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Home My WebLink About065-080-035J(�5- 00 ! A � 152$ Humbug 5 Perm_ it#2577-$2B,P en bl'O 1 065-080-035 04-2266 BUDJAKO, SUSAN 15211 HUMBUG RD, MAGALIA CONT: RIDGL-TOP ROOFING REROOF /JJLJCtJ 930-OLt Ll 065-080-035 04-2338 DECKER, MARK C SUZANNE 15211 HUMBUG RD, MAGALIA CONT: MCCLELLAND A/C NEW HVAC County of Butte Oroville, California GENERAL CLAIM CLAIMANT: McClelland Air Conditioning, Inc. ADDRESS: 801 Marauder St CITY & STATE: Chico, CA 94973 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY AMOUNT Refund Claim - See attached calculation sheet APN: 065-080-035 Permit No.: 042338--V PAID RETAINED REFUND Development Services $ 110.00 $ 54.99 $ 55.01 THERM DRNG $ - $ - $ - SMIP $ $ $ SHR $ $ $ - TUA $ $ - TOTAL $ 110.00 $ 54.99 $ 55.01 .:.:.:.:.:.:.....:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:....•.•.•..•..I..•.• .............. ................................................. IS:: ET::::AGCOlJi1i $........... I : ............. :IYtUUN I ............. 101001 DVLPMNT SVC 440-001 4210500 $ 55.01 1011822 THERM DRNG 1800 280 $ 1011430 SMIP 1001 280 $ 1011811 SHR 1800 280 $ 1011816 TUA 1800 280 $ - TOTAL $ 55.01 $ 55.01 I, the unaersignea, aeciare unser penairy or perjury alai aro scwicca a _� _ _� • _ �« •rte• •�^••�� • --•••- -- - -- - claim is true and correct as stated. o r Iry/G� . Dated this � / � day CAP , 2005, at ,Calif. Signat of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have bee rformed or delivered and that there • a Budget Appropriation or Specific Board Approval rejror the s e1 Dated this day of Departme Head or 4ut46rized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND UU NU 1 WKI I t ULLUVIr I M10 L11vt - HUu1I UR J UOF- UrdL r EPT & SU PROD I SUB. OBJ I CLAIM NO. I INV NO. I INV. DATE I ENCUMB. GROSS AMT. o�OTrFo Butte County Department of Development Services e G Building Division O O o -0 7 County Center Drive c0Oroville, CA 95965 (530) 538-7541 REFUND REQUEST APPLICATION REFUND POLICY - Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the fees, whose name is on t he receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt. 2. The request must be made within two years from the date of fee payments on permits not issued, and two years from the date of permit issuance for permits issued -if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees aid to other County Departments are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the CLAIMANT'S NAME: 44 nio MAILING ADDRESS: 1 J�rrl73 .. PHONE: ) �J � 2, ASSESSOR'S PARCEL NO.:S [Please use one claim form per permit.] BLDG PERMIT NO.:� Receipt No. 1 Receipt No. 2 Receipt No. 3 N ` s RECEIPT NO.: ' RECEIPT DATE: (Plans for cancelled permits will be disposed of within 10 working days upon submission of a Request for Refund. If you want the plans, you may pick them up prior to that time. Si ature K:/Forms/Refun cation 082203 lP Date WANT: McClelland Air Conditioning, Inc. LESS: 801 Marauder St 6 STATE: Chico, CA 94973 :OF CLAIM: 11/09/04 APN: 065-080-035 RECEIPT INFORMATION NUMBER: DATE: ISSUED TO: CHECK 0: AMOUNT: PERMIT 9: REFUNDS: DETAIL BLDG — BUILDING APPROVAL Date Reviewed Michael Vieira Building Manager 04-2338 PAID RETAIN I REFUND 110.00 54.99 55.01 0.00 0.00 $ 110.00 $ 54.99 $ BLDG THRM DRNG AUD SUSP. SHER DEV FEE THRM URBN 0010 1800 1001 - 1800 1800 440-001 rHRMDRN (SMIP) - (SHR) (TUA) 4210500 280 280 280 280 101001 1011822 1011430 1011811 :1011816: ::::::::::::::::::::::::::: 0.00 o.00 :•:•:::::.::.:.:.:.:.:.:.:. :.. 0.00 :::::::: ........ 110.00 0.00 :::::::::::::::::::::::: ::: .54.99 :::::::::•::::•:•:•: .. 55.01 ::::::::::::::::::::::::::::: 0.00 : :' - 0.00 :...:.:.::: : 0.00:::•:•:•:•:•:• 0.00 55.01 1 $ 55.01 1 $ $ - 1 $ $ 005/055//[22005 DIFFERENCE: $0.00 �� (Should be blank) PERMIT Off-SWRA W Bin �MAPN LAST NAME CONTRACTOR STREET NO USE VALUATION FEES PAID FEES 2 FEES 3 FEES 4 Comments: STREET NAME TYPE RECEIPT RECEIPT 2 RECEIPT 3 RECEIPT 4 ST NAME -CITY/CTY Q CITY. REMARKS ••► APPLIED ISSUED FINALED < 0 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 a PERMIT NO. BP042266 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION Issued Date: 07/30/2004 APN: 065-080-035-000 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 Site Address: 15211 HUMBUG RD MAG effect. License Class: License Number. Map Index: Date: Contractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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 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, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner. WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: U 