The URL can be used to link to this page

Home My WebLink About064-610-025rr� b � K b I 64`'61:25M ` 92°=21 IAV I •� I LAVERNE,� Dari` 14456 Ni�nshew Rd, Magalia =. Permit #19-82A 14456 Nmshew, Rd, .'Magal'a AGRICULTEMML BtILDING EXEMPTION PERMIT Ae- �xemntion' Permit �' •� �` ' ' - (hay storage &horse stall) -:•_� Y 64-61-25 64`'61:25M ` 92°=21 IAV Daniel & Christine Laverne LAVERNE,� Dari` 14456 Ni�nshew Rd, Magalia =. Permit #19-82A 14456 Nmshew, Rd, .'Magal'a AGRICULTEMML BtILDING EXEMPTION PERMIT Ae- �xemntion' Permit �' •� �` ' ' - (hay storage &horse stall) -:•_� Y APPLICATION FOR CERTIFICATE ' ., 64-61 - 25 OF MERGER APN# o i S/ - �O /O - Q Z y. ¢. Permit �k 1991-82E(t p•c�0 nst ole f r -Building of Barn) 9 O 2 S _ 64-61-25,. Permit # 2753.82E(ele S/C)SF �d r , 64-61-25t#M,.c LPermi: G-8 B,E(addition/SF) _ 064 -610 -025 -OS -2696 LAVERINE CHRISTINE "A S, TRUST • 4=k' w. . 14456 NIMSHEW RD, MAGALI��. ,c YCont:.DELJOHNSON A S HVAC d C/O��.�' �S :b f 1. 3' • • t 1 i S a a Butte County Department of Development Services • eurre, Haan N O T E S `. 7 County Center Drive, Oroville, CA 95965 e (530) 538-7601—_buggcounty neUdds eeouNtye RESIDENTIAL S APN: Permit No. 064-610-025 05-2696 - Owner: ILAVERINE CHRISTINE A S, TRUST --- ) 1 14456 NIMSHEW RD, MAGALIA Site Address: __Cont: DEL; JOHNSON -AC. Contractor: I _HVAC C/O Type of Permit: SPECIAL CONDITIONS CHECKED BY ❑ SRA ❑ FLOOD CERTIFICATE EQUIRED ❑ FIRE SPRINKLERS REQUIRED ❑ SPECIAL INSPECTION ITEMS ❑ VERIFY ❑ USE PERMIT CONDITIONS ❑ SUB -STANDARD HOUSING LETTER ❑ ENCROACHMENT PERMIT ❑ REINSPECTION FEE PAID ❑ ENV HLTH CLEARANCE El DATE JOB FINALED: �' _OS SIGNATURE: . =OK 0 = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION Lj SOFT -SET, 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr, Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat ❑ or LP❑ Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE D E C K S'C O V E R S -CA R P O R T S `GARAGE S 1 Zoning -Setbacks -Easements 2 Ftgs; Soils-Sz-DpthSpacing-Cnnctrs-Steel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-Cnnctns-Splice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls a,.� m��c DATE IPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes-Enclsrs-pnlboards-Insultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide Oa Vis` o; Pool Drawing V. �=OK 0=Not RESIDENTIAL (Single. & Duplex) DATE JUNDERFLOOR DATE PLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth. 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First flr-Tub Ace 5 Stemwalls Main; Steel -BI ockouts-Wrapped 57 Test Tub & Shwr, 2nd fir - Tub Ace 6 Stemwalls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs -Rgltr-Seryice Test DATE IM E I C A L 12 Elec Undrgrnd AC Ducts Insultn & Support 13 Plenums & Ducts; Clrnc-MaterialSupport-Insultn 14 Girders-Sills-Anchr Bolts Joists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insultn 15 Ace & Vntltn 63 Csr nsate Drain & Ovrflw, Sz & Grade 16 Insulation urnace-Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Ace & Pltfrm if Furnace in attic 0` F+w S 0\C Oq`0 0`c` DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage; abv-flr-Ducts-Mech Prtctn 22 Headers & Beams-Sz & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns 70 GFI & Bath Fxtrs & Tub Ace -Spa 24 Ceiling Joist-Rftr Ties -Purl in -Roof Brac-TrussShthg 71 GFI Arc Fault 25 Frplc Ties or Type A Flue-Frplc Throat Clrnc 72 Elec Trim & Subpnl, Breaker Szs & Labels 26 Attic Ace; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frplc or Stove, Clrnc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 30 Ext Doors -One 3• -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door; Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-CImc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Ace Mech Prtctn; LPG Appince Undr House 3" drain 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 81 Plmb; Elec & Mech Eqp Listed for Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnis 83 Insultn-Foam-Looked in Attic 38 Insultn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑Yes [:]No 87 Stucco Brown -Finish o'o o� o' m 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-CImc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc-Ins Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous Inspctns 44 Eqp Grnd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec 45 Grndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz ga ❑ CU or ❑ AL 98 Address Posted AC Wire Sz ga ❑ CU or ❑ AL 99 Fire Sprinkler 48 Range Circ ga ❑ CU or ❑ AL Oven Circ ga ❑ CU or ❑ AL Insulated Neutral ❑Yes ❑No 49 Sece-Riser Cndctrs & Grnd Main Dscnnct qp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector 0 0` BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 FAx;rl: (530)538-2140 WEBSITE: www.buttecounty.netldds 9F AO. LICENSED CONTRACTORS DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under Issued Date: 09/29/2005 APN: 064-610-025-000 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 Site Address: 14456 NIMSHEW RD MAG effect. . License Class: Gy3 License Number: 3J%��Qg Map Index: Date: ?-M-405- Contractor: Akc aJ?jb¢Q_QQV l G Description: NEW HVAC UNIT 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 Owner: LAVERNE CHRISTINE A S TRUST Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a LAVERNE CHRISTINE A S TRUSTEE signed statement that he or she is licensed pursuant to the provisions of 14456 NIMSHEW RD the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or MAGALIA, CA 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 Applicant: DEL JOHNSON AC & HEATING INC Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 5800 COPELAND ROAD sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of PARADISE, CA 95969 proving that he or she did not build or improve for the purpose of 530 877-4564 ( ) 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 Contractor: DEL JOHNSON AC & HEATING INC pursuant to the Contractors' State License Law.). O I am Exempt under Article 3 of the Business and Professions Code 5800 COPELAND ROAD Date: Owner: PARADISE, CA 95969 (530) 877-4564 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for License #: 373198 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 Architect: the work for which this permit is issued. My workers' compensation Engineer: insurances carrier and policy number are: Carrier: - �c2��aJ Policy #: 7S — Grimm Total Square Ft: 0 S. F. ❑ I certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Census Code: 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 This permit is hereby issued under the applicable provisions of the Butte County Coda ?nrVpr I hereby affirm that there is a construction lending agency for the Resolutions to do work indit7td above for which fees have been paid. performance of the work for which this.permit is issued (Sec 3097 Civ.) 05 Name: BDate: y q `2(� - Y,:. Address: PERMIT EXPIRES ON: 9 :Q2 — )a) K.6. Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. O Attached are copies of the required E.P.A. notification forms. 