Addition ❑ Single Family Remodel Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family • Non-residential ' ❑ New Commercial ❑ Commercial Addition ❑ Commercial Remodel ❑ New Industrial ❑ Industrial Addition ❑ Industrial Remodel WS'reptic ❑ We -11 ❑ Agricultural Exempt Building Ugricultural Buffer Form ❑ Applicable N/A ❑ Other: Brief Explanation (if necessary),:, -�5 DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Site Plan Stamped Approved • By Date 1-1— Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: 4K 9- Snow Load Area: 2 -rO 2.E;Z)1D -PT 1 • ❑ 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: (Seea -hed) • Flood Zone: • Flood Panel No.: D 4 OO Index Date: 6-- ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) ❑ Oroville Enterprise Zone Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ----------------------------------------------------------------------------- ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: rg,) — 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 c^� vL 1✓ Side Side Street Rear 6 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 Formula • ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ 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 ❑ 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/Notice 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 f Subdivision Map/Parcel Map: ��r?fa�1S 6 pl SCS # ', Map Date of Recording: M-1-7-'7 l7 Lot: 2- B ❑ Use Permit/Minor Use Permit Permit Number: Book: .3 & Page: 7 % Date of Approval: Parcel Map/Subdivision Map[Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Attached ❑ None ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 `-VY • ❑ 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' Distriet, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. El ON Page 4 of 5 • BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.neAdds PERMIT NO. BP041486 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 06/16/2004 APN' 064-590-054-000 the Business and Professions Code, and my license is in full forceand effect. /1 ��1T -frJ1 �(p` l License Class: 0— l 1 L License Number. SiteAddress: �Z D c�kf-A A-� 6� �, a.. -c- / Date:(A� Contractor. � o C 7n R,IL' Map Index: Description: DETACHED GARAGE 400 P ( ) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: LINDA SAMMIS to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's Slate License Law (Chapter 9 commencing with Section 14705 BRIDGEPORT CIRCLE 7000) of Division 3 of the Business and Professions Code) or that he or MAGALIA, CA 95954 she is exempt therefrom and the basis for the alleged exemption. Any 530-873-8706 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 Code: The Contractors' State License Law does not apply to an Applicant: LINDA SAMMIS PP owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: DU PAR 8r ANGEL INC and who contracts for such projects with a contractor(s) licensed MICHELLE FREEL pursuant to the Contractors' State License Law.). 2532 SANTA ROSA AVE ❑ I am Exempt under Article 3 of the Business and Professions Code SANTA ROSA, CA 95404 530-821-5850 530-821-5854 (fax) Date: owner: michellef88@sbcglobai.net License #' 457364 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perl'ury 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. I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation carrier and policy number are: an 6kt__ ,insurancee Carrier. v Total Square Ft: 400 S.F. ` ^fit # � ` R �i '—' ' Policy #: ` \ Valuation: $9,600.00 ❑ 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 comply with those provisions. Date -Y �G � U Applicent:�--M I, WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one 41 Z �� hundred thousand dollars ($100,000), in addition to the cost of /� (fJ` compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY Thihis/ppe itL' her y iss eed�und r thheeaiapplcble provisions of the Butte�Counntty Code a. nrVer _ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Res I op, to o i to b v fo which f s have been paid. Name: By. PERMIT EXPIRES ON: ate Address: ❑ 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. Cl Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes � p� Print ��1 Name�f Signature., l— ,`�� Date: 0 Owner "11�ontractor ❑ Agent for Owner 13 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION OWNER Name Uv,\dCL_ ` rnc,nl5 Address 4_-7,o6 � R I t�G EPI��2T G� r2c c.6 City MGA 01(0- State Zip g6954 Phone ��3 _ $-1 p(_p Fax E-mail CONTRACTOR Name-bu.Par � Anei Address <gU,R L3. b n - {9 City 61 1 State cA Zip gSgq I Phone �a ( 5 2� Fax `3a-1 - S E-mail Uc. # qS-73,(� -1 r1aT APPLICANT NAME ARC I ECT/ENGINEER Name City Address Zip City Fax State Zip Phone Page Fax E-mail State License Number APPLICANT NAME Name Q a3 Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X ��La� 0 Ij _6 - \]Tt� j For office use only: Zoning I Flood Zone I Y, I SRA Yes No Occ• Type Const. Subdivision Name Map Book Page Lot# Planner Date 7.prol, r p OVER FOR- SUBMITTAL REQUIREMENTS' K:\FORMS\BUILDING F0RMS\131dgApp1SubRgmts.doc PERMIT NO. BPo+I LOCATION AP# 0004— cjv— 05L/ Prop M—M— Crosi Street Cre�-�-fly WORKER'S COMPENSATION Policy Number I'7 L4 �Rnq D - &6C3 Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name n' Address Description or Scope of Work: l Q o xao' oke Cry �O s� Sq. Footage 11 Structure Built without Permits O Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Iv by: Amount: A 17 q• 9�BIdg SM, SRA Receipt M Sheriff l I SMTP Page 1of2��j����/`j % - Total cbt tc. SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division+in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPERI ❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed ❑ 3. calculations. I ' ". 1 ❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to ❑ 7. mobile or modular homes.) ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 8. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 9. Sanitation and site plan approval from the Environmental Health Department. ❑ 10. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in ❑ 11. triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed b t� 'neer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPERI ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation andlsite plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. ❑ 9. Letter of intent. ❑ .0. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04 iAAq COLYNTY 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 �n (� �/% OWNER: jl�% ASSESSOR PARCEL NUMB ( '*L/ T 5 / 6- D� Propos d Building Use: Counter Technician: Date: t ms squired in order to pply for a per All boxes MUST be checked OR marked NA in NUM; der to apply. 1. Site plans, 3 or 4 sets, signed by 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. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or frld 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. Site plan and business license approval from the City of Biggs ❑w�� 12. Letter of intent for non-residential buildings 0,,d y s [ 13. Detached Accessory Building Form filled out by the owner S" .i �. ,❑ , ( 14. Hazardous Material Form , 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by 19. Soils Report and/or Engineered Foundation required ........................................... 20. Erosion Control Plan Required........................................................................ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. 22. City of Chico Plumbing permit.: ..................................... . . < 23. California Department of Forestry plan approval ❑ paid. Sent by. •�' ❑ 24. Planning approval (A) Use:©K (B)Parking: (C) Parcel Check: - 0 ❑ 25. Contact Land Development about -Improvements, _ Drainage ......................... 26. NPDES Form............................................................................................. 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... 29. Contractor's license information. (Number, Name Style, Classification) ................... C' 30. Worker's Compensation Carrier and PolicyjN6mber.......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization......................................:............................. 1133. Recorded copy of Agricultural Acknowledgment Statement ........................; .......: ❑ 34. Manufactured home utility clearance............................................................... ❑ '35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................:.................................................................. ❑ 37.