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HomeMy WebLinkAbout065-190-042• 65-19-42 // Kathleen Medford � `yta l p'S f %b SW-corner of Holly t Holmwood,.Magali Permit A 5262-76P,E(uti�,` EIE C. s�S GAS SUPPOR STRUCTURE REQ." COMPACTION TEST ,REQ, yl. 65-19-42 _ - contr: Beich Mobile Homes, Chico-`•' Permit #5316-76MHI Issued_ 9 - /0 /'17 ' 00--1901042" e,;'w.06-1221 . BROWN; JOCINE A ., . = �. 14545 HOLMWOOD DR; MAGALIA - z" Cont-KRAIG.KROSCHEL' NSF/GAR/DECK(OPEN) 41; B07 l 526, t 065-190-042 FMISCEL•LANEOUS"`''Electrical '`REPAIR ELECTRICAL SERVICE PER c . 4' 14545 HOLMWOOD-DR's t ' � ,BROWN JOSINE C A: ,,B07-2024-',,' k> h x X065.190;042' ' MISCEL•LANEOIIS f'+y;`. Demolition nDE,MO 0b,I. ;&H0 F ('i6�i'n) 14545'1-{OLMW6OD DK'`f- i t yI r i •off 5 C �� - � � � 1 A - a I � BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 14545 HOLMWOOD DR Owner: Permit No: B07-2024 APN: 065-190-042 BROWN JOSINE C, Issued Date: 09/25/2007 By KEJ' Permit type: MISCELLANEOUS P O BOX 1073 Subtype: Demolition MAGALIA, CA 95954 Expiration Date: 09/24/2008 Description: DEMO MOBILE HOME (1610) (530) 873-3510 Occupancy: Zoning: Contractor Applicant: Square Footage: BROWN JOSINE C, MARY DALLMAN Building Garage Remdl/Addn P O BOX 1073 MAGALIA, CA 95954 MAGALIA, CA 95954 Other Porch/Patio Total (530)873-3510 (530)873-3510 FEE INFORMATION DBMSC Demolition $58.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires BROWN JOSINE C, OL:CRW 00407156 / / I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 09/25/2007 Contractor's Signature Date _ WORKERS' COMPENSATION DECLARATION I I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑1 HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Carrier: Policy Number: Exp. (This section need not be competed if the permit is or one hundred dollars ®ICERTIFY 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. X 09/25/2007 Signature Date WARNING: FAILURE70 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip I otal Charged: $58.00 Fees Paid: $58.00 Balance Due: $0.00 Receipt No: B4759 OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that 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 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]; Please check one of the following: 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 Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the 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 improvement is sold within one year of completion, the owner -builder will have the burden of proof 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 Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). 0 1 AM EXEMPT under Section B. & P.C. for this reason: Owner's 09/25/2007 Date I hereby certify that I have read this application and stale that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or aM_authorized to act on the property owner's behalf. ❑ Owner 1-1 Contractor OR. ®Agent for Owner ElAgent for Contractor FILE COPY )osine Brown P.O. Box 1073 ® Magalia, CA 95954 ' it awn, CA, oidl 6�16 � lye ys . o 0 o 000 00 (7iI/lam cl . tt11•a DO • • Os • , .. • • " •so., Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile www.buttecounty.net/dds www.buttegeneralplan.net REQUIRED SWIMMING POOL SAFETY UPGRADES (EFFECTIVE JANUARY 1, 2007) TO: All Single Family Residential Remodel and Modification Permit Applicants FROM: Scott Rutherford Manager, Building Division RE: Correction of Pool & Spa Hazards, Assembly Bill 2977 (Mullin) Chapter 478, Statutes of 2006 California Health and Safety Code Section 115928 DATE: February 28, 2007 To eliminate safety hazards on existing pools and spas, Assembly Bill 2977 (Chapter 478, Statutes of 2006), effective January 1, 2007, requires the installation of pool anti -entrapment covers whenever a building permit is issued for the remodel or modification of a single family home. The permit shall require that the suction outlet of the existing swimming pool, toddler pool, or spa be upgraded so as to be equipped with an anti -entrapment cover meeting current standards of the American Society for Testing and Materials (ASTM) or the American Society of Mechanical Engineers (ASME), ASME/ANSI Standard A 112.19.8. DECLARATION The property located at k L1 J� T'tD�M V.ODy a has: (Check all that apply) ❑ a swimming pool ❑ a spa ❑ a wading /toddler pool % does not have a swimming pool, spa, or wading/toddler pool If there is an existing swimming pool, spa, or wading/toddler pool, I understand that a pool anti -entrapment device is required at the above address in conjunction with my permit. I also understand that if a pool anti -entrapment device is required, the completed Installation Certification below must be received by the building inspector at final inspection. Please note that permits cannot receive final inspection approval without this certification. I acknowledge that I have read and understand the requirements of AB 2977 and that the above is true and correct. Signature Print Name Date Relationship to Project (please check one): ❑ Owner P& Agent for Owner ❑ Licensed Contractor ❑ Agent for Licensed Contractor Company Name Contractor's State License Number INSTALLATION CERTIFICATION For the property located at I hereby certify that an anti -entrapment cover meeting the current standards of the American Society for Testing and Materials, or the American Society of Mechanical Engineers is installed in the ❑ swimming pool ❑ spa ❑ wading /toddler pool Signature Print Name Relationship to Project (please check one): ❑ Owner ❑ Agent for Owner ❑ Licensed Contractor ❑ Other: Date ❑ Agent for Licensed Contractor If "Licensed Contractor" or "Agent for Licensed Contractor" is checked, please complete the following: Company Name Contractor's State License Number K:Forms/Building Forms/Swimming Pool Affidavit Anti -Entrapment Updated: 9/25/2007 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIAIIE OFAPPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name h First Narrr�� � t�JJ ✓� Mailing Addre 101. City m ; Staten �t Zip Phone,5 Fax E-mail �V) CONT. ARCHITECT/ENGINEER Address { Address • City StateZip APPLICANT SIGNATURE X PERMIT NO. 'o -JI - aC' BIN # rrPROJECT LOCATION AP# UP �J ' b > 0 Property Address (4,,J'4!;_ t"l � City Y -n �; ex WORKER'S COMPENSATION Policy Number Garner If hiring anyone other than license contractors, a certificate of worker's compensation must tie shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): i For office use only: ARCHITECT/ENGINEER Name { Address City StateZip Zip . Phone Fax E-mail State License Number APPLICANT SIGNATURE X PERMIT NO. 'o -JI - aC' BIN # rrPROJECT LOCATION AP# UP �J ' b > 0 Property Address (4,,J'4!;_ t"l � City Y -n �; ex WORKER'S COMPENSATION Policy Number Garner If hiring anyone other than license contractors, a certificate of worker's compensation must tie shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): i For office use only: APPLICANT INFORMATION Name { Address City State Zip . Phone Fax E-mail APPLICANT SIGNATURE X PERMIT NO. 'o -JI - aC' BIN # rrPROJECT LOCATION AP# UP �J ' b > 0 Property Address (4,,J'4!;_ t"l � City Y -n �; ex WORKER'S COMPENSATION Policy Number Garner If hiring anyone other than license contractors, a certificate of worker's compensation must tie shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): i For office use only: SRA Zoning Flood!IT Yes No Occ. ype Const. Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 ®P (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. \1:4 1 PERSONALLY P T PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMEN (YES R NO) (HAVE/HAVE OT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. 1 HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: DEMO MOBILE HOME (1610) Reference Number: B07-2024 Applicant Name: MARY DALLMAN Owner's Name: BROWN J n I E C, AP # :5-190`142 n NP +'- : Signature of Property Owner, Date: V Q DEMOLITION PERMIT ASBESTOS NOTIFICATION STATEMENT Pursuant to section 19827.5 of the California Health and Safety Code, all demolition permit applicants are required to fill out this form. "19827.5 A demolition permit shall not be issued by any city, county, city and county, or state or local agency which is authorized to issue demolition permits as to any building or other structure except upon the receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both, pursuant to Part 61 of Title 40 of.the Code of Federal Regulations, or the successor to that part. The permit may be issued without the applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project. The permitting agency may require the applicant to make the declaration in writing, or it may incorporate the applicant's response on the demolition permit application. Compliance with this section shall not be deemed to supersede any requirement of federal law." Attached is a copy of the Asbestos NESHAP Notification of Demolition and Renovation form for the project located at (Address) (City) (Zip Code) Assessor's Parcel Number Date Signature of Applicant Ism 1 I hereby declare that a written asbestos notification to the United States Environmental -gency is not applAicable to this demolition project located at . / acL Iiia cc,� J'C,a C (Address) Signature of Appli( ' BUTTE COUNTY : DEPARTMENT OF DEVELOPMENT SERVICES T BUILDING PERMIT ' 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) ' OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds ` PROJECT INFORMATION { Site Address: 14545 HOLMWOOD DR OWNER /BUILDER DECLARATION Owner: Permit NO: B07-1526 APN: 065-190-042 BROWN JOSINE C, I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensec under provisions of Chapter 9 Issued Date: 7/13/2007 By GLB` Permit type: MISCELLANEOUS P O BOX 1073 Subtype: Electrical - MAGALIA, CA 95954 Expiration Date: 7/12/2008 Description: REPAIR ELECTRICAL SERVICE P (530) 873-6165 Occupancy: Zoning: Contractor WORKERS' COMPENSATION DECLARATION COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR Applicant: Square Footage: I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: Law does not apply to an owner of the property, who builds or improves thereon, and who does BROWN JOSINE C, Building Garage Remdl/Addn are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or P O BOX 1073 improve for the purpose of sale.). ❑ I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by j� I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED [ CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. MAGALIA, CA 95954, Other Porch/Patio Total thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). (530)873-6165 (This section nee not a completed if the permit �s or one dollars ($100)or less.) FEE INFORMATION I 4M EXEMPT under Section B. & P.C. for this reason: - DBE Misc Residential Wiring $58.00 ' Compensation laws of California, and agree that if I should become subject to the workers' X UA 7/13/2007 r ` Total Charged: $58.00 Fees Paid: $58.00 { Balance Due: $0.00 Receipt No: B3886 LICENSED CONTRACTOR'S DECLARATION .. OWNER /BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensec under provisions of Chapter 9 also requires the applicant for such permit to file a signed statement that he or she is licensed (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. 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 X 7./13/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; Contractor's Signature Date Please check one of the following: ❑ I, AS OWNER OF.THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE WORKERS' COMPENSATION DECLARATION COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). ❑ I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by j� I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED [ CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are;' thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier. Policy Number: Exp. Date: (This section nee not a completed if the permit �s or one dollars ($100)or less.) I 4M EXEMPT under Section B. & P.C. for this reason: - ❑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' X UA 7/13/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Oiv s Signature Date X 7/13/2007 ' I heVby certify that I have read this application and state that the above information is correct. I agree Signature Date to comply with all City and County ordinances, rules, regulations, and Slate laws relating to building WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte , ATTORNEY'S FEES. Cou ly to enter the ab a mentioned property for inspection purposes. I hereby certify that I am the CONSTRUCTION LENDING AGENCY pro rty oPmer or an a thorized to act on the property owner's behalf.- " 7/13/2007 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for n o Permitte N] , Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner .. Contractor OR; ❑Agent for Owner Agent for Contractor Lender's Address City State Zip, s FILE COPY ` BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION OFFICE #: (530)5')8-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: w. w.buttecounty.net/dds BIN # **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Nam First Na Mailing Addre CityY)q c StateZip City Phone,-� 3_ b � Fax E-mail APPLICANT INFORMATION CONTRACTOR Name Q' City Address- po 1 City - State C� Z' Phonec) 525-11 Fax. E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail PROJECT LOCATION Property Address City WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open v ❑ Structure Built without Permits ❑ Proposed Change of Occupanc (Note previous use): For office use only: Zoning Flood Zone SRA I Yes No Occ. Type Const. 11 �, r `4 065-190-042 t ..:. ,_ 06-12215 . NOTES 13kowN> J_OC_INE; ,4 ; 4-545 HOLMWOUD DR,'MAGALIA. Cont KRAIG KROSCHEL`.'t'�,`:-:" • °°" ;ASF/GAR/DECK(OPEN) ' -N'T IA L , f. fi APN: Permit No. Owner: Site Address: _ Contractor: . Type of Permit: r 1 r' t • r� C 10 R 1 J LL b SPECIAL CONDITIONS ; • -CFI r SRA , Q FLOOD CERTIFICATE EQUIRED ` Q FIRE SPRINKLERS REQUIRED r 0 SPECIAL INSPECTION ITEMS Q VERIFY Q USE PERMIT CONDITIONS. 9 El B -STANDARD HOUSING LETTER Q ENCROACHMENT PERMIT ' Q REINSPECTION FEE PAID NV HLTH CLEARANCE DATE JOB FINALED: kedo L. SIGNATURE: rt COUNTY OF BUTTE BUILDING DIVISION ,DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Groville, CA • (530) 538-7541 CORRECTION NOTICE Trf r I'Al X/ -- OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. 1&j11 �/ [ 1eC 11111V16_71 l-//ftv ��16 2 -3) o YiUlv/// 6" 19.611'AWIZ�4 rye <,�, Date 7 Inspector _ate REV 4/05 Phone # ` FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive - Oroville, CA - (530) 538-7541 CORRECTION NOTICE \.mow C�� — VZ? l . - OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at x. the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. rcw ` C, O F ('D�►at c� � Genf Date ^� Inspector " w ^x REV 4/05 Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 . _ f COUNTY OF BUTTE -u � BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES. 7 County Center Drive • Oroville, CA • (530) 538-7541 44}}A CORRECTION NOTICE t OWN R PERMIT NO. a A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you haves y questions pertaining to this matter, or need additional ' g explanation, phase contact t>6 Bui ing ID4ctor as indicated below. e- ; 4S.tjj Date Inspector C ! 'Z?//I 1 REV 4/05 Phone # �• r FOR RE -INSPECTION CALL:*-. 538-7636 OR 891-2834 z ''i ;*COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES j 7 County Center Drive • Oroville, CA • (530) 538-7541 0 CORRECTION NOTICE r 89 QLU t�� - fry OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicate below. d 61ArD Date` v v Inspector 'REV 4/05 Phone # 25 % D - -� 5-F FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 M. )VL - COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 1.1 CORRECTION NOTICE J OWNER PERMIT NO. { A routine inspection indicates that the following violateons of Butte County Ordinances exist at s the above address and should be corrected. Please call for re -inspection when correction of n work is completed. If you have any questions pertaining to this matter, or need additional 3 . kh' Date r " v Inspector 1 (h - REV 4/05 Phone # -` FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 4; Date: 1.1/15/06 Job #: 06598 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF -4R. Project Address 14515 Holmwood Drive, Magalia Builder or Installer Name BCW Heating and Air Builder or Installer Contact Telephone BCW Heating and Air (530) 873-6153 Plan/Permit (Additions or Alterations) Number HERS Rater Telephone Mery Martin (530) 894-8466 Sample Group Number 2 Compliance Method (Prescriptive) 1,400 Climate Zone 11 Certifying Signature i11� - •y i/, D�simih sieved by Mwvm Martin Date n f'� pats: 2=.11.17 08:14:32 -08W Sample House Number Fin' Energy Calculation Services HERS Provider CHEERS Street Address: 574 Manzanita Avenue, Suite 9 City/State/Zip: Chico, Ca. 95926 c:opleS to: BUILDER, HEM PROVIDER AND BUILDING D PAKFYIE NT HERS RATER COMPLIANCE STATEMENT The house was: ✓ m Tested ✓ ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with the diagnostic tested compliance requirements as checked ✓ on this form. The HERS rater must check. and verify that the new distribution system is fully ducted and correct tape is used before a CF -4R may be released on every tested building. The HERS rater must not release the CF -4R until a properly completed and signed CF -6R has been received for the sample and tested buildings. ® The installer has provided a copy of CF -6R (Installation Certificate). ® New ducts are fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). ® New ducts with cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections.). ✓ 0 NWiiMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Procedures for field verification and diagnostic testing of air distribution systems are available in .RACM, Appendix RC4.3. Duct Diagnostic Leakage Testing Results NEW CONSTRUCTION: Duct Pressurization Test Results (CFM @ 25 Pa) Measured Values 1 Enter Tested Leakage Flow in CFM: 2 Fan Flow: Calculated (Nominal: ✓ ® Cooling ✓ ❑ Heating) or ✓ ❑ Measured Enter Total Fan Flow in CFM: 1,400 ✓ ✓ 3 Pass if Leakage Percentage < 6% [ 100 x [_(Line # 1) / j.400(Line # 2)]] ❑ Pass ❑ Fail ALTERATIONS: Duct System and/or HVAC Equipment Change -Out 4 Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. 