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 �l�T/L �rr�/�'U✓�� Print Name: Signature: Date: 0 Owner 12 Contractor 0 Agent for Owner ❑ Agent for Contractor f� Tr BUTTE COUNTY 0 0 DEPARTMENT OF DEVELOPMENT SERVICES 0 0 BUILDING PERMIT APPLICATION .0 0 AND SUBMITTAL REQUIREMENTS 0_--124-0 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 0 __ce> 0 OFFICE #: (530) 538-7541 c0U �'�� A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" OWNER Last Name,,1,4�� First Na e Address / y S�J WWS City Stat Zi - Phone 873— Sl7 Fax E-mail CONTRACTOR Name�G ��60�SO•U ✓� ��7iv Address D Lvo ��✓ City ,z�?�� State rw �Q� Phone e7?_5,�� / Fax 877— 2,V�3-S� E-mail 3 # ' lass APPLICANT NAME ARCHITECT/ENGINEER Name - Address State_ City Phone 8.77 O State Zip Phone - Fax E-mail Planner State License Number APPLICANT NAME Name �a tis � .� Address - City X01 SrL' State_ Zip 9��9 Phone 8.77 O Fax S'7?— _�2y3S E-mail Subdivision Name -APPLICANT SIGNATURE X For office use only: . Zoning I J Flood Zone Cross Street SRA Yes No Occ. • ! Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BIN # LOCATION AP# 0 PropertyAddress City Cross Street WORKER'S COMPENSATION Policy Number �adL7�gs ZOD� 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: S T,4GG Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. I I Received by: KG Amount .� Bldg I I OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING F0R1v1S\BldgApp1SubRgmts.doc Page 1 of 2 Receipt #:q 3q sc�3 Date: q2ryN ,1 SRA Sheriff IF, Other .� Total REV 6-16-04 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 PAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 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. (Note: Not required for additions to mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. 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 GRAPHPAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. o 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 KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 Department of Public Works C u n t y o f B u t t e J. Michael Crump, Director LAND DEVELOPMENT DIVISION 7 County Center Drive Warner C. Phillips, Assistant Director Oroville. CA 95965 (530) 538-7266 (FAX) 538-7171 April 23, 2004 Christine Laverne 14456 Nimshew Road Magalia, CA 95954 -Re: ' Application for Certificate of Merger AP 064-610-024 & 025 Dear Ms. Laverne: BUTTE COUNTY APR 2 7 2004 DEVELOPMENT SERVICES E Enclosed please find the Certificate of Merger that was issued by the Butte County Department of Public Works and recorded on March 22, 2004, under Serial Number 2004-0015647, in the office of the. Butte County Recorder. If you have any questions concerning this matter, please contact this office at (530) 538-7266, Monday through Friday, 8:00 a.m. to 4:00 p.m. Sincerely, Stuart Edell Manager, Land Development Division SE/kp Enclosur cc: Building Division Environmental Health Dept. Sierra West Surveying (8077) K II{{III III I IIII I li IIII II 1111111 I II Eaelem4—CDS i sr=3,.4a RECORDING REQUESTED BY and Recorded I REC FEE 16.00 AFTER RECORDING RETURN TO: Official Records I County Of BUTTEI Butte County Public Works CANDACE J. GRUBBS I LAND DEVELOPMENT DIVISION Recorder ROSEMARY DICKSON I 7 County Center Drive Assistant I Barbara Oroville, CA 95965 04:05PM 22 -Mar -20@4 I Page 1 of 4 CERTIFICATE OF MERGER LANDS BEING MERGED: RO AP NUMBER(S) 064-610-025 & 025 NUMBER OF EXISTING PARCELS: Two EXISTING FARCEi� CREATED BY: O PATENT 9GRANT DEED ❑ GIFT DEED ❑ PARCEL MAP ❑ SUBDIVSION MAP ❑ OTHER RECORDING DATA: YEAR D 6-o to e_,r �l9 S°I BOOK / PAGE OR SERIAL NUMBER: 1024 OR 222 2001-61346 SUBDIVISION / PARCEL MAP: BLOCK LOT(S) As of the date of recordation, those lands noted above are merged to create 2 paroel(s) of land as described in Exhibit(s) A & B attached hereto. MARCH 19, 2004 MIKE CRUMP DATE Director of Public Works OWNERS' CONSENT TO MERGER THE UNDERSIGNED, as owners of all that real property to be merged, do hereby consent and agree to the merger of such lands into that / those parcel(s) as described in Exl:i:::t(s) A & B attached hereto. ALL SIGNATURES MUST BE NOTARIZED Print name and title (if applicable) below signature line Christine A.S. La Verne, Owner Date Date 08/11/2003 14:47 5308941525 MAILBOXES ETC f CALIFORNIA ALL-PURPOSE ACKNOWLEDOMEMT State of California County of t-� -� - ss' On 8 before Q/,: r 146TA0-y Detm Name and 7111e of Mar (e.g., ana Dp9, NOtary Public-) nl r per,sonaliy appeared PAGE 01 Name(a) of Slgner(e) f11C R d to me on the basis of satisfactory evidence to be the person' whose neime(s) isO subscribed to the within instrument and acknowledged to me that-he/she/tWexecuted *°— the same in 4k/her/Mek- authorized U TWILA DELMAR� capacityl� and that by 4# Wher/their COMM. # 1369973 signature ® e NOTARY PUBLIC -CALIFORNIA ® (8�person(; or the instrument the personor BUTTS COUNTY C) the entity upon behalf of which the person( COMM. EXP. AUG. 13, 2006 acted, executed the instrument. WITNESS my hand and official seal. Place Notary 8991 Above 3igruture of Notary Publio -W OPTIONAL Though the the informeltion below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. (Description of Attached Dcum nt - Me or Type of Document: I 1 U U / J Document Date: /�— C7 Number of Pages: Signer(s) Other Than Named Above: Capacity(les) ClS' ad by S finer Signer's Name `Individual Top of thumb here 0 Corporate Officer — Title(s): E7 Partner — 0 Limited E3 General E] Attomey in Fact E] Trustee El Guardian or Conservator 0 Other: Signer Is Representing: - ® 1997 Nollonal Notary Associztlon - g3!io Da Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313.2402 Prod. No. 5907 Reorder. Call TolWree 1-800-876-8827 - � 0 EXHIBIT "A" All that certain real property situate in the County of Butte, State of California described as follows: BEING a. portion of the southeast quarter of the northeast quarter and the • .northeast quarter of the southeast quarter of Section 22, Township 23 North, Range 3 East, M.D.B. & M., more particularly,described as follows: 8E6INNIN6 at the northwest corner of the southeast quarter of the northeast quarter of said Section 22; thence leaving said POINT OF BE6INNIN6along the quarter -quarter section line• South 000 31' 34" East; 949.00 feet to the TRUE POINT OF 8E6INNIN6 of the parcel herein being described; thence leaving said TRUE POINT OF BE6INNIN6 parallel with the north line of said southeast quarter of the -northeast quarter of Section 22, South 880 43' 24" East, 435.00 • feet; thence parallel with the west line of said southeast quarter of the northeast quarter of Section 22, South 000 31' 34" East, 100.00 feet to the southeast corner of the certain parcel of land described in the Deed to Darcy Horn recorded March 16, 1938 in Book '197 , of Butte County Official Records, at Page 281; thence South 000 32' 41'; East, 263.12 feet; thence South 89° 28' 26" West, 217.43 feet; thence South 00° 31' 34" East, 57.20 feet; thence South 89° 28' 26" West, 217.44 feet to a point on the westerly line of said quarter -quarter section; thence along said westerly line and said west line of the southeast quarter of the northeast quarter of Section 22, North 00° 31' 34" West, 434.00 feet to the TRUE POINT OF BEGINNING. Containing 3.98 acres of land more or less. �p11\NDSU �k No. 40.10 ' EXP. 6/30%04 OF C:Descriptions\8077LaVerne.D-1 Robert G. Agee, Jr. 0 Q L.S. 4010 Registration Expires 6/30/04 . 