- ❑ Grant Deed, ❑ M.H. Title%Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ` ❑ 39. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: ` Date:�J 1. Index permit application forte above items numbered: Plan Check Letter 2. Additional items required ^ Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, own% , was advised of the above Ota y phone, ❑ mail, ❑co b Date: All Plans reviewed by: Date: •) Plans approved by: _ Date Structural reviewed by: 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 TELEPHONE (530)538-7541 • SCHEDULE OF RECEIPT OF FEES %/ �j OWNER A.P. # Z_` gM5'5 L PROPROSED BUILDING US&i- DATE REC IPIA� PATIE RE . BUILDING PERMIT FEES �-L���� Balance Due ..................... $f !!// --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ 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 $510.0 ( id at Building Division) IItE 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. Coercial (s ........ X = $ • Sq. Fig. QAmt. 10. OTHER At time of permit application, I was a vised the ab ve fees re required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT DATE—`t''-ls 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) Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX DETACHED ACCESSORY BUILDING OWNER'S STATEMENT OF USE Plan review will not be started until this form is completed, signed by the property owner, and returned to the Butte County Building Division. Attached Accessory Buildings and Additions will be checked for residential use. Exception: Garages and Carports. Owner: Phone: 17� — T1 Cl n Mailing Address 1q -70S C�)j-1dQe—p2 L, e_d f M a a1.Q�i Site Address: ( ,�Ac,- Ctrl Coin , cyyav;aLo-, Assessor's Parcel Number: 0(-0C4--Sq0--. OE54 Zone: Please answer questions 1-16, and explain any yes answers for questions 2-14 in the space provided on page 2 of this form GENERAL LNFORII�IATION: 1. Is there a primary dwelling on the property? Yes © No ❑ 2. Is the structure already built, under construction, or under notice of code violation? Yes ❑ No Q 3. Will items produced in this building be offered for sale? Yes ❑ No El 4. Will the public have access to this building? Yes ❑ No 5. Will any advertising, on or off site, be associated with the use of this building? Yes ❑ No SITE CONDITIONS: 6. Is the structure foundation within 5' of septic tank or 10' of leach lines? Yes No 7. Is any portion of the structure located closer than 20' to your front property line? Yes No S. Do you plan to Odddvwor modify existing access to a county maintained road? Yes ® No ❑ 9. Will the proposed structure encroach within any recorded easement? Yes ❑ No [] CONSTRUCTION FEATURES: 10. Will this building have insulated floor, walls, or ceiling? Yes ❑ No [21 11. Will this building be heated or cooled? Yes ❑ No 12. Will this building have a water closet/toilet? Yes ❑ No 13. Will this building, have a sink? Yes ❑ No 14. Will this building have a water heater? Yes ❑ No (5) 15. What type of floor covering will the building have? 16. What type of «vall covering will the building have? girl D a ri AT- 1E, ; Vj-*1 1 of 2 PROPOSED USE: (check only one box) 1. ❑ Residential Storage Shed = I will be storing in this building and it will not be used for any other purpose (no bathroom and no heating or cooling). 2. ® Private Garage — "A building or a portion of a building not more that 1,000 square feet (3,000 by exception) in area in which only motor vehicles used by tenants of the building or buildings on the premises are stored or kept" A garage door is required. 