5 Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for Duct S stem Alteration and/or Equipment Chan Se -Out. 30 6 Enter Reduction in. Leakage for Altered Duct System L_ (Line # 4) Minus 3D—(Line # 5)] (Only if Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) 8 Entire New Duct System - Pass if Leakage Percentage < 6% 100 x 30 (Line # 5 / 1.400 Line # 2 2.14 ®Pass ❑Fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out Use one of the following four Test or Verification Standards for compliance: ✓ ✓ 9 Pass if Leakage Percentage < 15% [100 x [ 3n (Line # 5) / 1 40n . (Line # 2)]] , ❑ Pass ❑ Fail 10 Pass if Leakage to Outside Percentage < 10% [100 x L(Line # 7) / —1A00(Line # 2)]] ❑ Pass ❑ Fail 11 Pass if Leakage Reduction Percentage > 60% [100 x [ _(Line # 6) / (Line # 4)1] and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fail Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Ins ection ❑ Pass ❑ Fail Pass if One of Lines # 9 through # 12 pass ❑ Pass ❑ Fail Residential Compliance Forms December 2005 Date: 11/15/06 Job #: 06598 INSTALLATION CERTIFICATE (Page 3 of 12) CF -6R Site Address Permit Number 14515 Holmwood Drive, Magalia An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The information provided on this form is required) After completion of final inspection, a copy must be provided to the building department (upon request) and the building owner at occupancy, per Section 10-103(a). HVAC SYSTEMS: Heating Equipment Equip Type (pkg. heat um CEC Certified Mfr. Name and Model Number # of Identical Systems Efficiency (AFUE, etc•) ;--CF-I value Duct Duct Location attic etc. Duct or Piping R -value Heating Load tu/hr Heating Capacity tu/hr Gas/Electric Packa Ruud RRNABO42JK08E 1 80 Crawlspac 6 80000 Cooling Equipment Equip Type (pkg. heat um CEC Certified Mfr. Name and Model Number # of Identical Systems Efficiency t (SEER or EER) zCF-1Rvalue) Duct Location attic etc. Duct R-value(Btu/hr) Cooling Load Cooling Capacity tu/hr Gas/Electric Packac Ruud RRNABO42JK08E 1 13 Crawlspac 6 42000 1. > symbol reads greater than or equal to what is indicated on the CF -IR value. Include both SEER and EER if compliance credit for high EER av conditioner is claimed. ✓ ElI I, the undersigned, verify that equipment listed above is: 1) is the actual equipment installed, 2) equivalent to or more efficient than that specified in the certificate of compliance (Form CF -1R) submitted for compliance with the Energy EfJFciency Standards for residential buildings, and 3) equipment that meets or exceeds the appropriate requirements for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) Owner ' Signature: Date: Copies to: BUILDING DEPARTMENT, ITERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 Date: 11/15/06 Job t 06598 INSTALLATION CERTIFICATE (Page 4 of 12) CF -6R Site Address Permit Number 14515 Holmwood Drive, Magalia INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE INSTALLER COMPLIANCE STATEMENT The building was: ✓ OTested at Final ✓ ❑ Tested at Rough -in INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE FOR NEW DUCTS: 0 Remove at least one supply and one return register, and verify that the spaces between the register boot and the interior finishing wall are properly sealed. ❑ If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points between the air handler and the supply and return plenums to verify that the connection points are properly sealed. 0 Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used on new ducts. ✓ DUCT LEAKAGE REDUCTION Procedures for field verification and diaenostic testing of air distribution swemr are available in RACM_ Annendir RCe_3 NEW CONSTRUCTION: Duct Pressurization Test Results (CFM @ 25 Pa) Measured Values 1 Enter Tested Leakage Flow in CFM: Fan Flow: Calculated (Nominal: ✓ 13 Cooling ✓ ❑ Heating) or ✓ ❑ Measured 2 If Fan Flow is Calculated as 400 cfin/ton x number of tons or as 21.7 cfin/(kBtu/hr) x Heating 1.400 Capacity in Thousands of Btu/hr, enter total calculated or measured fan. flow in CFM here: ✓ ✓ 3 Pass if Leakage Percentage < 6% for Final or < 4% at Rough -in. without air handle: ❑ Pass ❑ Fail 100 x[_(Line # 1 / 1.400(Line # 2 ALTERATIONS: Duct System and/or HVAC Equipment Change -Out Enter Tested Leakage Flow in CF1v1 from Pre -Test of Existing Duct System Prior to Duct 4 System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered Duct 5 System for Duct System Alteration and/or Equipment Change -Out. 30 Enter Reduction in Leakage for Altered Duct System 6 ine # 4 Minus 30(Line # 5 — (Only if Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) ✓ ✓ 8 Entire New Duct System - Pass if Leakage Percentage < 6% for Final. 2.14 ❑pass ❑Fail 100 x 0 (Line # 5 /1.400 Line # 2 TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change- ✓ ✓ Out Use one of the following four Test or Verification Standards for compliance: 9 Pass if Leakage Percentage < 15% [100 x [ 10 (Line # 5) / 1 4(10 (Line # 2)]] ❑ Pass ❑ Fail 10 Pass if Leakage to Outside Percentage < 10% [ 100 x [ (Line # 7) / 1 4nn (Line # 2)]] - ❑ pass ❑ Fail Pass if Leakage Reduction Percentage > 60% [100 x [_(Line # 6) / (Line # 4)]] 11 and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fail Pf Pass if Sealin of all Accessible Leaks and Verification b Smoke Test and Visual Ins ection ❑ Pass ❑ Fail Pass if One of Lines # 9 through # 12 pass 121 Pass ❑Fail ✓ DI, the undersigned, verify that the above_ diagnostic test results were performed in conformance with the requirements for compliance credit. 1, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in Section 150 (m) of the 2005 Building Energy Efficiency standards. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Signature: Date: Copies to:.8UIL0tNG .IDEPAIt'l'XEN'1', HERS RATER (IF APPLICAH3 C) IlUILOING OWNER A't' OCCUPANCY Residential Compliance Forms December 2005 WESTERNWOODS EWP PAGE 01/01 APA=FF%V Certificate of Conformance Certificate 054086 - THIS 54086 THIS IS TO CERTIFY that the glued laminated timber products identified with a collective mark of Engineered Wood Systems (EWS) were manufactured In accordance with the applicable standards and associated specifications indicated below: ANSI Standard A190.1-1992, For Wood Products— Structural Glued Laminated Timber NER-486 Glued Laminated Timber Combinations And "GAP" Computer Program For Determining Design Stresses AITC 117-93 — Manufacturing — Standard Specifications For Structural Glued Laminated Timber Of Softwood Species IT IS HEREBY CERTIFIED that the APA EWS trademarked structural glued laminated timber members were produced in a manufacturing facility subject to regular audits In accordance with the Engineered Wood Systems (EWS) Quality Assurance Program. Routine audits include inspection of the manufacturing process and evaluation of the in -plant QA program with adequate sampling to verify conformance to industry standards for lumber grade and glueline bond quality. 0 SEAL `H ,Nr b �/ ' Thomas G. Williamson Executive Vice President ENGINEERED WOOD SYSTEMS is a related corporation of ARA — THE ENGINEERED WOOD ASSOCIATION 7011 South 19th Strsot • P.O. Box 11700 • Taooma. WA 98411.0700 Tafapftona; (283) 586.66110 • Fax NurrWer: (253) 585-7265 CertainTeed-M­ InsulSafe°4 � Builders Statement Premium Blowing Wool f ••fes Homeowner Name / Jobsite Name R -VALUE NO. OF BAGS PER 1,000 SO. FT. NET AREA Installer/Contractor (sign) Company Name Date Builder (sign) Company Name Date Inspected By (sign if required) . Date R -VALUE NO. OF BAGS PER 1,000 SO. FT. NET AREA MAXIMUM NET COVERAGE MINIMUM WEIGHT INITIAL INSTALLED THICKNESS --MINIMUM SETTLED THICKNESS To obtain a Thermal Resistance (R) of: No. of Bags 'Contents of bag should not cover more than: (sq. ft.) Weight per sq. ft. of installed insulation should not be less than: (lbs./sq. ft.) Should not be less than: (in.) Should not be less than: (in.) 60 36.5 27 0.986 22.00 22.00 49 29.6 34 0.800 18.50 18.50 44 26.4 38 0.712 16.75 16.75 38 22.8 44 0.615 14.75 14.75 30 18.0 56 0.485 12.00 12.00 26 15.5 65 0.418 10.50 10.50 22 13.1 77 0.353 9.00 9.00 19 11.1 90 0.301 7.75 7.75 13 7.7 129 0.209 5.50 ..5.50 11 6.6 151 0.179 4.75 4.75 THERMAL PERFORMANCE—ATTIC BLOWING APPLICATION • In accordance with the chart above, you must install the. minimum number of bags per 1,000 sq. ft. of net area for each R -Value listed. • The maximum net coverage must not exceed that specified for each R -Value. • The installed insulation must be at or above the specified minimum thickness for each R -Value. • Failure to install the required minimum weight per sq. ft.- of insulation at or above the minimum thickness will result in reduced R -Value. • This product should not be mixed with other blown insulations or the thermal claims will become invalid. • Initial installed thickness testing per ASTM C 1374 using-Unisul VoluMatic III; 3rd gear; 16 -inch gate opening; 150 -ft. x 3-1/2 inch -diameter internally corrugated blowing hose. R-Values'are determined in accordance with ASTM C 687 and C 518. Complies with ASTM C 764 as Type 1 insulation. "R" means resistance to heat flow. The higher the R -Value, the greater the insulating power. To get the desired R -Value, it is essential that the insulation is installed properly. DANGER: RECESSED LIGHT FIXTURES—TO PREVENT OVERHEATING, DO NOT INSULATE ON TOP OR WITHIN T' OF SUCH DEVICES. DOES NOT APPLY TO TYPE IC LIGHT FIXTURES OR TO FLUORESCENT FIXTURES WITH THERMALLY PROTECTED BALLASTS. 30-24-233 InsulSafe@4 Builders Statement A Saint-Gobain Company 02005 CertainTeed Corporation 11/05 R -VALUE THICKNESS AREA (SO: FT.) InsulSafe 4 (✓ BAGS USED BATTS/ROLLS IV) CEILINGS "' ? V0 / WALLS 1,3 A g FLOORS THERMAL PERFORMANCE—ATTIC BLOWING APPLICATION • In accordance with the chart above, you must install the. minimum number of bags per 1,000 sq. ft. of net area for each R -Value listed. • The maximum net coverage must not exceed that specified for each R -Value. • The installed insulation must be at or above the specified minimum thickness for each R -Value. • Failure to install the required minimum weight per sq. ft.