4 Robert G. Agee, Jr. 0 Q L.S. 4010 Registration Expires 6/30/04 EXHIBIT "B" All that certain real property situate in the County of Butte, State of California described as follows: BEING a portion of the southeast quarter of the northeast quarter and the northeast quarter of the southeast quarter of Section 22, Township 23 North, Range 3 East, M.D.B. &'M., more particularly described as follows: BEOINNIN6 at the northwest corner of the southeast quarter of the northeast quarter of said Section 22; thence leaving said POINT OF BE6INNIN6along the quarter -quarter section line South 000 31' 34" East, 1354.4 feet to the TRUE POINT OF BE6INNIN6 of the parcel herein being described; thence leaving. said TRUE POINT OF.BE6INNIN6 North 890 28' 26" East, 217.44 feet; thence North 00° 31' 34" West, 57.20 feet; thence North 89028' 26" East, 217.43 feet; thence South 000 32' 41" East, 404.20 feet to the northeast corner of the certain parcel of land described in the Deed to Calvin G. Rasmussen, et ux, recorded November 1, 1950 in Book 561 of Butte County Official Records, at Page 241; thence along the northerly line of said Rasmussen parcel, South 890 28' 26" West, 163.00 feet to the southeasterly corner of that certain parcel of land. described in the Deed to Richard D. Atkins, et ux; recorded November 22, 1950 in Book 551 of Butte County Official Records, at Page 118; thence along the easterly line of said Atkins parcel, North 000 31' 34" West, 200.00 feet to the northeasterly corner of said parcel; thence along the northerly line of said Atkins parcel, South 890 28' 26" West, 272.00 feet to the northwesterly corner of said Atkins parcel, said corner lying on the westerly line of said quarter -quarter section; thence along said westerly line, North 000 31' 34" West, 147.00 feet to. the TRUE POINT OF BE6INNIN6. Containing 2.50 acres of land more or less. �p LAND SU A �k No.4010 ' EXP: 6/30/04 Robert G. Agee, Jr. L.S. 4010 Registration Expires 6/30/04 OF CAL C: Descriptions\8077LaVerne. D-2 END OF DOCUMENT sl' r 10 TT�o,� Department of Public Works ° ° C o u n t y o f B u t t e o O O O J. Michael Crump, Director LAND DEVELOPMENT DIVISION O O 7 County Center Drive CQ'�y Warner C. Phillips, Assistant Director Oroville, CA 95965 y A U N (530) 538-7266 �UC WORD (FAX) 538-7171 BUM January 28, 2004 COUNTY JAN 2 8 2004 DEVELOPMENT SERVICES Christine Laverne 14456 Nimshew Road Magalia, CA 95954 Re:. Application for Certificate of Merger AP 064-610-024 & 025 Dear Ms. Laverne: On January 28, 2004, the Department of Public Works made the finding that the Certificate of Merger on the above referenced property is exempt from environmental. review, and approved the project subject to the following conditions: ENVIRONMENTAL HEALTH DEPARTMENT CONDITION: 1. Verify that the existing septic system is completely located on proposed parcel that serves the existing structure. BUILDING DIVISION CONDITION: 2. Verify utilities serving parcel with structure are contained on that parcel (well, septic, electric & gas. We will record the certificate after the Environmental Health Department and the Building Division verify that the conditions have been satisfied. If the conditions of approval are not met within one (1) year from the date of approval by the Department of Public Works, the approval will be considered null and void. Should you appeal the decision of the Department of Public Works, please submit your appeal, in writing, with the appeal fee of $50.00, to the Clerk of the Board of Supervisors, 25 County Center Drive, Oroville, California, prior to 4:00 p.m., February 9, 2004. Christine LaVerne, Merger . AP 064-610-024 & 025 January 28, 2004 If there are no appeals, we will submit the Certificate of Merger to the Butte County Recorder's office. for recording. and processing, and we will return your certificate to you. If you have any questions concerning this matter, please contact this office at (530) 538-7266, Monday through Friday, 8:00 a.m. to 4:00 p.m. Sincerely, UY Stuart Edell Manager, Land Development Division SE/kp cc: Environmental Health Department ,Building Division Sierra West Surveying (8077) Q O� ok. ogvTrFo INTER- DEPARTMENTAL MEMORANDUM ° Bum O O PUBLIC WORKS DEPARTMENT COUNNW O O O MAR 0...1 2004 „ MI T,O: Planning Division DEVELOPMENT SERVICES Public Works Department d Land Development Division Fire Dept Environmental Health Division Building Dwsion FROM: Mike Mays - Land Development DATE: February 27, 2004 SUBJECT: Christine LaVerne Certificate of Merger MER. 04-04 REVISION 2 AP: 064-610-024 $ 025 This Department / Division has received the attached written request for a modification of the proposed parcel line. Please review this request and either verify below that the minor modification is consistent with the application, fees and mitigations, as reviewed and approved by your Department / Division or determine the request i8 not consistent requiring additional action by the applicant. Comments from this Division: The. proposed parcel line between Parcels 1 and 2. as shown on the attached plat, has been modified (second revision) to avoid conflict with the existing septic/leach system on Parcel 1. Comments from responding Division: y Planning: Public Works: Land Development: Environmental Health: Fire Dept.: NOT CONSISTENT CONSISTENT BY DATE X SE WALD ProjectsWER\LoVerne MER 64-61-24\LcVerne memo to modity.doc 0 A pO+ 3 W C C M W Q r Q J O � Q O W 100 W W dv w P I � _ . . r S88'43'24"E(R 1) NW COR. 1348.12'(R1) — SE 1/4 LINE •�OF NE 1/4, SEC. 22 ' N. SE1/4 OF NE1/4 OF SEC. 22 S88'56'46"E(R 1) 1341.57'(R 1) o (D1,D2) f S88 -43-24"E ► _. — BAjN188943'24w, 435.00'(D2) .:a 04 a o 1,D2,D5 n c —W 35.00'(DS) I 4 ORIGINAL *03 LOT LINE N n= PARCEL 1 N s. ssfAc. �^ NEW LOT LINE`4 217.43'(C) 217.44'(C N89'28'2 (� N89'28'26"E(C) f _FENCE (E) PARCEL Zv N89 -28-26"E 2.50tAC. o N 272.00' 3 ! 'Ln i o (D3,D5) M o M (� oo O (D5) I Z 01-1 3. 0'-, —30' N89'28'26"E (D4) 3/4" IP OPEN A 0 � o APN 064-610-024 & 44 o' 3 ( o J o. a ti � N N � L 30' O W ra CL A 8077 N 1 n _ . . r S88'43'24"E(R 1) NW COR. 1348.12'(R1) — SE 1/4 LINE •�OF NE 1/4, SEC. 22 ' N. SE1/4 OF NE1/4 OF SEC. 22 S88'56'46"E(R 1) 1341.57'(R 1) o (D1,D2) f S88 -43-24"E ► _. — BAjN188943'24w, 435.00'(D2) .:a 04 a o 1,D2,D5 n c —W 35.00'(DS) I 4 ORIGINAL *03 LOT LINE N n= PARCEL 1 N s. ssfAc. �^ NEW LOT LINE`4 217.43'(C) 217.44'(C N89'28'2 (� N89'28'26"E(C) f _FENCE (E) PARCEL Zv N89 -28-26"E 2.50tAC. o N 272.00' 3 ! 'Ln i o (D3,D5) M o M (� oo O (D5) I Z 01-1 3. 0'-, —30' N89'28'26"E (D4) 3/4" IP OPEN A 0 0 N v SCALE. 