3. ❑ Residential Carport — A covered structure intended for parking of vehicles. Two or more sides must be entirely ooea. 4. ❑ Residential Occupancy — Structures meant to be occupied, as opposed to a storage shed, garage, or carport If you checked ##4, please check the uses below which best fit this building. ❑ GuestHouse ❑ Pool House ❑ Studio Apartment ❑ In-law quarters ❑ Recreation Room ❑ Game Room ❑ Study ❑ Library ❑ Bonus Room ❑ Playroom ❑ Den ❑ Studio ❑ Artist Studio ❑ Hobby Room ❑ Craft Room ❑ Sewing Room ❑ Canning Kitchen ❑ Music Room ❑ Family Room ❑ Sun Room ❑ Private Office ❑ Workshop 1 ❑ Home Occupancy' ❑ Other — Use = 1. Deambe type orWorL-hop .. MAn be approved by the Butte Country Plarming Division Explanations: This area is for explanation of any "yes" answers on questionsJ-' l4:Please indicate the question number before the explanation. Additional Information: Plan review will not be started until this form is completed and received. A Plans Examiner will contact the owner with specific requirements per the use indicated. I Nearby affirm under penalty of perjury that the above information is true and correct. I understand that any changes to the use, or character of use, of this building will require permits from the permitting authority. I understand that Real Estate Disclosure laws require disclosure of this information if or when the property is offered for sale. O«wner's Name: Please Print L 1 Vick Cy R ..�� �d mm is Owner's Signature: i;�< /zl_ y� Date: S= 074 2of2 AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 04.0 1495 so �� M^Ilt 2004-0031 848 Recorded Official Records CoBUTT Of TE CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 02:10PN 27 -May -2004 REC FEE 10.00 CONFORM 1.00 Kathy Page 1 of 2 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this.property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Date ✓r 196 PROPERTY OWNERS: State of California County of-bUkT7C. On MAS o2lQ a CUci before me, personally appeared L11'4or.- !y. Sa,rY„r nes personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name&p(&m subscribed to the within instrument and acknowledged to me that -he /e � executed the same in•his/�i�'ye /thein authorized capacity and that by4i by/their signature(Jqon the instrument, the person%or the entity upon behalf of which the person(i) acted, executed the instrument. WITNESS my hand and official seal. Signature�d`, 0)J. dX du_a Seal: A.P.# QL.OL4-SC/o _65/ MICHELLE LEE FREEL NComm.# 1435881 A NOTARY PUBLIC- CALIFORNIA VI 801 County MY Comm. Expires Augus124,200I" •. MICHELLE LEE FREEL QLEComm. # 1435881 'S NOTAPV PUBLIC•CALIFORNIA N Bu!'� County MY^�. Expires August IN yC' 111 MI101111111 I mmill 1-3 e t F—' OD N -- 4%wm S OG L IMM vd*&X to I tQz4 btbnO:)tA 2tM0399 Isiollio io3TTUH 288UA8 E 3-INVA3 iob-to,3tA V102i OIQ YRM32CM lastelaeA #695'Ysm-T5 M19I M in w All that certain real property situate in the County of Butte, State of California, being more particularly described as follows: Lots 28 and 29, as shown on that certain map entitled "PARADISE PINES UNIT 11", filed in the office of the County Recorder of Butte County, California, on December 17, 1970, in Book 38 of Maps, pages 17, 18 and 19. EXCEPTING THEREFROM all minerals, oil, gas, asphaltum and other hydrocarbons substances with provision that any and all mining operations shall be done from orifices outside the surface area of the land herein described and that no damages shall be done to the surface of said land. AP No. 064-590-053 G COPY of Document Recorded 27 -May -2004 2004-0031848 AND WHEN RECORDED MAIL TO: Has not been compared with G BUTTE COUNTY BUILDINDIVISION original 7 COUNTY CENTER DRIVE BUTTE COUNTY RECORDERt OROVILLE, CA 95965 i i r i i i } AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents 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: f Dee - Date PROPERTY OWNERS: State of California County of On MAS ae� I a WL( before me, M�%ultE LEE TP -Fa - personally appeared UNnlk Py, personally known to me (or proved to me on the basis of satisfactory evidence) to be the person@ whose nameWfallas subscribed to the within instrument and acknowledged to me that-heAie7they executed the same in •!mss/�ie�/their !authorized capacity(st and that by /their signature(,Oon the instrument, the person( or the entity upon behalf of which the person acted, executed the instrument. j WITNESS my hand and official seal. j Signature�,hpl - , e dx &.a-. Seal: A.P. # ©(o Ll - S Cl O �USL/ MCOMFMLEO�IAI EL .1 I� • NOMY PUBLIC •CALIFORNUI N Bul!^ County If Comm. Expires Augus124.2007 MICHELLE LEE FREEL [*my Comm. # 1435881NOTAPV P(IBUC.CAUFORNIABu!fe Cuty j ^•^m. Expires Auaust2t=71P ,, 'V -4U. ! 