- of insulation at or above the minimum thickness will result in reduced R -Value. • This product should not be mixed with other blown insulations or the thermal claims will become invalid. • Initial installed thickness testing per ASTM C 1374 using-Unisul VoluMatic III; 3rd gear; 16 -inch gate opening; 150 -ft. x 3-1/2 inch -diameter internally corrugated blowing hose. R-Values'are determined in accordance with ASTM C 687 and C 518. Complies with ASTM C 764 as Type 1 insulation. "R" means resistance to heat flow. The higher the R -Value, the greater the insulating power. To get the desired R -Value, it is essential that the insulation is installed properly. DANGER: RECESSED LIGHT FIXTURES—TO PREVENT OVERHEATING, DO NOT INSULATE ON TOP OR WITHIN T' OF SUCH DEVICES. DOES NOT APPLY TO TYPE IC LIGHT FIXTURES OR TO FLUORESCENT FIXTURES WITH THERMALLY PROTECTED BALLASTS. 30-24-233 InsulSafe@4 Builders Statement A Saint-Gobain Company 02005 CertainTeed Corporation 11/05 Manufacturer Insulation Fact Sheet This is CertainTeed Corporation I n s u l Saf e° 4 Premium Blowing Wool CertainTeed Corporation P.O. Box 860 Valley Forge, PA 19482 THERMAL PERFORMANCE -HORIZONTAL OPEN BLOW The following thermal performances are achieved at weights and coverages specified when insulation is installed with pneumatic equipment in a horizontal open blow application: R -VALUE NO. OF BAGS PER 1,000 SO. FT. NET AREA MAXIMUM NET COVERAGE MINIMUM WEGHT INITIAL INSTALLED THICKNESS MINIMUM SETTLED THICKNESS To obtain a Thermal Resistance (R) of: No. of Bags Contents of bag should not cover more than: (sq. ft.) Weight per sq. ft. of installed insulation should not be less than: (lbs./sq. ft.) Should not be less than: (in.) Should not be less than: (in.) 60 36.5 27 0.986 22.00 22.00 49 29.6 34 0.800 18.50 18.50 44 26.4 38 0.712 16.75 16.75 38 22.8 44 0.615 14.75 14.75 30 18.0 56 0.485 12.00 '12.00 26 15.5 65 0.418 10.50 10.50 22 13.1 77 0.353 9.00 9.00 19 11.1 90 0.301 7.75 7.75 13 7.7 129 0.209 5.50 5.50 11 6.6 151 0.179 4.75 4.75 R -values are determined in accordance with ASTM C 687 and C 518. Complies with ASTM C 764 as Type 1 insulation. THERMAL PERFORMANCE-SIDEWALL RETROFIT APPLICATION When installed with pneumatic equipment in sidewalls, the following thermal performances are achieved at the thicknesses, weights and coverages specified. Based on a design density of 1.6 pcf/25.6 Kg/m=. R -VALUE NO. OF BAGS PER 1,000 SO. FT. NET AREA MAXIMUM NET COVERAGE MINIMUM WEIGHT INITIAL INSTALLED THICKNESS MINIMUM SETTLED THICKNESS To obtain a Thermal Resistance (R) of:. No. of Bags Contents of bag should not cover more than: (sq. ft.) Weight per sq. ft. of installed insulation should not be less than: (lbs./sq. ft.) Should not be less than: (in.) Should not be less than: (in.) 29 35.8 28 0.967 7.25 7.25 22 27.2 37 0.733 5.50 5.50 16 19.8 51 0.533 4.00 4.00 15 17.9 56 0.483 3.625 3.625 14 1 17.3 1 58 ' 0.467 3.50 3.50 What you should know about R -Values: The chart shows the R -Value of this insulation. R means resistance to heat flow. The higher the R -Value, the greater the insulating power. Compare insulation R -Values before you buy. There are other factors to consider. The amount of insulation you need depends mainly on the climate you live in. Also, your fuel savings from insulation will depend upon the climate, the type and size of your house, the amount of insulation already in your house, and your fuel use patterns and family size. If you buy too much insulation, it will cost you more than what you'll save on fuel. To get the marked R -Value, it is essential that this insulation be installed properly. 40 • BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 1 PERMIT*NO. BP061221 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 , 1 I hereby affirm under penalty of perjury that I am licensed under / provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 07/27/2006 APN: 065-190-042-000 the Business and Professions Code, and my license is In full force and \effect. .� 793 Site Address: 14545 HOLMWOOD DR MAG License Class: License Number: -5 - Date: %b% 7/0 6 Contractor:Map Index: 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' Stale 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.nol 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 Description: nsf (1267), gar (413), open (160) Owner: BROWN JOSINE C P O BOX 1073 MAGALIA, CA 95954 Applicant: KROSCHEL CONSTRUCTION PO BOX 1811 MAGALIA, CA 95954 530-873-3567 Contractor: KROSCHEL CONSTRUCTION ❑ 1 am Exempt under Article 3 of the Business and Professions Code PO BOX 1811 MAGALIA, CA Date: Owner: 95954 WORKERS' COMPENSATION DECLARATION 530-873-3567 J I hereby affirm under penally of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for License #: 593793 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 _ Architect:_ _ - - the work for which this permit is issued. My workers' compensation Engineer: Insurance carrier and policy number are: Carrier: Policy #: 0 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 forthw'lh comply with those provisions. Date: D CO Applicant:^(s 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. Totel Square Ft: 1840 S.F. Valuation: $93,867.00 Census Code: �U -*'FS6(0 3 �J /�fa<F ff-- i nereoy amrm mat mere is a construction tending agency for thercesomr n to av v performance of the work for which this permit is issued (Sec 3097 Civ.) Name: B Address: P MIT EXPIRES pato. Date: 0 tiI JV ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorizere4resativesof Butte Co my to enter upon the ove mentioned property for inspecllon purposes. Orint NameSignature: Date: • Q UOwner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01.16-04 pg 1 r +=OK 0 = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; FalUC/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Cirncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat ❑ or LPD Inch Sz Ft Lngth 7 Blckng; SzSpacing-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 Electiicity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD LabeUlnsignia Numbers Serial Numbers DATE D E C KS -C O V E R S'C A R P O R T S •GARAGE S x / °�' 1 Zoning -Setbacks -Easements 2 Ftgs; SoilsSz-DpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-0cking-Brcing . Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg, Frmg-Brcng - 5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs 6 Carports; Wndws-Doors_ 7 Electric 8 Frmg; Sills-AnchrsStuds-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls 0 ° DATE IPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcis/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec.Encisrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcitng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes-Enclsrs-pnlboards-Insults 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 41 40 0g 00 rya Pool Drawing v=OK 0 = Not OK 0'7roMaterials & An ails Studs -Nailing -Nailing Spacing &Braces-PlatesSound B aring Walls over Girders & fir Nailing 2It Stop In Walls (rat proof) Stops, Furred Ceilings -Stairs -Chasers -Tubs �2 Headers & Beams-Sz &Bearing t ars-Post Caps-Anchrs-Cnnctns Ming Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg c Ties or Type A Flue-Frpic Throat Clrnc 26 ANC Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 27'Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions )28 Garage Fire Prtctn Framing -RC Channel 29,ftrty Line Firewall & Opngs 30 Ext Doors -One X -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn lywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs ding -Nailing Veneer 34 Stqpco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc azing Area -Glass PrtctnSkyLts-Plastic 36 Shear Wal , ail• -Bolts 37 Bract nUall ppnls 38 Insulin -Walls -Ceilings 39 I nfi I trati on -W a l Is -W n dws I DATE JELECTRICAL 40 FW& Trnsfrmr Clrnc4ns Prtctn ec Rcptcls Spacing-Lts & Switches at Doors Boxes & No Of Cndctrs Stapled exx Installed Close to Edge of Studs & CJ E}tp Grnd made up w/Mech Fstnrs 4S Kdng Electrode Bond Gas & Wtr 4G 2 Appinc Cires in Ktchn & Cndctr Sz GFI 2jSubfeed Wire Sz ea ❑CU or DAL AC Wire Sz ga ❑ CU or DAL A,8/ange Ckc ga ❑ CU or ❑AL Oven Circ ga ❑ CU or ❑AL Insulated Neutral ❑ Yes ❑ No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 W Clrncs pnis-Motors-Mech Eqp Clothes Closet Lt-Shwr Lt -Spa Lt moke Detector o' o`er 0'9 & SideLt Prtctn-Landings Furnace nts-Clmc-Comb, Air-Cnnctr In age; abv-flr-Ducts-Meeh Prtctn end °Om Exiting GFI & Bath Fxtrs & Tub Acc-Spa GFI Arc Fault Elec Trim & Sub^.....'.�ker Szs & Labels 75-E,p lets at Wood Pnl, Int & Ext tchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc ;A lec O lets & Rcptcls at Ktchn Counter '� rage. Fire Door; Swing -Landing -Closure n Garage -Damper ts-Clrnc-Com Air Cnnctr-PRV; abv fir Mec�+tctn; LPG Appince Undr House 3" drain t31'PlmyrEfec & Mech Eqp Listed for Loctn le cls in Garage (GFI) Romex Prtctn nsul°am-Looked in Attic 8 u4 -G' Is & Deck Cnstrctn-Post Caps ndn Vnts & Crawl Hole Door Drn e & Wood -Earth 86 Clrnc Drnge Planters T Yes ❑ No 87 Stucca.BroTiGn-Finish cnnct, Elec-Plmb o_of, Plmb-Appinc-Frpic-Clrnc to Opngs sennet, Elec, Plmb Im, GFI Rcptcl-Undrgrnd House 94-epoqxivettions from previous Inspctns 95'Gas Test -Meters Tagged, Gas-Elec 96 V UP -9 Sewer Cnnctd-C/O to grade -HD Apprvl E gy Cmpinc Cert -Other Certs 9 ddress Posted 99 Fire Sprinkler LA, -a` RESIDENTIAL (Single & Duplex) DATE UNDERFLOOR DATE IPLU BING �n Setbacks-Easements-FloodSlope yFt aam; Soils-Elec Grnd �� Ftg DRth tr; Vent-Acc-Cmbstn Air Baffle ipe; Test & Anchr-Nail Prtctn 9-Ftg Garage; Soils-Steel-Elec Gm'Ftg Dpth DWV; Test Fittings & Anchr_ Nail Prtctn 4 Fig Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First flr-Tub Acc . 