1'=200' APN 064-610-024 & 3 M APN 064-610-025 3 0 J N M a W 00 � L t W ra CL A M � n 0 N v SCALE. 1'=200' APN 064-610-024 & M APN 064-610-025 3 w O N M a 00 n U 3 a N88'56'46"W(R1) i 900.18'(R 1) LEGEND D1 --- RWORD DATA PER DEED 197 OR 280 D2 --- RECORD DATA PER DEED 197 OR 281 & 2000-0022062 D3--- RECORD DATA PER DEED 551 OR 118 D4 --- RECORD DATA PER DEED 561 OR 241 D5 --- RECORD DATA PER RSN 2000-0022063 R1 --- RECORD DATA PER a/c BK 54 MAPS PG 20 4p, VICINITY MAP /2" REBAR N.T.S. /4" IP LS 3634 :34 - 30' `9 i on ego DETAIL "A" 0o a7 N T S. M 1 N m_ o m MERGER c_ ® FOR CHRISTINE A. S. LA VERNE BASIS OF BEADINGS THE BEARING OF N88*4324"W ALONG THE NORTHERLY LINE OF THE SEI/4 OF THE NE1/4 OF SECTION 22, R. 23 N. R. 3 E. M.D.M. AS SHOWN ON RECORD OF SURVEY RECORDED IN BK. 54 OF MAPS AT '.PG. 20, WAS TAKEN AS THE BASIS OF BEARINGS SHOWN HEREON. BEING A PORTION OF THE SE 1/4 OF THE NE 1 /4 AND THE NE1/4 OF THE SE1/4 OF SEC. 22 T. 23 N., R. 3 E., M.D.M. BUTTE COUNTY, CALIFORNIA SIERRA WEST SURVEYING 5437 BLACK OLIVE DR. (530)877-6253 PARADISE, CALIFORNIA 95969 FEBRUARY 3, 2003 SCALE: 1 " = 200' REV. 1/27/04, 2/19/04 7A A Xn� , PERMIT NO. 1296=85$',.E' ( PERMIT EXPIRES 5/7/86 OWNER LAWRENCE LaVERNE ' y CONTR. owner ASSESSOR PARCEL 64-61-25 LOCATION 144% Nimshew Rd, Magalia k F l j ;• o i , i Temp.•Power Pole y Called PG&E f Temp. Elec. Service i Called PG&E Temp. Gas Service , Called PG&E JOB FINALED (Date) Signatureaz %I OK . 0 = Not.OK = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 3. Sewer; Location -Test -Fall -C/0 -Concrete Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -.Easements 2. Footings; Size -Depth -Spacing -Connectors 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Con nec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI - Date MOBILEHOME INSTALLATION (Plans) OK except s's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector. 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval Card B -I Date Card -BI Date 10. Plumb; Cir. Test -Water Supply Test Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date / J = OK 0 = Not OK = Not Applicable * Not Ready RESIDENTIAL (Sing -le and Duplex) Date UNDERFLOOR Plans OK exce tk's Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel -B lockouts -Wrapped -S lab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors 55. Shear Walls; Nailing -Bolts 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except k's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 56. Ext. Steps -Door & Sidelight Protection -Landings 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. 60. Bedroom Exiting G.F.I. & Bath Fixtures & Tub Access 17. Shower Pan; Test, First Floor -Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except q's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection • 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. &Mech. Equip. Listed for Location 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water 72. Insulation -Foam -Looked in Attic ❑Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size 73. Guard Rails &Deck Construction -Post Caps 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes E) No 75. 76. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No Stucco; Brown -Finish 28. Service -Riser Conductors & Ground -Main Disconnect 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. 80. Water Well; Disconnect, Electrical, Plumbing Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B-1 Date Card -BI Date 81. Ventilation throughout House Card B I Date Card BI Date 82. Glass Protection Date MECHANICAL (Permit) OK except N's 31. A.C. Ducts; Insulation &Support 83. Corrections from Previous Inspection 84. Gas Test -Meters Tagged; Gas- le tr 85. Water & Sewer Connected -C/O to G e -HD Approval 32. 33. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 86, Energy Compliance Certificate er Certi.ficalqs 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date rd -BI Date Card -BI Date Card -BI Date Card -BI Date Car BI Date Card -BI Date Card -BI Date Card -BI Date Carol I Date Date FRAMING Plans OK except q's Commen% F 36. Sills; Proper Material & Anchors 37. 38. 39. 40. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) Fire Stops; Furred Ceilings -Stairs -Chases -Tub N1 IV 41. Header & Beam -Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors 43. 44. 45. Ging. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Sh_thng_.-Rfn_g_._ _ Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: An entry must be made each time youvisit jobsite) Q/d--LV1 Pz S F2P..4� r�� amu, L-6.Ind� L) Lij -i LLj O LO c - Li] co rj� C> LL; -N: C) LL Z Ld L.j M �) - 0 Cj 0 0 Nr L-) C-4 117 %0 03 C1 cl-j C-1 w c ol N N n t3^1", fl) F,, oD %r V) 0 M to rw) :3 N 0) CN N rl) 0-0 030303 "0 Ir C"J 0 0) -,r L7 L-) V) -4 •r vq 11 Z •L 0-o, h0. 0. Cj 0 LD 0" LN 03 -.0 IJ-) U-) C'] u r -j c.., c,.,, ri F -I M Li 0 10 UN I'D fe) 0 Z 0 0, n m cq 0 q -i 01- -.0 v C1 0 m z '.0 'G, -,Z! -0 �o Li-, CL, N -.J C.j Ld z z H ZOOOOOOO COOOOOOO 1-0000000 cO C'J o) --r rw) -4 N r -J, IT X Z . . . . . . . < 0 OD N a G n 'r 0 U --q — --I " -4 -4 - LU CJ U-) � r, Lu U C7, LJ z M U L) U u L) u u N N %r -P, Ol N 10 03 --1 v N 0 --r N ci 0.4 --1 0 0 0- CID 03 N C.., C.4 C -i C-4 r -j r -j I \\, sr, 03 0 �r 03 r3 r, so ct- m -0 3- n -�o M N Cj " 0 C> os OD 03 0) 0 0 0 N N CN Cl N N c,., cj 0000000 0000000 0000000 I,% 0 N 03 —4 'o N -i C.1 IW) �r LI-) -40 N -.i k -.j r�) -, C. -I C.4 N N N (I.J, N -4 — -q , wmmwmmm L) U U L) U L) U COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, .CALIFORNIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET OWNER Proposed Building Use. Permit Fee Based Upon Building Inspector Permit No. Complete Contract Price er (Explain) DPW Valuation At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED All items have been submitted. . . . . . . . . . . . 2 Plot plans in duplicate iplicato . . . .. . 3. Complete plans in duplicate/triplicate..$G�. 1e6r . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . 6. State Energy Forms No. 7 pentMnntr on -He to and AC Build�ns. ,ef e. Letter ofuthorizatJon. (S 10. Sanitation approval from 1� Health Dept. ��a b '4e_�� 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . •. . 17. Pre -Inspection for Pre-Inspec. request to Required. Building Inspector (Date) 18. Other When you issue the permit, process as follows:y Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other //)l Applicant Date Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at ti e fa PT:gircl . i .) 