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section, 3700 the Labor Code, for the performance of the work for which this permit is Issued. My workers' compensation insurance carrier and p6licy 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: % — X4, ^ o -/ Applicant: `7S/ 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 Description: RE ROOF COMP/TORCH 17 SQ. Owner: BUDJAKO SUSAN PO BOX 511 MAGALIA, CA 95954 Applicant: BUDJAKO SUSAN Contractor: RIDGETOP ROOFING 16522 LOVLOCK ROAD MAGALIA, CA 95954-9761 (530) 873-5000 License #: 557217 Architect: Engineer: Total Square Ft: Valuation: Census Code: 0 S.F. $0.00 Y 22,64 15-7111 Yum-toj M BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP042266 I PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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 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, 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 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 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 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 p6licy number are: Carrier: Policy J I certify that in the performance of the work for which this permit is V 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: 7 Xy 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: 07/30/2004 APN: Site Address: 15211 HUMBUG RD MAG Map Index: Description: RE ROOF COMP/TORCH 17 SQ. Owner:. BUDJAKO SUSAN PO BOX 511 MAGALIA, CA 95954 Applicant: BUDJAKO SUSAN Contractor: RIDGETOP ROOFING 16522 LOVLOCK ROAD MAGALIA, CA 95954-9761 (530) 873-5000 License #: 557217 Architect: Engineer: Total Square Ft: Valuation: Census Code: 0 S.F. $0.00 This permit is hereby issued under the i Resolutions to do }work In¢Icated above PERMIT EXPIRES sions of the Butte County Code ar have been paid. ❑ 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 Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: L A.,, ,.. '�`LJ.�-c� Signature: Date: 7--,1 O _ O ❑ Owner Contractor ❑ Agent for Owner ❑ 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 PERMIT NO. BP042338 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under Issued Date: 08/06/2004 APN: 065-080-035-000 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 effect. -1 Z �-, /' 11r r License Class t uJ License Number. V4 J Z ( Site Address: 15211 HUMBUG RD MAG - 1 A , / _ y+f Date: Contractor: �L �/14.�n /L (&01 Map Index: (_ Description: NEW HVAC 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 Owner: DECKER, MARK & SUZANNE permit to construct, alter, improve, demolish, or repair any structure, prior 15211 HUMBUG ROAD to its issuance, also requires the applicant for such permit to file a MAGALIA, CA signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 95954 7000) of Division 3 of the Business and Professions Code) or that he or (530) 893-5068 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 Applicant: MCCLELLAND AIR CONDITIONING, INC Intended or offered for safe (Sec. 7044, Business and Professions pp 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 690 THUNDERBOLT STREET sale. If however, the building or improvements are sold within one CHICO, CA 95973 year of completion, the owner -builder will have the burden of 891-6202 proving that he or she did not build or improve for the purpose of (530 ) 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: MCCLELLAND AIR CONDITIONING, INC 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 690 THUNDERBOLT STREET Date: owner: CHICO, CA 95973 (530) 891-6202 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 #: 345121 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 Architect: required by Section 3700 the Labor Code, for the performance of Engineer: the work for which this permit is issued. My workers' compensation insurance carrier and p6licy number are: Carrier: % r✓ZF� Total Square Ft: 0 S. F. Policy #: -7/-Z`3�( ❑ 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 Census Code: 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 QS G G - Q 1 i S!�-, •— 154% compensation, damages as provided for in Section 3706 of the Labor 1 code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit i hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions do work indicated above f9r which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) & a n Name: - Bv: - �- A Date: 8 - 6 ' 0 S Address: PERM XPIRES ON: 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 fortes. 