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 lost Tub '& Shwr, 2nd fir - Tub Acc 6S walls Garage; Steel-Blockouts-Wrapped Gas Pipe; Sz & Anchrs old Downs and Special Anchrs 59 Fire rinkler; Test 7 Sla tee[ Wrapped tit - and Gas Piping ars-Frpic FtgSteel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr pe; Test-Anchrs-RgltrService Test 12.E Undrgrnd lenums & Ducts; Clrnc-MaterialSupport-Insultn DATE MECHANICAL 61 AC Ducts Insultn & Support 14 GirdersSills-Anchr Bolts -Joists Vnts-Cripples 62 Vent Fan, Exhaust abv Insultn 15 Acc & Vntltn �� 63 Condensate Drain & Ovrflw, Sz & Grade 16 Insulation �%� 64 Fuer ace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet rag -Attic Acc & Pltfrm If Furnace in attic o�s_a� °�—(19 0'7roMaterials & An ails Studs -Nailing -Nailing Spacing &Braces-PlatesSound B aring Walls over Girders & fir Nailing 2It Stop In Walls (rat proof) Stops, Furred Ceilings -Stairs -Chasers -Tubs �2 Headers & Beams-Sz &Bearing t ars-Post Caps-Anchrs-Cnnctns Ming Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg c Ties or Type A Flue-Frpic Throat Clrnc 26 ANC Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 27'Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions )28 Garage Fire Prtctn Framing -RC Channel 29,ftrty Line Firewall & Opngs 30 Ext Doors -One X -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn lywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs ding -Nailing Veneer 34 Stqpco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc azing Area -Glass PrtctnSkyLts-Plastic 36 Shear Wal , ail• -Bolts 37 Bract nUall ppnls 38 Insulin -Walls -Ceilings 39 I nfi I trati on -W a l Is -W n dws I DATE JELECTRICAL 40 FW& Trnsfrmr Clrnc4ns Prtctn ec Rcptcls Spacing-Lts & Switches at Doors Boxes & No Of Cndctrs Stapled exx Installed Close to Edge of Studs & CJ E}tp Grnd made up w/Mech Fstnrs 4S Kdng Electrode Bond Gas & Wtr 4G 2 Appinc Cires in Ktchn & Cndctr Sz GFI 2jSubfeed Wire Sz ea ❑CU or DAL AC Wire Sz ga ❑ CU or DAL A,8/ange Ckc ga ❑ CU or ❑AL Oven Circ ga ❑ CU or ❑AL Insulated Neutral ❑ Yes ❑ No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 W Clrncs pnis-Motors-Mech Eqp Clothes Closet Lt-Shwr Lt -Spa Lt moke Detector o' o`er 0'9 & SideLt Prtctn-Landings Furnace nts-Clmc-Comb, Air-Cnnctr In age; abv-flr-Ducts-Meeh Prtctn end °Om Exiting GFI & Bath Fxtrs & Tub Acc-Spa GFI Arc Fault Elec Trim & Sub^.....'.�ker Szs & Labels 75-E,p lets at Wood Pnl, Int & Ext tchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc ;A lec O lets & Rcptcls at Ktchn Counter '� rage. Fire Door; Swing -Landing -Closure n Garage -Damper ts-Clrnc-Com Air Cnnctr-PRV; abv fir Mec�+tctn; LPG Appince Undr House 3" drain t31'PlmyrEfec & Mech Eqp Listed for Loctn le cls in Garage (GFI) Romex Prtctn nsul°am-Looked in Attic 8 u4 -G' Is & Deck Cnstrctn-Post Caps ndn Vnts & Crawl Hole Door Drn e & Wood -Earth 86 Clrnc Drnge Planters T Yes ❑ No 87 Stucca.BroTiGn-Finish cnnct, Elec-Plmb o_of, Plmb-Appinc-Frpic-Clrnc to Opngs sennet, Elec, Plmb Im, GFI Rcptcl-Undrgrnd House 94-epoqxivettions from previous Inspctns 95'Gas Test -Meters Tagged, Gas-Elec 96 V UP -9 Sewer Cnnctd-C/O to grade -HD Apprvl E gy Cmpinc Cert -Other Certs 9 ddress Posted 99 Fire Sprinkler LA, -a` AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2006-0038532 Recorded I REC FEE 7,00 Official Records I County of I CONFORMED COPY 1.00 Butte I CANDACE J. GRUBBS I County Clerk-Recorderl I 012:07MM 27 -Jul -2M I Page 1 of 1 IIII"III"II"III�'�I'II'I'�III�I AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. J L. A that real property sit to in the Coun f Butte, St to of California, described follows: Ap lClU/�'V,( ` l� 0-0-L, O- !?JY14i.. �. l)t_ haA) L�i lis . i ctZ�Jccoi co o' �, - u� avirua 'r1'1 9 1 s vn 01 Date � 2lQ P OPERTY OWNE S,.../ • ' >� State of Ca 'forn'a ) County of ) On plwglblow before me, personally a0peared tin _ ricawnP� known -4e me (or proved to me on the basis of satisfactory evide e) to be the person(s) whose nameL56'1S/NF8 subscribed to the within instrument an cknowledged to me thate they executed the same in er their authorized capacity(ies), and that brZ thak signature(s) on the instrument, the person(s) or the entity on behalf of which the person(s) acted, executed the instrument. WITNESS hand and officr4l seal.- i ' AMY O'BRIENSignatureoil Seal: m WA' 0 15717366UTTk COUNTY COMM. EXP. APDL 22.2009: I 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. BP061221 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 Issued Date: 07/27/2006 APN: 065-190-042-000 the Business and Professions Code, and my license is in full force and effect./� License Class : �- License Number: 113%7 3 Site Address: 14545 HOLMWOOD DR MAG Map Index: Date: Contractor: Description: nsf (1267), gar (413), open (160) OWNER -BUILDER DECLARATION 1 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: BROWN JOSINE C permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such permit to file a P O BOX 1073 signed statement that he or she is licensed pursuant to the provisions of MAGALIA, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 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: KROSCHEL CONSTRUCTION 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, PO BOX 1811 provided that such improvements are not Intended or offered for MAGALIA, CA sale. If however, the building or Improvements are sold within one year of completion, the owner -builder will have the burden of 95954 .proving that he or she did not build or improve for the purpose of 530-873-3567 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: KROSCHEL CONSTRUCTION pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code PO BOX 1811 MAGALIA, CA Date: owner: 95954 530-873-3567 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 License #: 593793 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 Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Policy #: � 0 1 certify that in the performance of the work for which this permit is Total Square Ft: 1840 S.F. issued, I shall not employ any person in any manner so as to Valuation: $93,867.00 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 (( J (_'L ��0� forthwith comply With with those provisions. Date: l/ N7 `j� Applicant: 91 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'�rxi}L'�i N-0) 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 Code and/or ResoI t' n to do work i icate bo a for which fees have been paid. I hereby affirm that there is a construction lending agency for the J71/0_Z�Name: performance of the work for which this permit is issued (Sec 3097 Civ.) Date: BQ P MIT EXPIRES ON: Address: Dafe ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I'have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. 1 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 repres tatives of Butte County to enter upon the ove mentioned property for Inspection purposes. rint Name. Signature: Date: 17 • w6wner C3Contractor ❑ Agent for Owner C3 Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buffecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name 6 Address P o g� ��fj first Name E Address 5 q0 tfNV_ City JYI A6AC:r & Fax N�,Q State C P, Zip g56?59t Phone b73`— 61615 Lot # Fax E-mail IAISA CONTRACTOR Name K R.osGl{ F_ L Address P o g� ��fj City /nom A State G� Zip195�54( Phone g30 _ 273-35.C7 Fax N�,Q E-mail N /y� Lic. # 5937,q -3 Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Lot # Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning i A -WIT Flood Zone City SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BPO BIN # PROJECT LOCATION AP# IT . Property Address City Cross Street wl:o 7wwo -Piz , WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Page 1 of 2 Description or Scope of Work: NSr / 2G7 Sq FT- Living Garage Open Cov ❑ 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. Receiv �3 Receipt #: s#: � Lv V\ 2, -7 Amount: k I Bldg Za L/ V SRA Sheriff SMIP REV 8-12-05 otal 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 /N INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR -Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non=heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd. plans, all in duplicate I , ❑ 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. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items maybe required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work 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 F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 COUIVTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES-BU/CDINGD/VISI(N 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: 1!�� W AJ ASSESSOR PARCEL NUMBER 06 — /%O — 69 V G Proposed Building Use: N 5F Permit Technician: a_5 Date: �� o Items required in order to apply for a permit All boxes MUST be checked OR marked NA in order to apply. I N 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. \ • r N 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. I N 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. �m/tv 4. Engineered truss details and layouts in duplicate. No faxesl 0 5. Letter from Engineer or Architect for truss design review. �j1 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal Bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Hazardous Material Form �❑ I 12. Acknowledgement of building permit application without required clearances. . ❑ 13. Other wining items needed to issue the permit (May require additional plan review upon receipt of the following items.) 14. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 15. Fire Sprinklers............................................................................................ \❑ 16. Agricultural Buffer dr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................ \b Erosion Control Plan Required:. "..... ._................ ... ............-........ ;........... i —C� role C_)VT 1 ees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ City of Chico Plumbing permit........................................................................ ❑ 2 . Site plan and business license approval from the Ci off' gs"""-j, . _ . California Department of Forestry plan approval paid. Sent by: = anning approval for (A) Use: (B) Parking: (C) Parcel Check: ..... <S6 ❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 25. Fire Marshall Review (commercial projects only). Sent by ...................... �1� 6. NPDES Form............................................................................................. ncroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... qLetter of Signature authorization.................................................................... � J.Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... o . ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... 36. ther. G &—T7a2 — 41 A1 • 7-0 t -c- A& Other. When issued Telephone kP2k%% 673 -356 -7 ---and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant - Date: 91 -3 AA 1. Index permit application for the above mu r Plan Check Letter 2. Additional items r red Contractor, design ,owner as d f the ve dat by ph e, mail, ❑ counter, y ate:�� Contractor, designer, wner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner was advised of the'abov data phone, ❑ mail, ❑ counter b Date* reviewed by: Date: : Plans approved by: Date:. ate: U Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division TO: FROM: Building Division = Development Services Environmental Health Y Plot Plan Attached Floor Plan Atfad�ed Sent to 8D/DS c \ MD SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal: Clearance for ✓dwelling. Other l ✓_' 4e e,el4g ,ae,e Hold final for: Final clear ce O.K. for: NOTE: Environmental Health SpValist Building Clearance 9/2005 Water Supply: Public Private Well Date BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 www.buttecounty.net/dds PHONE (530) 538-7541 FAX 538-2140 RECEIPT OF FEES SCHEDULE - RESIDENTIAL Owner App Date brown s/9�/9nna APN No: 065-190-042 Permit Type: Subtype: Permit No: BP 06 1221 Permit Desc: BUILDING PERMIT FEES ESTIMATED AT APPLICATION $2,359.31 Plan Check portion of Permit Fee $943.72 $1,415.59 Balance of Building Permit Fee 2 FEMA RYes Flood Elevation Review $109.98 0 3 SRA* Yes Fire Plan Check - Non -Refundable $95.00 $95.00 _ $204.98 (State Responsibility Area) Building Inspection $109.98 $109.98 NON-REFUNDABLE portion of fees due at application $1,038.72 _ FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION FEES (BELOW) DUE PRIOR TO ISSUANCE OF PERMIT 4 Balance of Building Permit Fees (from No. 1 above) 5 SMIP* - Strong Motion Instrumentation Program (Enter amount from permit system) 6 Additional Plan Check Fees (NON-REFUNDABLE) 7 Other*: 7a Other*: 8 IMPACT FEES - RESIDENTIAL* Per Dwelling Per Dwelling MFD CHICO STORM DRAINAGE MASTER PLAN Applications After 04/15106 ,c SFD ,> County 4249.11 3183.54 774 Lindo Channel Chico Urban Area 6146.23 4538.82 EI Medio Fire District 3249.97 2385.76 North Chico Specific Plan SR -1, SR -3, SR-1/PD 8801.091 7395.04 R-1 8897.09 7491.04 do R-2 822L.09L 6984.04 R-3 7604.091 6198.04 Processing Fee is automatically added to impact fee total 9 WATER TENDER FEE (Not collected when impact Fees Applicable) Enter Bat.# DRAINAGE FEES* 10 CHICO STORM DRAINAGE MASTER PLAN 770 Butte Creek 771 Comanche Creek New construction, vacant land, on 1 acre or less - Enter 1 or less acre value 772 Little Chico Creek 773 Big Chico Creek 774 Lindo Channel 775 SUDAD Ditch 776 Mud -Sycamore Creek 777 PV Ditch Per MH 3238. PT DATE Tech/Asst 1$1,148.70 1�� �� $1,424.98 yf $1,415.59 _ $9.39 �u 7289.40 RECEIPT DATE Tech/Asst 0 $100.00 $200.00 $7,997 $8,341 $9,088 $6,776 $8,267 $7,211 $6,275 RECEIPT DATE Tech/Asst $8,893 E= - 10a More than 1 acre, existing buildings - fees to be assessed by Public Works Fee Determination Sheet Needed - Enter amount determined by PW 11 THERMALITO DRAINAGE AREA 1 $684 Maximum Per each new living unit on existing lots where full drainage fees have not been paid 11a Temporary Dwelling 1 $136 At time of building permit $136 annual renewal fee for first 4 renewals. Not to exceed $684. PROOF OF PAYMENT OF FEES (BELOW) MUST BE RECEIVED PRIOR TO ISSUANCE OF PERMIT. Forms will be prepared after plan check is completed for applicant to take to respective district office. 12 SCHOOL DISTRICT FEES* Paradise High 093 �' 7 12a RECREATION DISTRICT FEES* Paradise } At the time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. Applicant: Date: Pursuant to Government code �%ction 66020, you are hereby notified those Items followed by an " " may have been imposed on your prdect. You have 90 days from the date of approval of the porject or from the impostion of the above referenced items during which you may protest. The requirements for a protest are specified in Goverment Code Section 66020(a). K:/Building/Forms/Schedule of Receipt Fees Residential 041506 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile ADMINISTRATION * BUILDING * PLANNING June 9, 2006 Jocine Brown 14545 Homewood Dr. Magalia, CA 95954 Subject: . Permit (APN 065-190-042); Build/gPeirmit #061221 Single Family Dear Applicant/Representative: The Butte County Department of Di submitted permit application, and information in order to continue the below): int Services, Planning Division, has reviewed the the following revisions to your site plan, or (this may be for notification purposes, please see ❑ Creation Deed ❑ Site Plan Resubmit — Follow Requirements ® Erosion Control Plan ❑ Setback Conformance ® Watershed Protection Zone ❑ Front Yard ❑ Cohasset Specific Plan ❑ Side Yard ❑ Subdivision Map Note ❑ Rear Yard ❑ Off -Street Parking; Development S andards ❑ Special Setback or Parcel Limitation ❑ Parking for Specified Use I ❑ Federal Aid Road/Arterial ❑ Lot '& Landscaping Re uirem is ❑ Easement ❑ Oak Tree Plan ❑ Subdivision Map Condition/Note ❑ SRA Setback* ❑North Chico Specific Plan — Erosion Control ❑ Fire Sprinklers* ❑ Notification Only — No Action Required ❑ Other: r ire spriniuers, ana the 3KA selbacK, are not requirements Jor the Planning Division approval, and this notification is for informational p rposes, however it may be required for the issuance of a building permit. The requested information, qr notification, is described on the included hand-outs. You will also be given some brief dire ion, on the following page, of how the information should be submitted or returned to fhe County. Should you have. further questions please contact me between the hours of 8:00 a.m. and 4:00 p.m. Monday through Friday at (530) 538-7603, or the appropriate Department/Division identified in the hand-out. Sincerely, G._p unris i oney Associate Planner Cc. i,TTF0 Department ®f Public Works 0 0 C o u n t y o f B u t t e 0 0 0 0 7 County Center Drive Oroville, CA 95965 \AC�UN�yy J. Michael Crump, Director (530)538-7681 (FAX) 538-7171 �t_rc wo�'� Shawn H. O'Brien, Assistant Director Assessors Parcel Number: — Building permit # %jjPO�/ZZi Owners Name: Owners Mailing Address: Property Address: ENCROACHMENT PERMIT ACCEPTED: PERMIT NUMBER: ENCROACHMENT PERMIT EXEMPTION: Reason for exemption: J91, Not a County maintained road F1 Existing driveway conforms to County S-31 standard Other Approved by Printed Name Title Date 5-- -_2=4/� §2 CONDITIONS FOR EXEMPTING A DRIVEWAY PERMIT 1. An existing home with a driveway 10 years or older and doesn't cause any problems with the county road or drainage. 2. An existing home with only minor remodeling or repairs. Butte ColultyDeparlment ofDevelopnent Se.rvzces $6103 Ir 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile 0- R-1 BUILDING PERNUT APPLICATION WITHOUT REQUIRED CLEARANCES I/request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, 1County Fire, and Agriculture. I j I hereby acknowledgd: I need to submit applications for septic and/or well to Butte County Environmental Health r immediately. I am required to bring the approved Environmental Health siteplan and approved sanitation clearance to the Building Division as soon as clearance is obtained I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building_ permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to. the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not .limited to, verification the parcel was legally created, adherence.to_all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). : " ` Please print: Applicant Name: Kit G i �K0 SRF_ L Building site address: 1.415,45 f'j6mewcocD PQ APN: 0615- /7.0- 64`.Z--6 Permit No.: I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: SIGNATU EF OF APPLICANT DA71 E 0 Copy to Applicant/EH/File Y`Forms/BldePermitwithoutClearances 020705 �TM ENT 10TT°0���, Department of Public Works \ C o u n t y o f B u t t e IO C 11 C tr� O LAND DEVELOPMENT DIVISION /� J. Michael Crump, Storm Water Management Program 0 ov��ycI Director 7 Counly Center Drive Oroville, CA 95965 Av �5 (530) 538-7266 ek1c WOR FAX) •538-7171 National 'Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE1 