1. Index permit for above Items No. 2. Additional items required: Y (Contractor, Design Plans checked by - Plans approved by Other: Copy—DPW advised of above requir By Mail Date, , Date Date —7 pf t COUNTY OF BUTTE - DEPARTMENT 0F 7 County Center Drive - Orbville, California 95965 - APPLICATION AND -PER PUBLIC WORKS Telephone 916/534-45 MIT PERMIT NO. Z ASSESSOR PARCEL NUMBZR Z NG _ BUILDING PERMIT OWNER TELEPHONE SQ. FT. OCC.1 BUILDING VALUAT ON OWNER'S MAILING A DRESS " CONTR CTOR'SN AAMEE, �W �M'/ ✓ TE PHONE 3/ {U `� v 49 CONTRACTOR'S MAILING ADDRESS Fireplace �rj 0. !T6 CONSTRUCTIONA__NL'LENNDER UNKNOWN Total Valuation �, b (, 00 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ,(}a ARCHITECT OR ENGINEER h�EN LICENSE No. Plan Checking Fee ot ,eeuaLty. C$ 1 y l� ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ , BUILDING ADDRESS r� //�,�- - S PLUMBING PERM I Filing Fee Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME ARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S I G I IN I I 110-00e TYPE OF WORK New ❑ Additio ,,Remodel l�tilities❑ Installati n❑ Other Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service e0v OR LESS 1000 AMP OR LESS 10.00 ov Main service EA. ADD'L 100 AMP 2.50 NEW ,& CONST. DW OCCUP OR ADDNS. ( AC S. 2hQSgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NON.RESID R.BRANCH CI R_ 2.50 ea NEWCON ST R. ( POWER APPARATUS &'1 NON . RES I D, SINGLE OUTLET CIR. / 200500 Ex. Occup(OUTLETS OR FIXTURES BAL®30 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Viring A 15.00 J� Permit Fee $ t Contractor MECHANICAL PERMIT FiIingFee 1 .00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate 1f Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in ciKnequence of the granting of this permit. %(�V •��/LC.c Date C Signature of Applicant — Owner5 Contractor ElAgentwork An OSHA permit is required for excavations over ' " dee n demolition Or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ �,, 3(�, M TOTAL P IT FE riSSO OCCUP, GROUP TYPE OF CONST. PARCEL PD HD This permit is hereby issued under sions of the Butte County Code and/or indicated above for which DIRE R OF PUBLIC By P IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date,! 7—A% Receipt No. '31 4 " 2EZZ WHITE-D.P.W., YELLOW-ASSFSSOR, PINK -INSPECT GOLDENROD -APPLICANT To:. Building Department From: Environmental Health Subject: Sanitation Clearance rer\) La U 4 VI Owner. Plans approved. for: t k44S� NiMsbe�,a Location V Sewage Disposal q--(oI- Z AP Water Supply Hold final for: Water Supply Final Clearance O.K. for: Water Supply; Clearance fore bedroom mobile home. Other Clearance for addition of �`Xl3 �� B .e 4�t,1Stcm 2,otad von r '--(San tarian Date 1 + a COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center.Drive, Oroville, CA 95965 PHONE: 916-534-4541 DATE May 189 1984 Lawrence LaVern RE: Building• Permit Application 41468-84 14456 Nimehew Road Magalia, CA 95954 A•P• # 64-61-25 With reference to the above subject: �l Attached is: Application for permit Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet Engr: Calcs Typical Plan Sheet Owner -Builder Verification Form List of Codes Enforced OTHER 1XWe need the following information: Permit application signed and completed where indicated with all copies returned. _'Fees of $ Ape nate (2) payable to Butte County Treasurer. Certificate -of Workmen's Compensation -Insurance or check exemption statement. "'Contractor's License Law information or check exemption statement. Complete plans in including plot plans. x_ Plot. plans in duplicate that correspond to building layout. Structural details in - Complete plans and calcs in by registered engineer or architect. Energy design including Street and drainage improvement plan approval from Land Development Section (DPW). sets of plans in accordance with the changes marked in red. C9 �_ X Sanitation approval -from Butte County Health Department at: 196 Memorial Way, Chico 7 County Center.Dr., Oroville x_ Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville,. for Completed Owner -Builder Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. Jgt OTHER ?" t3 Complete floor plans in duplicate of new construction and adjacent rooms c « showing room usage, room sizes, doors and window locations and sizes. Also, show any _remodeling being done in existing structure_ NOTE 1) These floor plans and plot plans are reau'ired so•that a Plan check may be Should you have any questions concerning the above, please contact this office. Yours very truly, William Cheff Acting Director of Public Works .F. Giander JFG/aj Chief Building Inspector r ENERGY S.HEET ,FOR. . ADDITIONS TO RESIDENTIAL BUILDINGS. PERMIT NO. -' PACKAGE "A", (Additions) .. NAME k 4itJR.�NC LA -.SQUARE FOOTAGE JOB ADDRESS . I q '5�& . /,I/inb/4If- 1MK-,44 I£xisting . Residence TYPE OF WORK Wm P.o,0cFj; ,, dew Addi tion 7 SnZ ic�L C)Azz New Total The following information sheet,. showing mandatory features and required features of Package "A must be completed and attached to all.plans for additions. to dwellings. Additions to dwellings include room additions, converting garages and patios to I i vi ng . areas, house moves that add footage and attic conversions, and any space that is ex isti.ng noxi -conditioned. space that is converted to conditioned space. Remodeling of existing conditioned space is not included: ZONE INSTALLED APPLIES TO NEW AREA --�CEILING R-30 Rm30 R-38 AAWALL R-11 R-11 R-19 o4LOOR R-11. _ R-11 R 19 SLAB R- 7 R-11 R- 7 GLAZING ,65 .65 65 SHADING SOUTH - OPTIMUM OVERHANG or 36. Sm.0 .AWE S T - A6 6 - S . C LOOSE FILL INSULATION (Density). ✓INFILTRATLON CONTROL.(Weatherstrip doors, certified windows, caulking) VAPOR BARRIER (Zone 16) DUCTS PER U14C - Ch; 10 i16HTING KITCHEN & BATH NOT LESS THAN 25 LUMENS/WATT .-41., UM GLAZING 16% OF AREA PLUS REMOVED GLAZING NEW HVAC AND HOT WATER IN CONJUNCTION WITH AN ADDITION SHALL.COMPLY .AND FILL OUT DATA ON BACK OF THIS SHEET 41 .DOM r.$ 7(G o W << This set of plans and specifications MUST b,-- kept on the job at all times and it is unlawful to make any changes or alterations on some without written permission from the Departmen.f of Public Works, County of Butte. NOTE:—All Materials & Workmanship Shall Be in Accordance with Recognized Good Practices and of a quality prescribed for f6. Specified use in the Uniform Building, Plumbing & Mechanical Codes -and the National Electrical Code. gAJPI �Lun� 1 atp V,,00/h 9/10-P A setback of /ft. from the ' - property lines and a setback I NF W of 50ft. from the road 10017rbN centerline shall be clear of structures or equipment except for a 2 ft. eave overhang. 1, 44 s iy� F xI S -11A,6 IJ 04 S1-` SaP7,i i, 70Fr CI ' TIE COUNTY oi4 Ne i Dj'EPART� ! . ,V APPROVX p 6 � RL_L,aaa� -ow S C 0 vc12/, 0 15 131 FOLO ire x. 3 � Roo fLy J�la ' F7 20 . D caD T r-7 13 ZXC WO �,1 G i7 nJ XTgA/flo.+. - k C-/% � ! 2i a� ! 0002 UTT CbU�ITY 40 3- �Zr7 ' c�FtuILDI DEPAnfi. L A IS F L L c no 0uNO/i7/arm PG�pNS Provide 1/2" x- 10" anchor bolts @ 6' O.C. max. and within 12" of joint.OF Q 4X6 61'W "a 4'(y • �v57 ' BUTTE COUNTY BUILDING DEPAPTI' 4, APPROVED 146 k4 - c -7/O 6 LL j S" T�7 yD�6C' D e on• s 7/�C� o �- H o)�'s7(Vls� 7H ce",l14 r 4 l % Provide adequate kacing. wOLIS /70 M W k/ot(S TO fg,� coV4''OD W1,;-// /1.z /i OR y w►�L� cr/Lin_*G _Tv 6� Co 4f/1 7XIV 11c.