4 v r All that certain real property situate in the County of Butte, State of California, being more particularly described as follows: Lots 28 and 29, as shown on that certain map entitled "PARADISE PINES UNIT 11", filed in the office of the County Recorder of Butte County, California, on December 17, 1970, in Book 38 of Maps, pages 17, 18 and 19. EXCEPTING THEREFROM all minerals, oil, gas, asphaltum and other hydrocarbons substances with provision that any and all mining operations shall be done from orifices outside the surface area of the land herein described and that no damages shall be done to the surface of said land. AP No. 064-590-053 9 Department Michael Crump, Director Public 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 II Construction Storm Water Permit and Storm Watertion Prevention Plan (SWPPP) Acknowledgement (LESS THAN 1 ACRE Project Description: Project Location and/or Parcel Number: 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. 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: Ao-(�I, a Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program O B.-1 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES I7 NO ❑ 2. I HAVE _o" HAVE NOT ❑ signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CITY: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIG D: �P�R�OyP♦ETRTQYOWNER: DATE: NOTE. This Owner -Builder Yer fcation is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit., OVER O.B.- I I OWNER BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials' and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. 4Nfic ly, C. Vi ira, C.B.O. r, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. r NOTES S r 'RESIDENTIAL PERMIT NO. -,-064=590=054.. __ _ U4-2800 t 1 SAMMIS, LINDA 6290 CHATHAM CT, MAGALIA t I Cont: OWNER I OPEN DECK Ml/f ! f 0 11 SPECIAL CONDITIONS 11 CHECKED BY SRA FLOOD CERTIFICATE REQ. _ FIRE SPRINKLERS REQ. _ SPECIAL INSPECTION ITEMS -_ VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER 11 , a rF U65 m, -j JOB FINALED (Date) ' y-�� Signature Af""" jb r = OK = Not OR = 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; -/ P' L'ft. / P Nat. or/ P' L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 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 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. Verity #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 SCELLANEOUS Date DEC , COV , CARPORTS, GARAGES (Plans) OK except #'s Zo ' Requirements -Setbacks -Ease ents Ings; Sens=Size•Deptk-Sorin ctors-eteel 3 --Decks, Girders -and/or Joists -De racing -Stair ails 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; hthg-Roofing 1 .; Steps -Doors -Landings j 12. Braced Wall Panels I ` Date ' ' ' Card B-1 a 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 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-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 . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date FRAMING (Continued) Card B-1 Date Card B-1 Date Hangers -Post Caps -Anchors -Connectors Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Date 57. Card B-1 Date Card B-1 Date 58. Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Glazing Area -Glass Protection -Skylights -Plastic 24. Fixture & Transformer Clearance -Ins. Protection Shear Walls; Nailing -Bolts 25. Elec. Receptacles Spacing -Lights & Switches at Doors Brace Interior/Exterior Wall Panels 26. Size Boxes & No. of Conductors Stapled Insulation -Walls -Ceilings 27. Romex Installed Close to Edge of Studs & C.J. Infiltration -Walls -Windows 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Card B-1 Date Card B-1 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI Card B-1 Date Card B-1 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes O No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector 69. Elec. Trim & Subpanel, Breaker Sizes & Labels Date 70. Card B-1 Date Card B-1 Date 71. Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Elec. Outlets at Wood Panel, Int. & Ext. 36. A.C. Ducts Insulation & Support Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 37. Vent Fan, Exhaust above insulation Elec. Outlets & Receptacles at Kit. Counter 38. Condensate Drain & Overflow, Size & Grade Garage Fire Door; Swing -Landing -Closure 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet A.C. Duct in Garage -Damper 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 80. Insulation -Foam -Looked in Attic 41. Sills Proper Materials & Anchors Guard Rails & Deck Construction -Post Caps 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 43. Bearing Walls over Girders & Floor Nailing Clearance Looked under Floor ❑ Yes 44. Draft Stop in Walls (rat proof) Following Instld./Drive 0 Yes ❑ No/Walks O Yes B No/Planters O Yes ❑ No 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs Stucco Brown -Finish 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FF.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes _ 83. Following Instld./Drive 0 Yes ❑ No/Walks O Yes B No/Planters O Yes ❑ No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: - � + • .: .► tar• 1l,. +, r �:..` ' y ,. � i, �.- C. � • � � ' .r. i oo,. wxao. o0 ooa� ra.,�, . • laeae lvmn ® ® _ Shell � '����'S'R �� �� �����_ f �' . . • • 6D � 8 .. . + tl1y�•'^``NN�� R�.r�3} f yt aSL}� « Y a� � syr �i �.iSS P�b�•P r��� ' �i ; i +�..s am 1 om'n;e s �co IA, a1 l i P„ p Nr -p—M ma, cm �®Rgo c o ; F y _ x a _ia mN ,£ •may 1 ® x.-"� _ - NW nF a - 10 s 4 • �p Otl noa_ oN •,F . o 0 Il oet noa `� I I._ ,Eg ,,��N��,,.....eeie'E' icy-.•- $ ' !�' -------- Np -' 401 Dl E le :0 8 ft D 19'a .,}. - • obi 9' 1 O Ti it i' O O •tY jq�% Y ey'q'-�.'i-s 't="fit-`' : h s `�`' - _ y!�� �• �3 'CtifFxa �i�t 1 �u, �,, 51> 17 PT�1.",ek M' f�,C ,y¢��,�. �fi• � ��� {,&+,z3*'+'� "£ �? '� 1 . � �� � .t� �� -x`^.41. T. j��N� �'`s� D '4L' •��� � �'�:;52 ,. v _ 1 r' 1' ! tom. • .. m 3 i r9�y4�,,-�'��y ik .. ��+.i�. �.,,�.��, 1 j�9}d�.'rt �4 .} �a _ y Y _ 'n, • 1 - N xe� � � �, ss6 i�% 4� 1��+�t`�5 i3"•c, �i ��,'ai , 1 .y,`.. -r\ 1 1 s C > a+ \ a• - �, ♦ -. w : tea •. � . .. w_ FIs r' • 1 ,� ry � • F 1 147.96 0 t N17 ilz`3a3'Ga�'3�= ��•OS '�`? i`' ��� � � �. U � ' I 'Sig s3' 9 o N 100.00 v i — 0 SCALE: -LA 1 =20' -•�— - - �-140.00' 1 LEGEND: 1 LOCAIM NAPAM n i� 3 c 1 PROPERTY.LINE —" L4m1v3R 5eirnmtS CENTER . LINE _- C t AZ �4 arvt rL F MAGALIA, CA 95.954 i A.P.N. 064-590-054 AREA: 0.35* e Environmental Health MAY -1 y 2004 Chico, California If 0 • l Po -o �c 147.96' o a 1 f 1 LOCA" NAP/M8 rKl ! ® I E o N 100.00 SCALE: 1 "= 20'�- �, _ 14n nn' PLANI Use: . Parkii LEGEND: - Other PROPERTY, LINE — CENTER UNE Signa r. LA m --)Ls Gua rx ann 0 -pi Ve_ r MAGALIA. CA 95.954 A.P.N. 064-590-054 AREA: 0.35± • U • • 0 • • 44 SITE PLAN ..... l... .... ..... ...... .............. .. .. .. .. ............. .. .. .. ...i... - .. .. ............. ...I... .. ............. .. .............. .. .............. .. J. .. .. .. .. .. .. . . . . . . . . . . . .. .. .. .. .. .. .. .. .. .. ... .. .. .. .. .. .. . . . . . ... . . . . : : }.. ...:...i.............�.....i.............�..... i......t........ ..... .. ............. .. .. ... .. .. .. .. ... .. .. ............ �I ..:...... ... : ............. ............ .. ............. .. ... ............. .. .. .. .. .. .......................— - .... .. .. .. ... .. .. .. .�- ..T- . . . . . ..:. .:.. �...: ,. .. o ............ ....... .................... ...... trs' - - � . . . . . . . . . . . . -� '-���,`�i . .................................................... T �.. ................................................. ... ........................ .. .. - . ....... .. ... ... . . . . . . o>- : .. ......................... .. .. ......................a. m- .. .. .. ... .:L- > a t �. .� N !� b S :h. : : : : . : . . . . . . . d .. .. .............. .. .. .. tl• 3 : d-.. S .• >.. ;.. .. .. .. .. .�.. .�... 'moi. iQ �.. ;......; 1_ .. ..:.....:. �. .. .. .. .. .. ... .. .. ... .. . ?J .. .. ... .. .. .. .. .. ... . .. ..•.. .c _ i 8y S ... .. .. ... .. .. ... .. .. .. .. .. ... .. .. ... .. .. .-'mac.. .. ... .. .. ... ... .. .............. ... S, o : :x 1- .4. ...... . ;. .. .. .. .. .. ............... .. .. .. .. ............. ... ...;.... Q . ............. -t........: : Y--......:.. fir- ?� ,;t f - ,cZ ............. ............ .. .. ......:.... : : : : : : .... .. .. ............. . . . . . . . . . . . . . �1 A� ............ .. .. .. ... ... .. .. ............ .................... >.... .. .. .. .. .. .. - ......:...... ........... {...... ...........;...... .......................................... .. ............. ............ .. .. .. .. .. ... .. .. ... .. .. .. .. ......................... ... .. .. .. .. •E Assessors Parcel Number Q 0 0 — [ 0 Q — Q 0 ® Scale: 1" _ �a Owner Name Lads Address / Phone No. 290 Cho - ,r► C- ou r4- s3o - $ 7 3 - 512 0 41 Site Location Q.s9s�L Contact: Name Phone Odobw MW FOR OF ICI Zoning: General Plan Desig: .y Size, Acres a.00• PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: 6 �S_ =I S"= ..-< I �IJM 01 1 r. VURN J ELECTRICAL, MECHANICAL, AND PL ING T QH p ..... .... . ............ ...... 7 ............ ..... . ..... ...... ................... ..... ....... COINSTRUC. )9N.1..NQT --- KM.. EMMA ........... 7"*"***'*": ..... 7 ..... .................... ..... . ........... . 'VITH APPROVAL. COMPLY V :;UPRENT: WMIM. ................... ............. ................... NG EAVISON BUILDM PIAN A ............ ...... ......................... ...... ............. ...... ....................................... . ................................. L. ....... .......................... ...... ...... 7.1 Uie: _�l Date� ............ ................... ...... ............ ...... ............ ...... ............ ...... ...... ............ ...... ............ ...... .................... ... : ...... : ........................... ....... ...... ............ ...... . ......... ...... ............ ...... ................... ............ ...... ............ ............. Parking:__��Landsqaping: ...... ...... .. ...... ..... ............. ...... ........... .............. ....... ...... .. .. ...... . . . . . . . .............. ....... ................................... ............ ................... ...... .. .......... ............. ............. ...... ...... ...... ...... ............. ............................ ............. ..................... ............. ............. ...... ...... ...... ..................... . ...... ............. : ..... ......... ............. ...... ............. ...... ...... ............ ...... ............ ...... ............ ..... . ..... ...... ...... .... ...... ...... ...... ..... ............. ...... ...... ...... ..................... .......................... ...... ...... ... ........ ..... .. .. .... ...... ...... ...... ..................... ... ............ ............ ...... .................... ......... ...... ..... ..... . ............. 4M : ...... ............ ...... ............ ...... ...... ..... ...... ...... ...... ............ ............. ...... ............ ...... ...... ...... ............ ..... ... ... .1 : .......................... ...... . ........................ .. .... A ...... ....... ...... ...... ...... ...... ....... ....... ....... ........ X-9 .............. ..... ...... ............ ...... ...... ..... ...... ...................... ..... ... ... ... ........... ...... ............ ...... ...... ...... ...... ..................... ..................... ..................... .. .... ...... . .. ............... . .............. ... ..................... ....... ........ ........... ... ...... ............ .... ... ............... T7 -1-10 ttd ..... :jam . ..... ...... .................. ............ . ...... ............. ...... ............ ........................... ...... ... .................. ........ .... . .......... .. ............. ... ..... .... ...... . ..... ............ . ..... .. ............ ............................... . .. ............... .... ...... * ...... ..... ............ . .................. ............. .......... ...... ...... ............. ...... .............. ..... ............ ...... ............. ...... ....... ..... .... ...... ..... . ........ ...... .... ...... ...... ...... ...... . ..... . .. ............. ..... ..... ...... ...... . . . ....... ..... ...... .................... ............. ...... ..... . ................... ......... . . .. . . . . . . . ..... . .......................... ...... ...... 