1 hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of YAY official fo' doc ment of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes t' � Print Name: I Signature: Date: ❑ Owner ❑ Contractor ❑ Agent for Owner SCI 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 "PLEASE PRINT CLEARLY" CONTRACTOR Name `/L O Address I k City�. Stat Zip )5�� Phone 8q I _ ( Fax E-mail Uc. # Class& f;;,`-f�"I(✓1 APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name Q M/ I Address City State Zip Phone Fax E-mail .k _jlCALVT SIGNATURE VA, aw R., , 20-0.5", For office use only: Zoning Property Address Flood Zone Cross Street SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: 71 PERMIT NO. BP 04233$ BIN # LOCATION AN 065' OW •-o- 5 Property Address City Cross Street WORKER'S COMPENSATION Policy Number -2 `'� 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 OVER FOR SUBMITTAL REQUIREMENTS U K:\FORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 1 of 2 Description or Scope of Work: • `rt�P Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by:7.ount: 55 Bldg SRA Receipt #: Sheriff Date: el G 1O q, SMTP Other 515 Total REV 7-27-04 r 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). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). ❑ 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). ❑ 2. Impact Fees. ❑ 3. California Department of Forestryplan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ 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 Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING FORMS\BldgApPlSubRgmts.doc Page 2 of 2 REV 7-27-04 January 18, 2001 Andrew and Tina Cardin P.O. Box 4026 Chico, CA 95927-4026 quite �'o LAND OF NATURAL WEALTH A N D BEAUTY PLANNING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7601 FAX: (530) 538-7785 and Josie Vanschoick 3730 Mt. Diablo Blvd. Ste 100 Lafayette, CA 94549 RE: Application for Correction; 0 5-080-035 & 033, COR 01-01 Dear Mr. and Mrs Cardin and Mrs Vanschoick At the regular meeting of the Butte County Development Review Committee held on January 11, 2001, the Committee granted a Certificate of Correction to modify a recorded parcel map, to remove the note that states "No wells to be placed in this area or within 100 feet of 30% grade break line." on Parcel Map Book 89, Pages 19 and 20. There is a fifteen -day appeal period before this certificate can be recorded unless you sign and return the enclosed waiver waiving your right to appeal the Committee's decision. If the conditions are cleared prior to the end of the appeal period, a "clean" certificate with no conditions will be recorded upon receipt of correct recording fees. . Should you have any questions regarding this matter, please contact this office Monday through Friday, between 8:00 a.m. and 4:00 p.m., at 538-7601. Sincerely, Lynnin Richardson Administrative Support Service Assistant cc: - Environmental Health Department Building Division ✓ Land Development 2577-82B.P, PERMIT NO. _EM PERMIT EXPIRES ale - OWNER Clem Trent CONTR. Owner `�/^ oq ASSESSOR PARCEL 6 5 - 08 LOCATION L52-33 Humbug Rd,DeSabla r{zglfr3i Temp. Power Pole Called PG&E Temp. Elec. S Called P( Temp. Gas Sei CalledPC JOB FINALE[ Signature J = OK O = Not OK = Not Applicable MOBILEHOMES = Not Ready i MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) u,. ,.:xcept A 1. Zoning Requirements -Setbacks -Easements _ 2. Soils; Special MH Support -Sketch 2. Footings; Size_Depth-Spacing-Connectors 3. Sewer; Location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracin_g _ 5. Alum. Awn.; Columns-Connections-Splice-Decal-Enc!us„res 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 N'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-Connector3. • 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/O 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 - 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I •Date Card -BI Date Card -BI Date Card -BI Date r COUNTY OF BUTTE' DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chi•,o — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact thi/s/ office �immediately. 1 -,7 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS =196 Memorial Way, Chico - Phore� 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 ` Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 .CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this Inspector Date 9 s COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS °196 Memorial Way, Chico — Pnone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORR CTI N NOTICE . �; BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected: Please notify this office when correction of work is completed. If you have any question pertaining to this matter, ne itional explanation, please contact this office immediately. 