Project Description: Project Location and/or Parcel Number: 0(26- l - 0 " 0 Y2'` By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB I acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but, when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may -result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: eab_n,g_T�RC oez Date: Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program . Revised 5/24/04 i i**,w �, , d4ave a 5,zeat day! AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 COPY of Document Recorded 27 -Jul -2006 2006-0038532 Has not been compared with original BUTTE COUNTY COUNTY RECORDER AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. A that real property sitq A41L I . r Date in the Coun pf Butte; St to of California, described as follows: a- e/v4 CL Q kowxl,-L wt-rcu & i�coy ` � CO LtAo� State of Ca 'forn'a County of A'e On m(wg1 lnw before personally a0pea—red 5 i h knawu-te me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name is/ subscribed to the within instrument an cknowledged to me that,h�they executed the same in . er heir authorized capacity(ies), and that by-hI /their signature(s) on the instrument, the person(s) or the entityon behalf of which the person(s) acted, executed the instrument. WITNESS hand and of6c' l seal AMY O'BRIEN Signature Seal: 0 ARY COMM. 1571736 1571796 PUBUC�CAL�Ofdtp► BUTft COUNTY COMM, EXP. APRIL 24.2009 i A.P BUTTE COUNTY SCHOOLS IMPACT,FEE CERTIFICATION FORM GU - (DO) (One form per Building) School District Building Department No. A.P. Number Jurisdiction: -city County Property Owner Property Location Subdivision Residential Development No of Living Mobile Home Units Installation Commercial/industrial New Addition Building Department Lot No. .......... —L :Sq. Footage a C O Addition/ '- "Supplemental to (Group. R) Conversion" Permit # No foundation inspecfion) ............................... : ......................... 0 ............................. . . Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document), Sq. Footage (Including Exterior Roofed Areas) • UC Date District Identification No. School District certifies, that CKP-plic—ant) //- (Street Address 0'�Izeul Alf /7 ZI C_ 17 (Phone Number) qllf-e�T41- (State) - (Zipp, ode) has co plied Wip, -toe requirerppInts of Resolution No. by o paym�nt representing Z4_20 square feet. "2614 $ FB ULL MITIGATION $ School DiWct Rp(presgntative Date Paid by Check # I ;W7.11P /I I You may protest 6s FMI56sltlan of the iiiis fiftihtlfled above by submirtling a written protest to the DWWct, In comptlance with Gave i rnent Code Section 66020(a), within 90 days from the date fees are paid. Failure to submita drnely writion protest will prohibit you from challenging the Imposition of the fees In any*cotk action. ff, subsequent to the School District Representative sWng this Butte County Schools Impact Fee Certification Foran, the Schad District to notified by the applicable Local Planning Agency that this project Is befog reviewed under the Calif mi.a Environmental Quality w Act (CEQA), thfs project may be subject to additional school fees to hilly ndtlasts Its knoed an the school dk&Wssdmft. '_' , cam. fasionnift (3f05W= BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM 0 FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) 0 CHICO AREA RECREATION AND PARK DISTRICT (CARD) ,-4PARADISE RECREATION AND PARK DISTRICT (PRPD) 0 DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) Property Owner (s) UL P o'ect Location /Address &5_Po."Uas Building Permit Number Subdivision Name Assessable Sq. Ftge ���� Type of Residential Development (check one) _AzNew Development Single Family -Detached Single Family -Attached Alteration/Addition(s) ,Non -Residential to Residential Multi -Family Dwelling Mobile home Mobile home replacement verified by Assessor Department Demo Permit (date issued ) verified by Building Department Comments: Ren)A0.e� Building Department I' l.v' Date ❑ FPD -0 CARD ❑ PRPD�O DRPD certifies that: / tNa�me / \ Phone Number �ppli 1 /[ /Y lY Wiling Address ity State Zip Ma Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of. Dwelling Units @ $ per unit for a total of $ . Square Feet @ $ per sq foot for a total of $ Pai y/Ch�ck No: Paid by Cash: D � Rrrrrati�n and Park istrictRepresentative Receipt No: Date J PERMIT NO. 5262-76P,E PERMIT EXPIRES OWNER Kathleen Medford CONTR. owner 65-19-42 LOCATION (A.P. SW corner of -Holly & Holmwood, Magalia r, i f'. A", ITr } e 1 :1 Temp. Yower Pole Called PG&E Te . Elea Serv. ? ,' Called PG&E O J` emp. Gas Serv. Called PG&E ' loB dA -/7 FINALED l J 9. Electrical A is sei-vice large enoit& to provide :adequate amperage to mobilehome (must equal rating of mobilehome with a. -.:zinh,um of 100 drnp) anal other facilities on lot, i. -e. , water pumps, ,ara,,.y,e, camna, etc. r Yes VNo B. is ther-� proper clearances around panels? YesX No C. Is power supply cord or feeder assembly properly fused? Yes No_ D. Is continuity test satisfactory as per the following procedure? Yes No 1. De -energize electrical wiring, systet-i,i of the mobilehome at the pYeestal. 2. Make sure that the power supply cord or feeder assembly.conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one 1,sad of a test instrument to. the mobilehome grounding conductor and CAL; sfY ) Conduc LVL, iliel ud ing 11CLl L tell. app the o L L ie r Leah L.L) c- -1 - - - -111 TOOb -il e 1-tuci-Leu p 5. All non-current, carrying metal part s of the mobilehome (aluminum siding, gas line,, ' water line), including fixtures and appliances, shall be -tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the, power supply cord or feeder assembly conductors shad be connected to the, site ser -vice equipment. - A further continuity te----L shall then be made between Lhe grounding electrode and the chassis of the . . Mobilehome. Upon satisfactory completion of theelectrical tests., the lot or site ser -vice oqiji.pment may be approved for energizing. ;,D, is job card signed by Health Departmeat for water and sanitation? 11. If everything olsay, sign off card and ta- services. 'MOBILE"'O.ML DATA Manufacturer and/or Namestyle Length— Width Vehicle Serial No. 2 State Identification No. N (e --I S12 V-L-7-- P.&,Ltional Info-nnatjon or Comments: I fiUBli,l?IiUi`1.1 INS7'ALIA'1'ION INSPECTION CHECK 1,IS7' 1. Is the mobilehome 1oQate( w .i_li required separation from lot lines and buildings and generally conform to plot plan? Ye No� 2, Does they mr)bil.ehome have required clearances above ground? (Sec.5085) Yesy— No 3. Are footin-:;s and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No 4. Is the mobilehome level.? (Sec. 5088) Yes_ Noi s 5. If m. e than a single,unit, are crossover connections properly installed? (Sec. 5088) Yes .7e S. Water A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes No B. Test - Does water piping withstand working pressure or 50 lbs, air test? YesV, No C. Backflow - If coach is not ate of California approved, does station have backflow device and pressure -relief valve? No .7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yeq!�/ No B. Does it have minimum ," per foot slope and is it properly supported? YeS No C. Are any leaks detected in drainage system after running3-gallons of water through each fixture including washing machine standpipe? Yes No , D. If coach is not Stat f California approved, does station have required trap and vent? Yes No 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobilehome gas line inlet without reductions other than the mobilehome connector. Yes No B. Test OK as per following procedure? Yes_ No 1. Open all appliance connector valves. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect: gas meter to mobilehome with connector, turn. on gas, test connections with soapy water.. C. Are all appliance vents properly installed? YesNo_ �, COUNTY OF BUTTE DEPAR&ENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the C i oria Administrative Code, Title 25, Chapter 51 under permit number —7�' for th f 1 vin ovation: Owner _VJ i K ' Oi V Owner's Address Mobilehome MfgModel Year 7( - Insignia No. `S e S Serial No. yS� a51� It is hereby certified for occupancy at the above described location and may be occupied. f Direct r o. Public Wo -1-s Date rv/ By dd� THIS CERTIFICATE IS VOID WHEWMOB.I,LEHOME IS RELOCATED COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD Masonry Walls Throat - Rough ` Reinf. Stee Final Fixtures Bond Bea FIRES RINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels t Mesh MECH NICAL Grd. Fault Pr t. Scr ch V Heating Service Brdwn Cooling Temp. Pole Finish Ducts Underground Interior Lath : Ventilation Permanent Door Closer Final Final 1015 - DATE REMARKS OR CORRECTIONS z 7 7 6 i' 3,'c PX (NOTE: An entry must be made on this form each time you visit the job site.) I, I J.BUI-DING BUILDING (Cont'd) PLUMBING Setback `7Fir all Soil Piping Forms J Parallets 1st Floor Main Bldg. Restr om Finish 2nd Floor Footings Windo 3rd Floor Stemwall Siding To out Slab Roof SheNthing Water Piping Piers Roofing Sewer 5rlz 7176 Garage Fdn. Vents Fixtures Footin s Stemwal I Garage Vent Insulation Water Htr. Heaters Slab Carport Footings V Prov. for phy Cally handica ed Conformance o X. structure Appliances Gas Piping & Tks t Temp. Gas Slab A Final Sanitation Patio FIREPLACE Final 7`. Footin s Footingx ELECT AL Masonry Walls Throat - Rough ` Reinf. Stee Final Fixtures Bond Bea FIRES RINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels t Mesh MECH NICAL