�� (,�>2uS7ic Tv M r� �I BUTTE COUNTY RoW I BUILDING DEPART, rF' R CF off 6- Los 6 Fm=? F=r, i -C 7< 74 010 M o > C: Z i -C 7< 74 a 1 is a Lih:,vvAVd30 9NI011n8 pow ca� �sOd I/ fAb -- D C r 7� 'z I ® ® o _ � n C Z c � j . I 7� 'z I � S 9 � n c � a o� � 1 o ^GIN C. to0 � Z -o d C :� Z V r' ) vU o� � 1 o ^GIN V r' ) vU o� � LONGFELLOW., A,. LUMBER CO. INC., Il. f•F _N ...nsm unnue - .- . Z,_ mb A$ NUIkU UELOW ,II Ws Fu ma ea.uOahWtOA where Nem -Fir .. sp0cd..d.1 MRrEX: BheO a d m.r...n pr.oe a Il..p.."now. (004 a F. m y R-SOOD I+dcr.0 W O•MF'Ri: t0 bNl Or 00 n..t6'ait" bp. Tww .r• PmtluO ro Ov Ib.F F..tO"a7f" os Nom• v. n b. NOS12E SS OF sl' OF 02 OF CON Oi 59 Mf 4 Mf 12 Mt Cllt• Hi 2400 F 1 00 i 1 5 i 1?00 4t:eIERAL MOTES: tu..ee dM... loeo6.o1 1 �1•tYas«+wx h TOP C►tORD h• S• 3 A• S• -vT • • ]6 S 32 10 36 S• 3i 10" 3!• S• ?9 7• NOF 16• S• 3 34• 6 0 asev suimw m.b.o.1' d lr w .w w. • Oa@-rMA.. IwY ra «lr aesaem del• E erwwVewq d.'Im"I .op..IbowaYy.lA BOTTOM CHO 4 3A S• 3 7 3A' S• 73• ?• ?7' h h ) 3• E•c�i..ne.avraooY..-,r•.Ya WEB MEMBERS 2.4 STANDARD OR STUD GRADE HEM -FIR. 7■5 02 HEM -FIR OR AS NOTED ON EIESION 3 0 10 0 Uped bwpinp v IWr by .crq nm'Im.�lrlo.e.ew..Ib.n.•• Loup m d 0111e.e•D.nONw b Yw0 1 It " e SPACED 24,0. O.C. L 6.0312 PITCH 4/3 CONFIGURATION LL•OL ON ROOF s 23.0 PSF t. OL ON CEILING i 10.0 PSF • TOTAL DESIGN LOAD a 33.0 PIF • OFF PANEL POINT SPLICE (Tit) • S PSF CEILING -REDUCTION TAKEN.: aXb R4.094.S.T44 TO 36. 66 •' AXIAL STRESS ONLY L040 DURATION INCREASE P. 1 2S' PEAK JOINT DETAIL 4' S• - ' r' 2X6 R4.OX6.0,146 36• Of 2,0 4.00 4 210 R2.4X4.S.T2.S/4 TO 3A• S• MAXIMUM TRUSS MEMBER FORCES REACTIONs 1008 2x6 R4.0114.5.TS4 30. 0. 2.0 4.0• 4 T 1 *t6S1 S 1 147? .w 1 •377. in 2 526 •' 2x4 p4.0X4;5.T44 36. 41• 2.0 4.00 4 PANEL'POINT SPLICE CTJ2J T.2 -a 421 .S 2 .983 2X6 R4.6X6.0.0T56 TO 36• ON T2 2X4 R4;ON4..5.0T54T0 36' S• 6. �• NO SPLICE 72 R9o0X3'O.T31 .T0 i6! S•, �p099 lYln, ,l• ant 0: S cs� 04 O• ��P+,pINEF��yt 200) hmekISPL, TT Urg Me ;;Irrr�T 82 et _ 7070�. a eM i 4 BJ2 S EQUAL PANELS BOTTOM CHOF10 .Ir`'�•a3'3r,11'• • .. SPAN To36• .S iANEI t03NT SPl2¢E (SJa) ' SPRUCE -PINE F')i►,, ..arUss Rt•Sx6.o0TS6 TO 3b' S• R2.aX6.0 TO 36• ems. F4.Or4.S TO 360 i• R4.SX6.O0TS4'TO 30• 00 WAXA.! TO 34.10•. R2.4X7.6 TO 34• `S• s _ R4.ON4.5.T44 TB 240 •" R2.41116. 0 3 �' ^^ 3• �O SPL I E R2.5 �..,It4, • NA C .R2.4N4•S.T2.5/� 0 T 3. . 2 oxo S TO as•, TO 36• S- 6- •;q+ R2.t1X3.00T2.S/4 TO 30' 06 - �au1•� OOUG-FIR SPRUCE -PINE -FIR' COUNs/6 TO 36' S• T2.S/6 T0' 36• 0• iAYT.a f2;4/4 TO :1 • i• T2.5/4TO aS• !• OFF PANEL POINT SPLICE (02) BUILDINGDEPARTk4ANT •� '" Symmemw 02.4x6.0.72.5/6 -TO 36' S• About p2:4x4.s.T2.-5/4 TO'30' 00 A n to ^ „ • a - FILE NO.: 'i -36.6- 330 (241 4/3 DATE: -5/24/79 • SPF REF-:, 3-25-78 D44.Sr: TX CX.eT: TAI! .__•_ .__ T144111AL CONNUTOROr WWWw. d 0••r- WMry 7n vd t0 p.. 1, pYn,a.e drM eeed n.t w 4b�.YrA u b0.a --- 010tie -i Of OF KAT[ Me W.861111.•030 14 (•••ar.1.0 q V•.d'T"Y• • ISMpv 04 1".174.41" brb. Tomb N pl.rdlee &M Ow 11d. r .10'.7b" ac WIN w n w. MRrEX: BheO a d m.r...n pr.oe a Il..p.."now. (004 a F. m y R-SOOD I+dcr.0 W O•MF'Ri: t0 bNl Or 00 n..t6'ait" bp. Tww .r• PmtluO ro Ov Ib.F F..tO"a7f" os Nom• v. n b. M WYLWO.wr. Nwn•F. a.DFoha 1 Ru.wu (if-rAtW W PMAl -RN's b. IPS" A4000.aMCIW .0 w.r ttrd ..v of 10.11 WO hdo ong" tt01A. V' •1-r•b. u go 00* w.0. N.arnoft ib 0R tNtttrrt0ttr0;1•101e4e11M0.t.rw..etldAt.ee.dYw.rdtF4e.o/Iwro.m�...sm+nO..iAp...alrNni.. d....oOM1..IbY/. wo,tow dew •.uM. w I e 0 o. RRo low wd 110.140. a . LUMBER SPECIFICATIONS TOP CHORD 2X4 al DF -L 1650F -1.5E MSR -HEM -FIR BOT CHORD 2X4 •I HEN -FIR a2. OF -L 1450F -1.3E NSR HEM -FIR NESS 2X4 STANDARD OR STUD -HEM -FIR t NEB 93 IS 2X4 CONSTR. HEM -FIR PLATING IS FOR R-5000 SERIES / HF NSR NOTEi LOCATE INTER -PANEL SPLICES AT 1/S PANEL LENGTH •/- 6 INCHES FROM EITHER END OF THE PANEL INDICATED. j—j - 09315 f . . LE; %o -Gil': -a3%. JDE: 72 LO NGFELLOW MEMBER FORCESIFROM LEFTJO; RIGHTi TOP CHORD BOTTOM CHORD WEBS REACTIONS T In -3636 B 1■ 3428 N is 65 N 4a -1079 REACTION o IN 728' T 2a -2445 B 2a 3428 N 2a -1078 N Sm 65 REACTION a 50 728: T 3a -2445 B 3- 3430 N 3a 1$96 T 4■ -3636 8 4a 3430 BEARING AREA REO'D ISO IN) BEARING o I I.80HF/ I.16DF TRUSS LOADING ICON 1) BEARING o 5 1.80HF/ I.16DF LL*OL ON TOP CHORD a 29.0 PSF DL ON CEILING ■ 10.0 PSF w TOTAL DESIGN LOAD = !33.0 PSF w • M 5 PSF CEILING REDUCTION TAKENI5/8' DRY: -WALL) LOAD DURATION INCREASE a 1.25 ON -CENTER SPACING 1. 24.0' L .....,, cG�� No. C304 0 civ SYMMETRICAL ABOUT FLOIE RO111110 "'DEG. /G� U 4060 'BUTTE COUNTY SUIL®INr '1EPARTWNT "A D P - n, V 1: STEEL AND RAE DISTINGUISHED. AS FOL LOMS�� + �� 'OUR. ,.U"LT"HJu'a'aneeF GFNFRA1'NRTFg• (UNLESS OTHERWISE SPECIFIED) Hn.1 ln: 8 TEETH PER SD.IN. LINE.22"11.• LbNG. TEETHAREPUNCHED TWO PER HOLE R7 .10.11.25. O.C. MOLES'ARE 1N LINE. I. INSTILLATION IS ENTIRELY.THE RESPONSIBILITY OF THE RESPECTIVE F -.DOD: 10 TEETH PER SO REIN 0'X.52• LONG. TEE7M RRE PUNCHED iNO.PEO HOLE RT � -Z5'k.7S' O.C. HOLES ARE IN LINE. T RUSWAL 2 CONTRACTOR. ILL 'RE TOTRESIST LATERAL Li'.LEIE:•IS R SPECIAL R-5000 CONNECTOR NTTH EVERT THIRD RON OF TEETH RND HOLES S® 3. SRTONBETOESIGNEO ANDS PPERMANENT. DESIGN ASSUMES •OflT CONDITION' OF USE 1M NONCORROSIVE ��ITIC'1. F•'-11ICNING, PLATES SHRLL BE LOCATED ON BOTH FACES OF TRUSS pNO�PLACEO SO THEIR �'EkIEALiffES COINCIOE WITH JOINT 4.�0ESIGN ENVIRONMENT. ASSUMES LATERAL BRACING AT 3' OC TOP CHORD. 12' CENTERLIMES. UNLESS OTHERWISE NOT EO. CE1.175 INDICATE SOFE OF PLATE 1N 0C BOT70N CHORD. INCHES. L_•FCA: 5MFIR BE OF MINIMUM UTEGRADE i SPECIES IS IS SO. B IINT BE SUBSTITUTED WHERE MEM -FIR )S SPECIFIED. 3850 E. NIRALOHn ANAHEIM. CR. 92806 S. 6. DESIGN ASSUMES FULL BEARING RT SUPPORTS. SHIM OR WEDGE IF NECESSRRT. CAMBER T0U5S TO L/720 BETWEEN SUPPORTS. . bUFFIS "G' •+ SUFFIX -G- INDICATE 10 GR. STOCM USED. ALL DINERS ARE 20 1. AOEOUATE DRAINAGE IS ASSUMED. GA. . FOR BASIC DESIGN VALUES. SEE ].0 B.O. RR. 6 1. i NINE semENCK 01410> 0. IMPACT BRIDGING OR LATERAL BRACING RECOMMENDED WHERE SHOWN." - -6(- 62S �w�unrc� -da t.Plwu. zo e AbM 3 BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECTION REPORT Owner:— Address: wner•_Address: Tenant: Building Location:' Type of Inspection requested: / / 1. Housing ",2. 2. Financing 4. Other (specify) Present use of building: A. Sanitation (Housing) 1. Water closet: 2. Lavatory: 3. Bathtub or shower: 4. Kitchen sink: 5. Hot and cold water to fixtu s: 6. Heating facilities: 7. Natural fight and ven lation: _ '8'. Room and space requ' ements A.P. # Date of Inspection., Inspector / / 3. Change of Occupancy to 9. Bedroom window or oor for s and exit: _ 10. Infestation of ins ts, ver 'n, or rodents: 11. Connection to sewage spos 1: 12. Connection�to water supp 13., Rubbish and garbage facilities: 14. Comments: B. Structural 1. Piers and footings: 2. Floor construction: 3. Wall construction: 4. Ceiling and roof construction: 5. Fireplaces: 6. Comments: C. Electrical 1. Service and ground: 2. Receptacles: 3. Fusing: 4. Comments: It a E. F. Plumbing 1. Fixtures connected and vented: 2. Gas water heater: 3. Gas heating vents: 4. Comments: Other 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: 4. Weather protection: 5. Underfloor and attic ventilation: 6. Comments: Commercial Buildings 1. Roof covering: 2. Distance to property lines: 3. Physically handicapped: — 4. Restroom floors.and walls: 5. Exits: 6. Improvements: 7. Zoning: 8. Comments: G. Field n,.,.,.,,,.