7/ , A ell Inspector Date RES IDENT IAL ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE. THIS IS, TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFORMANCE WITH CURRENT_NERGYCONSERVATION REGULATIONS A BUILDING PERMIT NO. 5 !1 A. -P.. THE FOLLOWING HAVE BEEN INSTALLED -AS PER*APPROVED.PLANS: (Check each item or write N/A if not applicable) INSULATION: Slab Edge Fdn. Walls Floors -1 Walls" 131 Ceiling/Roof F - 3e Ducts' ✓/ Circulating Pipes APPROVED HEATER APPROVED WTR.HTR. GLAZING: Single Glazed Special (Insulated) ' CERT. & LABELED WDS. & SLIDING DRS. ✓ WEATHERSTRIPPED DRS. BACK DAMPERED FANS ✓ INTERMITTENT IGNITION DEEVVICES G!/ CERT. APPLIANCES 5 , I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE,TO THE. COMPLETENESS. OF THIS CERTIFICATE AS SUBMITTED.--....-,-. Insulation Applicator Name Lei!% l et� l%� Signature of (plea a ri ) Insulation Applicator to a Contractors License'No. General Contractor/Owner Name_ /�,'J &/, 7 Yee- JL eprint) Signature of General -Contractor Owne Date�� 9 Sta e Contractor License No. THIS CERT IF ICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. COUNTY OF BUTTE- DEPARTIAENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - OFOVIIIe, californ.ia 959E5 - Telephone 916/534-4541 APPLICAUGM 1AD PERMIT ASSESSOR PARC? NUMBER G DING PERMITOWNER PHON ffN OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS SQ. FT. OCC. BUILDING VALUATION Fireplace CONSTRUCTI LENDER UNKNOWN LENDER'S MAILING ADDRESS F � O c — Total Valuation I $ Filing Fee Permit Fee > O_ $ 10,00 $ Z 00 � ARCHITECT OR ENGINEER LI -CENSE NO. I Plan Checking Fee Penalty q $ $ ARCHITECT OR ENGINEER'S MAILING ADDRESS -_ Permit fee $ BUILDIN ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap Repair drainage or vent 2.00 5.00 piping Water piping ,f'va ,y', d D LOT NO.SUBDIVISION NAME PARCEL MAP p- Each qas water heater or vent I Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY j Building sewer ;per 9 a Lawn sprinkler system 5.00 TYPE OF WORK New Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: Permit Fee Contractor,0-zAv_R_-*,_ ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS-9.eo-0 cvi Main service EA. ADD'L 100 AMP 2;50 5 D NEW CONST. ( DWELLING OCCUP.JSII OR ADDNS. ACC. BLDGS. f 201q ft I, 2- 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 AiI, 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 NEWCONSTNON. RESID R BRANCH CIRCTITS 2.50 ea NEW CONSTR. ( POWER APPARATUS h1 NON -R ESID. SINGLE OUTLET CIR, / Ex. Occup(ouTL OR FIXTURES s0@z5¢ B IXED APP LNS. OR EX. Occup. (OUA TL.(RESID.) EA. 2.00 2 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ &31 7S Contractor MECHANICAL PERMIT Filing Fee 10.041 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 to the W. C. laws of California.��d$4r� 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. Heati dL Ic Cooling oti Hood 3.00 Ventilation _ -3 o� Permit Fee $ Z�' 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 k p harmless the County of Butte against all a iliti judgments, cos expenses which may in any way accrue ag ns s d ounty i co uenc o the gra ting of this permit. Date 2 Signature of Applicant — Owner A 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 O' 7 occuP GROUP TYPE of CONST. PARCE PO HD suE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF LIC ,.a By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS ate O� , Receipt No. C_� l� zi `p WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT R+eturn to DPW, - AGRICULTURAL STATEMENT'�' OF ACKNOWLEDGEMENT 82 FOR RESIDENTIAL DEVELOPMENT JY `Section 26-8.i of the Butte County Code requires this acknowledgement ,,.IJ ROS U �,�:..: -.be recorded prior. to issuance ofa building permit. ir' The property described herein is adjacent to land or included UG 3� 8 57 A,I1,1W within an area zoned for agricultural purposes, and residents of ELEANOR H, Bi"CKER ",� this property may be subject to inconveniences or discomfort arising CLERK - RECORDER) from the use of agricultural chemicals, including, but not limited to herbicides, FEE pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occa- sionally generate dust, smoke, noise, and odor, Butte County has established agricul- tural zones which have as a priority use for productive 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: Pnrcel 2, as shown on that r.,�rt:dn Parcel 111ap of a portion of the West half of the i�orllr;rc r:l (11101r(rr of Sty<'tion 11, Township 23 North, Range 3 Bast, M.D.B. & M.., which mai) e,ns [sial in the office of the Recorder of the County of Butte, State of California, Augl.lst 2, 1882 in Boot; 89 of Parcel Maps, at pages 19 and 20. EXCEPTING 'ri-IEREFROM the right to enter upon and extract all minerals in any manner that grantc^ relayelect, also the right to cut and use for mining purposes, all timer that mrrV r.s�' rc<irrir•cd to properly extract said minerals; as provided in that certain decd from 0. J. Martin to Superior Channel Mining Co., a corporation, dated September 8, 1.91.1 ill Robl< .137 of Deeds, -at page 478, records of Butte County, California. TOGETHER WITII a water line easement over the following described property: Being an easement for water line purposes over a strip of land 10.00 feet in width, lying to the left of and coincident to the following described line: PEGINNING at the most Northerly corner of Parcel 2, as.shown on that certain Parcel Map for Clem W. "Trent, located in the West half of Section 11, Township 23 North, Range 3 -Fast., ?.I.D.B. � p,7., kvhich map was filed in the office of the Recorder of the County of Butte, State of California in Book _89 of Parcel Maps,..at pages 19 & 20; thence folic::°ing elong the Easterly boundary line', of Parcel. 1 • a.-kstiowm :on said Parcel Map, North 3a 23' 00" West for 86:50 feet to ,the .beginning of a tangent 2200.00 foot radius curve to -tile left; thence following along the are of said curve, for an arc distance of 95 feet, more or less, to a point on a line located. East, from an existing .,:ell; thence continuing along the arc of said curve 'an are, distance of 5 -feet; -thence -. leaving said Easterly horrrrdary'line of Parcel 1; tilf•r;t for 120 feet,. more or -less, to a point located 5.00 feet North of said well; thence continuing West for 5.00 feet to the end of said described line. - Date:_ August 27, 1982 State of CALIFORNIA ) County of BUTTE ) SS, JULIANNE PETE -P ® NOTARY PUBLIC-CALIF0r0!' Butte County My Commission Expires July 5, ]'85 PRO d TY WNERS :. On this the 27th day of _ August before me, the undersigned Notary Public,_ ;personally appeared CL&K W. TRENT and SHIRLEY. 0..- TRENT, %' proved to me on -the' basis of satisfac-t-ory-�- vi�erice, aQy4KXZxfYe to be the person(s) whose name (s)' -are - subscribed to the within instrument and adknowledged that they executed the same for the , purposes- _ therein contained, _-__- IN WITNESS WHEREOF, I hereunto set my hand and, -official:. seal. _ - -- _ -; - _ /�' I Notary Public :.r S RESIDENTIAL PLAN CHECKING GUIDE 167 (S.F UPLEX,.& MISC. ONLY) 2R - Bldg. Permit OWNER - y A.P. �k A. GENERAL Zoning requirements (sideyards and parking). �raluation. Signature by R.C.E. or Architect (if required). B. PLOT PLAN Complete parcel size and dimensions. Setbackq, sideyards, easements, etc. Other buildings or structures. Grading, fills, drainage. C. FLO R PLAN omplete to scale plan with dimensions. equired windows for light and ventilation (Sec. 1405). -2 -2-V 1 O Required windows for second exit (Sec. 1404). llowable glazing for energy requirements (20`/a max. per State law). Human impact glass (Sec. 5406) . `twr/1--e-dtd,4-1- Required room sizes, ceiling heights (Sec. 1407). Y -t- G.F.C.I.'s in baths and exterior outlets (Sec. 210-8). Light fixtures, switches, receptacles, ex error receptacles for maintenance o ec anical equipm oca ions of water heater rheating & cooling equipment, other electrical or gas equipment, and plumbing fixtures. /moo Garage firewall, door size, and closer (Sec. 503(d)(4)). 1 - 3'0" exterior exit door (Sec. 3303d). Sfireplace location. moke detectors (Sec. 1413). D. SIRUCTURAL DETAILS Foundation plan complete enough to construct building. Floor construction details complete enough to construct building. Elevations and wall construction details complete enough to construct building. Roof construction details complete enough to construct building. Fireplace construction details and calcs if over one-story in height. Sufficient data and details to satisfy energy insulation requirements (State law). E. MISICELLANEOUS ITEMS TO LOOK OUT FOR ./CCX plywood on exposed locations and overhangs. tairway details (Sec. 3305). ,Guardrail details (Sec. 1716). _r< Brick or stone veneer (Chapter 30). : Exterior plaster - weep screeds (Sec. 4706 & 4708). roper roof pitch for roof covering (Chapter 32). after ties or bearing ridge beam. Garage door or porch header sizes. Adequate bracing. Living area over garage - complete 1 -hour separation required including supporting walls and posts, etc. Two (2) exits on three-story dwellings (Sec. 3302). s i Nol- b iti m2ro � lm,i`�, 4, o: � I If, 1, Y, , i O ��fi �', v-,�a k, ;�., ", �11t'Tlj AN" Pl— . ��i, , I .',N � ; tt, I i � 11�! I 11�1 I 1�1 I � : , �: . " 1�,l . . X'W�4 � , .�r , " , .-, I I I, I. _ " �� 1. X ; v ',,,I 1 5' , V,I,z :,.!�!,) '11� , ; . 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