Grd. Fault Pr t. Scr ch V Heating Service Brdwn Cooling Temp. Pole Finish Ducts Underground Interior Lath : Ventilation Permanent Door Closer Final Final 1015 - DATE REMARKS OR CORRECTIONS z 7 7 6 i' 3,'c PX (NOTE: An entry must be made on this form each time you visit the job site.) I, I - - COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — OroviIle, 6a(ifornia 95965 Telephone: 534-4541 APPLICATION AND PERMIT 76 auuwncC ivPivSCntatives of Ine County of Butte to enter upon the above mentioned property for inspection purposes. X Date £ Signature of Permitee Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PURCIC WORKS BY Date �—Z•i'-�'7 � Ilding permit expires Date r7-�� 7 BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mailing Address - Telephone No. Fireplace Contractor /3,c,/Gy �/� �j/vjn�� ��[ Total Valuation Mailing Address 2�v Cs���/ �� Permit Fee Plan Checking Fee&/or Penalty lephone No. ;I�s-: 72 Permit Fee Building Address ml-Gai�/�crl 4 L,L PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 ,!1 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. �� _ /�� �� Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration. parcel Ma P 60' R/W Im provements Lawn sprinkler. system 2.00 Bldg. Plans Recd P a r c e 46vV royal I Plan provol Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 100 AMP ORSLESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family Duplex Mobil Home Others 9 Y ❑ P ❑ '� ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST.DWELLING OCCUP. & OR ADDNS. ( ACC. BLDGS. ) 22 sq ft NEW CONSTR. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS &) NON.RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style YC_a, t Ex. Occup(OUTLETS OR FIXTURES) 109 FIXED APP LNS. OR Ex. Occup. LETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home'Facilities 15.00 License No. �� C( CC/ Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. p aced on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 (7 TOTAL PERMIT FEE 2 s 32 ITZ auuwncC ivPivSCntatives of Ine County of Butte to enter upon the above mentioned property for inspection purposes. X Date £ Signature of Permitee Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PURCIC WORKS BY Date �—Z•i'-�'7 � Ilding permit expires Date r7-�� 7 ' BUTTE COUNTY DEPARTMENT'OF PUBLIC WORKS 7 County Center Drive, Oroyilld', O.A. PHONE: 534-4541 MOB ILEHOME INSTALLATION SHEET 1. Owner's name • )AR'Re1_ L CCl;Ge nQ_ freD'i'e 2D .2. Installer's name: ►c h (Yla 6, IQ 4�0 rno— (Zq .2S n� 3. Is the site currently under permit? Yes / / No (If yes, furnish permit number �� — � `� 6-•) OR �0�_0_0 1:2 - a Is the site an existing site? Yes .W No (If yes; furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements?- Yes / / No (If no, clarify ) ( ) 5. What is the mobilehome electrical rating? ----------------------- ) 0 D Amps 6. What is the mobilehome site service rating? --------------------- //D - Amps 7. What is the mobilehome site circuit breaker rating? ------_---- / v U s p 8. Is there any other electric load to be served by the mobilehome site service? ----------------------=-------------------------- Yes /. / No / / (If yes, identify the load and size: (Load)' fps) 9. What is the mobilehome site gas pipe size? -------------=-------- , (i n ) 10. What is the type of gas service? ----------------------------- Natural / / LPG ZZ X11. What is the gas pipe length from meter or tank to the mobilehome? (ft.) '� 12. What is the mobilehome gas demand? ---------------------------� �vy �(BTU (This information not required if'pipe length less than 6 ft. o nat ur^al�gas or less than 50 ft. .on LPG.) % MOBILEHOME SUPPORT DATA r7 , Mob ilehome Mfr. I Y%ieSetup Model No. 7 os i Year 112 Width _<P- (ft.) Length (ft.) Expando Size % U ft..x ft. (Draw support details below) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on .file with the County of Butte). Sin le - b Footin s- (check. one) / 1 Cente Center Support Suppo Locations Footing Sizes (in.) 4; _A_ -I (ftp ('n -- 4,,l (in.)(in.) ..A. —. *If center piers are other than drawn above, draw in locations, spacing, and dimensions. Wood either pressure treated or fdn. grade. 1 1 2. Concrete pad. 3. Other, specify Supports (check one) / Concrete block 2. Concrete piers 3. Steel piers T-1 4. Other, specify la x d Footing ical ort oting Size in.)(in.) I Max. Pier Spacing 14– 13 i -Max. Overhang in.) BUTTE COUNTY BUILDING DEPARTMENT APPROVED COUNTY OF BUTTE — `'DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone. 5344541 APPLICATION AND PERMIT S-0 6 / AJ t U oy - - v-� Date l v J-'- i .v Receipt No. ,,��i �Z�l- �% J �� White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant B 0 ing permit expires Date22 BUILDING jW Owner 1-,E ='—A/ %2%5E A --0)2L9 SQ. FT. OCC. BUILDING VALUATION Mailing Address �6�L� 2�f ��Lc� 5�r, /cam ' '��� Telephone No. 2 9y Fireplace Contractor ��! Total Valuation Mailing Address �l/N Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address S w ��/� v PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 0 a� %/AP_ 14 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 4-80 c. O0 Each gas water heater or vent 1.50 /+�-- /�, _ A. P. No. / Zon.ing Gas piping system 1 - 5 outlets 1-50 �, 04 Each additional outlet .30 F s �Jv W[�. 9, Sa�yA.n I Fire Dept. FireZone U e Permit Building sewer 5-00 ® O EQA Parking Plans Parcel DeclaratAd-)r- io�n,T are Ma p 60' R/W ImprovementsLawn sprinkler system 2.00 Bldg. Bld . Plans Recd ' P-arce roval Pla ppr , Permit Fee $ - $ QC NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 00 Main service 11 '0OAMP V OR ORSLESS 5.00 .00 Main service EA. ADD'L loo AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L loo AMP 1.00 NEW CONST. DWELLING CCUP. & OR ADDNS. ACC. BLDGS. ) 2�Sgft NEW CONSTR. MULTI -OUTLET NON•RESID. ( BRANCH CIRCUITS) 2.50ea pMINIMUM E FOP, R')I NEW CONSTR. POWER APPARATUS & NON.RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES)@Lsa BAL@i1 Ex. Occu /FIXED APPLNS. OR p•\OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shal•I not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 1 2.00 Permit Fee $ $ 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. XrmiDate Q_ $ignatur of Petee or A ent TOTAL PERMIT E FE $ This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF BLIC WORKS t U oy - - v-� Date l v J-'- i .v Receipt No. ,,��i �Z�l- �% J �� White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant B 0 ing permit expires Date22 IT 'PtiM For his se- of plans a4ui5MpV9*ft;ft xeFit on the job at 'ail timps and, it ma<e any changes or alterations on written parmisson from the Depart Wrks,-'C Unty of Butte.. A X11,4� I) a vo?�,r V. - C, !2 91 The**.. Setback shall be 5 ff. from 4106 it fl side property line and 50 ff. from N the centerline -of the road, permitt' I n q a maximum of a 2 ff. eave overhang. s. unlawful to •same without ent of Public 4-0 DU I I L COUNTY NOTE; All Materials & WoAmonship. Shall Be in Accordance- with, 3UILDING DEPARTMENI ecocinized Good -: Practices ancl of a gialify-prescribed, - for -+h6,-Spe cifi;7d use in the Uniform pq I'm M. F APPROVED B "'Id _P1 " b- & aclict,�_iiEi�61 '(�ocles and Ica J_ I' Co.- -z -C the Na �;o,;a. fi�* _40 5 a _J Z P, Y fl C ions .:conrie sha I be ca in 4 f t --d-u-iskide- the `riddi �h'i:rd Se[th ct'bri- Of the n46We-`ho me zor)'J, e de 'dfthe mobil I - h--ome;, ., � his se- of plans a4ui5MpV9*ft;ft xeFit on the job at 'ail timps and, it ma<e any changes or alterations on written parmisson from the Depart Wrks,-'C Unty of Butte.. A X11,4� I) a vo?�,r V. - C, !2 91 The**.. Setback shall be 5 ff. from 4106 it fl side property line and 50 ff. from N the centerline -of the road, permitt' I n q a maximum of a 2 ff. eave overhang. s. unlawful to •same without ent of Public 4-0 DU I I L COUNTY NOTE; All Materials & WoAmonship. Shall Be in Accordance- with, 3UILDING DEPARTMENI ecocinized Good -: Practices ancl of a gialify-prescribed, - for -+h6,-Spe cifi;7d use in the Uniform pq I'm M. F APPROVED B "'Id _P1 " b- & aclict,�_iiEi�61 '(�ocles and Ica J_ I' Co.- -z -C the Na �;o,;a. fi�* _40 5 a Pouxr Ujarwk. Sept]SYSTeM and 1'06aflen." ' Mt?; 40 be as _71ounty -* H -alth, Dept per . Re- L 600 V 4 �_ 4 151cemene , GloCK U0 F* lui`r:ei:nents., +ts I his se- of plans a4ui5MpV9*ft;ft xeFit on the job at 'ail timps and, it ma<e any changes or alterations on written parmisson from the Depart Wrks,-'C Unty of Butte.. A X11,4� I) a vo?�,r V. - C, !2 91 The**.. Setback shall be 5 ff. from 4106 it fl side property line and 50 ff. from N the centerline -of the road, permitt' I n q a maximum of a 2 ff. eave overhang. s. unlawful to •same without ent of Public 4-0 DU I I L COUNTY NOTE; All Materials & WoAmonship. Shall Be in Accordance- with, 3UILDING DEPARTMENI ecocinized Good -: Practices ancl of a gialify-prescribed, - for -+h6,-Spe cifi;7d use in the Uniform pq I'm M. F APPROVED B "'Id _P1 " b- & aclict,�_iiEi�61 '(�ocles and Ica J_ I' Co.- -z -C the Na �;o,;a. fi�* _40 5 a v w SCALE IMMED14T ELY FOLLOWING DISTURBANCE A SSHowm OFo-SOILI APPLY, STRAW MULCH AND V*rt ASSHOWN HYDROSEED PER NOTES, SHOWN HEREON.'� INSPECT AND MAINTAIN PER x D*slgntd: RGA HYDROSEEDING APP UCATIO N'- RATES /tEED MIXTUR -NOTES SHOWN HEREON. . Drs". 2.000 lbs.. Strow/AC ........ Dwl. No. 1.500,' lbs.' Wood fiber/AC Chocked: INSTALL.' INSPECT -.�MAINTAIN Date: MAY, 2M ,120,lbs. Guaor,bos'e tickifger /AC FIBER ROLLS PER, NOTES AIZ,— --ST;—etNo, 120 lbs Gre6n to Gold AC DETAILS SHOWN HEREON.' 90. 235 lbs., 15-15 fdrtilize/AC' • 01 JOB NO. v w 7