-, 1. 3. What action recommended: / / A. Information only - file. / / B. Hold for ten days, then write letter. C. Write letter. Other: 1 COUNTY'OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-454 AGRICULTURAL BUILDING EXEMPTION PE IT PERMIT NO. 1 -Sz Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. OWNER PHONE NO. OWNER'S ADDRESS LOCATION OF BUILDING USE OF BUILDING O /= 72e/2C 70/' SIZE OF STRUCTURE ` Z Y • x e'/U = I � � 0 SQ. FT. TYPE OF CONSTRUCTION: WOOD FRAME_1� STEEL CONCRETEOTHER (Specify) TYPE OF SIDING i�tevU ROOF COVERING FLOOR TYPE - ESTIMATED COST OF CONSTRUCTION $ AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as follows: �C� ' ' � I - 5 FRONT SIDES REAR - AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. . AG Buildings greater than 1000 sq. ft. in floor.area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial .building. I declare under penalty of perjury that the building will be used as stated above and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Department of Public Works and will obtain any necessarypermits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date 7 Signature of Owner Permit Fee - $25.00 The above described AG Building is exempt from a building permit. Receipt No. 6;'? �� Director of Public Works By. Date White - DPW, Yellow - Assessor, Pink - B. I., Goldenrod - Applicant {COUNTY OF BUTTE n- DEPARTMENT OF `PUBLFC WORKS - BUILDING DIVISION 1 !-�7 COUNTY CENTERDRIVE- OROVILLE, CAL JF,ORNIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET ) i Permit No. OWNER �L� �S-w !/ A. P.'No; Proposed. Bu Iding Use �V Permit Fee Based Upon: Complete Contract Price DPW Valuation Other (Explain) 94�1.1114a 0• r Building Inspector a Date • At time 'of permit application, I was advised the following data must be submitted prior to permit processing and/or Issuance: 'DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2. Plot plans in duplicate/triplicate. . . . . . . . . 3. Complete plans in duplicate. /triplicate. 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . 6. State Energy Forms No. . .. . . . ` 7 Statement of Intent for Non -Heated and AC Buildings. k 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑,•Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . 16. Mobilehome Installation Data. . . . . . , . . •. . 17. Pre -Inspection for Pre-Inspec. request to Required. Building Inspector (Date) 18. Other When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at - office. Deliver w/inspector. Other Applicant �--� Date Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other By Date Plans checked by Date Plans approved by Date Other: Copy—DPW - - ' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: (916) 538-7541 • AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT NO. Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO./•� / 2S b J ZONING SRM N 3 OWNER LAW 44VQ14e PHONE NO. 1;73-- 15_0 OWNER'S AySS/".47 5, q,4 LOC TION OF BUILDING C�L) OW - C COA,-4XIL alot? c -CL �,�_ %Z S or`, U> sr o` /✓,"X,fla'v n�fl USE OF BUILDING //,4!tS�a� e floe Sr�l SIZE OF STRUCTURE Z ! p ` n S q 3/ 6 X _ SQ. FT. TYPE OF CONSTRUCTI WOOD FRAME STEEL CONCRETE OTHER (Specify) TYPE OF SIDING ROOF COVERING FLOO2 TYPE ESTIMATED COST OF CONSTRUCTION Z �O '40 $ AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as follows: `ICI .4—SIDES � d �0 FRONT�� REAR AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated above and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Department of Public Works and will obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date J( r 6 1, // /V /,'? 2- Signature of Owner Permit Fee - $940 TO, oD Receipt No. 5 7-5-G-7 The above described AG Building is exempt from a blyilding permit. White - DPW, Yellow - Assessor, Pink - B. I., Goldenrod - Applicant F/'00PARJ P.D. CE ROOFIN ISSUE Director of Public Works By ate COUNTY OF BUTTE - DEPARTMENT, OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE,,CALIFORNIA 4965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DA,TAlHEET L Permit No. OWNER i9n/ L /;I 1//fA46 A. P. No. Proposed Building Use /37 -61-9 1�.-/TK- Building inspector's Date At time of permit application, I was advised the following -data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicateAriplicate;-sigined by preparer of plans........ 3. Complete plans in ijuplicate/triplicate, signed by preparer. of plans . . 4. Complete engineers}d'plaiis"and talcs, with wet signature on plans .. 5. Hazardous Material Form .......... :.......................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid.o................................................... 13• . School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for requiredPre-Inspec. request to ' Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Wbrkmans Compensation Insurance ................... 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. ,Letter of signature authorization ................................... 26." 27. When you issue the permit, process as follows: ail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other /1 , C Appl icant Z Z(l� Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent . Health Dept. -Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone---jnail—counter by ..date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW / COUNTY OF BUTTE - DEPARTMENT- OF-PUBL-IC_W'ORKS PERMIT NO. t✓ 7 Count Center Drive - Oroville, i County California 95965 -Telephone 916/534-45412...— APPLICATION AND PERMIT _ ASSESSOR PARC„(=L UMBER _ G ZONING RN '3 BUILDING PERMIT OWNER ,s s TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1-(1q5'41 CONTRACTOR'S NAME i TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation .pQ LENDER'S MAILING ADDRESS Filing Fee ,$ 1000 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS q 4 5 /V PLUMBING PERMIT Filing Fee 10.00 + �4A .4 ! Each Trap 2,00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets USE OF STRUCTURE ` SF ❑ Duplex[] Mobilehome® Other 42A/l,R rat E SPECT FY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lilies ❑ Installation ❑ Other [? Describe work: _p f� //� r�IU!_� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.0000V OR Main service 100 AMP ORSLESS J� 5,00 -,1, oar Main service EA. ADD'L 100 AMP 2,50 NEW CONST. DWELLING OCCUP.51 OR ADDNS. ( ACC. BLDGS. 20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NNEW ON.RESID CONSTR. BRANCH CIRLF CTITS 2.50 ea NEWCONSTR. ( POWER APPARATUS eI NON.RESID. SINGLE OUTLET CIR, . 0250 Ex. Occup OUTLETS OR FIXTURES @?oo Ex. Occup.(OUTLETS (RESID )FIXED APPNSREA. 