4 x ..... ..... �d .......................... ... ...... ...... ..... . .. . ............. T' ..... ...... ............. ................ ...................... .............................. ...... .... ...... ............. .............. : .. .. .... ............. ......... ........ YYYYYY............. ................... ... 'z - t -': ...... . . ...... ...... . XS: 6e - the - �14 g M.- Pv lid . . .... ...... .... .. .. ... ... ...... ..... ....... . . . . . . . . . . . .......... ...... . . . ...... .. .... ............ .. ....... ....... .............. ...... C1. . . . . . le ...... ....... ..... ...... 4'- - ..... . .. .. = : -- r ............. ..... . ...... * ...... ...... ...... ...... ..... ...... ...... Rr4ow ................. ..... .......... ....... ........ . ..... ....................... .... .... ...... ..... ... .... .. .... ...... ...... ...... ........... ...... ........ .... ';"� ..... ...... ............. ...... ...... . . . . . . Pages: ............ ...... ..... ...... ....... ..... ...... ......... ........... ............ ...... .................... ...... ...... ..... ............. ...... . . . . . . . * ...... ...... ...... ...... ...... ...... ............. ...... ............ ..... ........ ...... ............ ............ ....... ............ ...... ............ ...... ...... ...... .... ...... ...... ...... ...... ...... .............. ..... . . .. . ..... ...... .......... .... .............. ...... 4 ...... ...... ...... ...... ...... ...... ............. ....... ............. ... ............ . . . . . ...... . . . . . . .............. ................... ...... ............. ...... . ..... ... ... ..... ...... ..... ............. . . . . . . ... ........................ ..... .... * ............ ...... ...... ..... ...... ...... ...... . ....... ­� ......... ;..: ................... ...... ...... ... . ..... ...... ............. ..................... ...... .... ... ...... r. . . . . . . . . . . . . . . . .................. ...... ...... ...... ............ ...... ...... ............. ...... ...... ...... ...... ................................. ...... ............ ...... ...... * .......... ...... ................... ............. ............. .......................... ...... ..... ...... ....... .......................... ............ ............ .................... ...... .................... ............ .......................... ...... * ..... ..... ...... .... .. ENVIROWEWAL. -HEALTf+---: ............. ...... ...... ...... .................................... ...... ......... ...... ..... I ...... ...... ...... ................... .. ...... . . ............................................... ...... SEP Z '412004 ............ ...... ............ ................... ...... ............ ...... ............. ............. ..... ...... ....... ............. .......... ..... ...... ......... ...... ..... .. BUTT C. t. -NA ... :: ...... * ..... ................... ................... ...... ............ E 0 ............... ....... ...... ................... ...... ...... ...... ..... ...... .......................... ...... ............ ...... a, ilUING-DEPARIMir ..... ..... ...................... ................... ............. ....... ........... n _11141C -CAL A-----:... 0, -PORNI :... .......... ...... . A .... p .. P .... ....... ............ ............. ...... ...... ...... ...... ............ ....................................... ..... . ............ ............. ...... ...... ..................................................... ...... .......................... ...... * ..... ...... .................... .......................................................................... .................... ........................................................................ ...... ...... * .................................................... ...... * ................................. 2 N1 El 12 R1 0 Scale: Ito Assessor's Parcel Number 2 ......,,Owner Name 4_4n'q Address/ Phone No. 6 29 Cha :IL6gm (oco-4 .5-56 - F 7 3 - 5'90 4, Site Location CA 2-5319_iL Contact Name Phone Odaw2%2= I FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acres I 4.00" PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: N �F 1 ' C� � Cr i." �•