2.00 Temporary service 10.00 /0 r7d Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Z pG Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. f� I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: if after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3 Ventilation Permit Fee S Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building 'construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue agaiinnst_'s/a�iid Country in consequence of the granting of this permit. %� "`" ' `''�' `-r r'�`�k-� Date � ��' f .I�'� Signature of Applicant — Owner 9 Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE Z�'a✓_ OCCUP. GROUP I TYPE OF CONST, PARCEI PO Ha 5911E This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. tRECTdR O UBLIC WORKS /`lf// By D�attew��/ PERMIT EXPIRES Date Receipt No. C�/ ...TE-O.P.W.. YELLOW-A59E850R. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND POMIT PERMIT NO. ASSESSOR PAR EL UMBER *&I ZONING 4RNI+73 BUILDING PERMIT OWNER / TELEPHONE SQ,'FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS / 4 &q,-5_&sarzw IRA, CONTR CTOR'S NAME— TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRES CAl/Lt se4 1-4t.) Rcl PLUMBING PERMIT Filing Fee 10.00 e , . '"A ` A-6.4 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 55,00 Gas piping system 1 - 5 outlets USE OF STRUCTURE ` SF ❑ Duplex[] Mobilehomey Other 4rJZA!4aX �OLC SPECI FY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other[ Describe work: t M P. DNS"- . �o b�- Rog � iV�Lb clll�y Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 I Oil Main service 100 AMP OR 5.00 -�� A _ Main service EA. ADD'L 100 AMP 2;50 NEW CONST. (DWELLING OCCUP.y1 OR ADDNS. l ACC, SLOGS. / 20 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business ElEx and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NO N.RESID CO N ST R. BRANCH CIRCTITS 2.50 ea NEW CONST R. / POWER APPARATUS 61 NON -R ESID. (SINGLE OUTLET CIR, / . OCCUpOUTLETS OR FIXTURES sDL@ BALI IXED APP LNS, OR Ex. Occup.(OUT LETS (RESID.) EA.) 2.00 Temporary service 10.00 /Q �0ZP Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Z5—?Q Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I'shall not employ any person in any manner so as to become subject LrJ to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee S Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue agai s id County in/conseq�ue ce of the granting of this permit. X ✓-� Date 7 9 Signature of Applicant — Owner )d Contractor ❑ AgentEl An OSHA permit is required for excavations over 5'0" deep and demolition or construct -ECT ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ zrs OCCUP. CROUP I TYPE OF CONST, PARCEL PD I No I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees R O UBLIC By ► PERMIT EXPIRES Date z_ �?—R–A the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. 69 a 6 E— WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT . .. - .,�. . � .o.r . ,.�.�;.,�... r r.-•- �.,, .:q:'. ��.�.<. �..y:.�v,�• . ;�.,,.,� �� _.... .. s�,r ., .-qr :-... �x4-•.. _.. .. -.. rJ . v_. COUNTY OF BUTTE - DEPARTNENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PEIftT NO. ASSESSOR PARCEL NUM ER �- ZONING XVIY,11 7 BUILDING PERMIT OWNER TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS (� J /Z/ a 2 ` M - .16.,¢ L l� CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS I Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S`MAILING ADDRESS 1 Permit fee $ BUILDING ADDRESS 144 L1 CL A%M.LU 'ki /I� PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF N 'Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other [� Describe work: (r� t,�a r Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 600V OR LESS Main service 100 AMP OR LESS 5.00' J �� Main service EA. ADD'L 100 AMP 2.50 Z V NEW CONST. (DWELLING OCCUP.51 OR ADDNS, l ACC. BLDGS. 2�sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F -1I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification Q I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec.—,- Business and Professions Code for this reason NEW NON -RESIT FL BRANCH CIRCTITS 2.50 ea NEW CONSTR. IPOWER APPARATUS E NON•R ESI D. %SINGLE OUTLET CIR. 50 @ 250 Ex. OCCUp�O OR FIXTURES BAL@1 FIXED A P LNSOR ED A Ex. Occup.(OUTLETS (REST. D.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring /~ .750 S u" Permit Fee $ ;-7,S Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. F-,,Jl I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee S Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. �� 1, 4�!,?.-/,.�_-C �, /; - �2_ X f i Date Signature of Applicant — Owner Q Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ :37 OCCu P. GROUP TYPE OF CONST, PARCEL PD ND 99UE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC �/' L BY —sa, ; ADate PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS / <- /' (.-� 7's .�/7'S Receipt No. r WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DF�PARTMENT OF PUBLIC WORKS �# 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATIAN AND PERMIT PERMIT NO. ASSESSOR PARC7 NUM ER � — 2 j ZONING AFILtv M_ UILD G PERMIT OWNER �7- T LEPHONE S ®� SO. FT. O BUILDING VALUATION OWNER'S I ING(_AAD�DRESS CONT NAME, ELEPHPH ONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRE s Permit Fee $ ARCHITECT OR .ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER' MAILING ADDRESS Permit fee $ BUILDING ADDRESS ^ `J PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New Add ition❑ Remodel❑ Utilities [:1 Installation❑ Other( Describe work: FLr_'CI064 !Q_ G'AI�C Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100v OR LESS 100 AMP OR LESS Q _eVIC� Main service EA. ADD'L 100 AMP 2'.50 NEW CONST. ( DWELLING OCCUP.N) OR ADDNS. 1 ACC. BLDGS. _ 20 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F -1I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification Ed I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) El 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR I -OUTLET 2.50 ea NON-RESID BRANCH CIRCUITS) NEW CONSTR (POWER APPARATUS &% NON.RESID. (SINGLE OUTLET CIR. 1 Ex. Occup OUTLETS OR FIXTURES B �@1 00 IXED APPLNS. OR Ex. OCCUp.�OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring j ' Permit Fee $ !S Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building. Department a Certificate of Workmen's Compensation Insurance ora Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee S Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also a ree to save, indemnify and keep harmless the County of Butte against all li i iti s, judgments, costs, and expenses which may in any way accrue against sal County in n/sequ�e ce of the granting of this permit. p� X Date k.� �^D 2— Signature of Applicant — Owner} Contractor ❑ Agent ❑ An OSHA permit is required For excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in xcavht7 Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP TYPE OF CONST. PARCEL PD HD ssuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIR Ft 10 ELIC " By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date ,/7 !— �/ Receipt No. P G Z/' 5 WAIT E-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT