HomeMy WebLinkAbout065-190-048i'. .. 'r ' ..'v rtiiY` �r•I
065-190-048 03-0770 ENVIRONMENTAL a °7' i ► `!
SMITH, Larry r.
fx 14592 Hohmvocd Drive, Magal <,_� HEALTH CLEARARANCE s
ConC Executive Homes INALE PATE
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NOTES __ RESIDENTIAL
065:190-048 03-0770
PERMIT N0. I.SMITH,'Larry . +tt
14592,Holmw66d Drive, Magalia
rC6nt: Executive Home`s N
New MHon Perm`
`•Fnd
THE HCD FORM 433A FOR THIS MH CANNOT BE
RECORDED UNTIL ONE OF THE FOLLOWING HAS
BEEN TURNED IN TO THE BUILDING DIVISION:
(1) LICENSE PLATE(S) OR DECAL (THE '
INSPECTOR MUST RETREIVE).
j (2) STATEMENT OF FACTS (ONLY ON NEW -
!{Y MH'S).
INSPECTOR TO VERIFY SERIAL & LABEL #'S.
SPECIAL CONDITIONS
i CHECKED
' BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
( VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
,
' OFFICE COPY
t ILL
1
4 Add es
lm
} GAS .�,Pf �V
13
1
Meter By k ' Dat �'
' ELECTRI
Meter By Date
r
JOB FINALED (Date ,
Signature
..r
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7-r2ounty Center Drive 9 Oroville, Qalifornia,, 95965 -'Telephone 530 538-7541 PERMIT NO.
(Rev.12(96) .,V, APPLICATION AND PERMIT T
ASSES§OR PARCEL NUMBER
8
ZONING
—9
BUILDING PERMIT
OWNER
Smith, Lumy
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
11449 R
.OWNER'S MAILING ADDRESS
57 1 Sa
CONTRACTOR'S NAME TELEPHONE
Executive Homes 891-6992
CONTRACTORS MAILING ADDRESS
3022 Esplarlie Chiasm CA -3
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $ SC
n
ARCHITECT OR ENGINEER
LICENSE NO.
—
Filing Fee
Z. 20.00
Permit Fee M_
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan CheckingFee
_
$ 1
BUILDING.DDRF�¢4592 Holmwood Yrive Ma$alia
1
Energy Plan Checking- Fee
yV
$
$
PERMIT FEE
$.320.00
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00 15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: Mh on Perm Fdn 26 X 56
Gas piping system 1 - 5 outlets
15.00 11,5 . 00
Building sewer
15.00 15.00
Mobile Home I S I G W
@20.00
PERMIT FEE
$ 65.00
ELECTRICAL PERMIT
Fling Fee 20.00
a00OR LESS
Main Service 2o0.OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class . Lic. No. LP 15 rS )
OWNER -BUILDER DECLARATION
hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ 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.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ I am exempt under. Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I* 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier " n c1
Policy Number ,' Jk'*
(The above sections need not a completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 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 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 � )0 Date .3i �`� [V
F
Sigma use of Applicaht - O Owner ❑ Contractor IP ent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over'3 stories in height.r �tr�
Main Service TO l
2 /y�
46.00so �J.�
NEW CONST. OWE OCCUP. SO
WE U
OR ( a Acc. 3.50F7.
CNS.
TLE
OUTLET
CONST. MULT.' CIRCUITS@7,50
POWER APPARATUS
a SINGLE OUTLET CIR.
20 @ 100
EX. Occup. OUTLET OR FIXTURES BAL Q .SO
FIXEDI
Ex. Occup. ouT rs .16°EA 5.00
PL
Temporary Service
23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE S 43.00
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 428.00
HAZ.
D. FEES IMP
FLOOD CDF
pggCEL
pp HD UE
This permit is hereby issued under the
of the Butte County Code and/or Resolutions
indicated above for *hich fees have
By
PERMIT EXPIRES ON
It
applicable provisions
to do work
been paid.
1
�� f
Date Id
W Dafe
ReceiptNo. 3-7.53:3 (�„3'c.(Jt.�a _ � �/ �^� }(�
WHITE-D.D.S.-B.D. CANARY=A: ESSOR PINKpI SPECTOR GOLDENROD -APPLICANT
Y
0
J=OK
1.
0 = got OK
2.
NotReadyable
MOBILE HOMES
Gas; MH Test -Demand -Valve -Connector.
4.
Date
MOBI HOME UTILITIES (Plans) OK except #'s
Drain; MH Test -Fall -Flex Connector
o ing Requirements -Setbacks -Easements
Water; MH Test -Regulator -Connector
Special MH Support Sketch
Water and Sewer Connected -C/O to Grade -HD Approval
S er; Location -Test -Fall -C/0 -Concrete
Gas and Electricity Tagged
&OVOter; Location -Test -Easement Needed (Sketch)
T A/l'as• Location -Test -Wrap; -P/5/ /'
/j 91/'.AdvMr / /" L "ft./ LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector.
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
5.
Drain; MH Test -Fall -Flex Connector
6.
Water; MH Test -Regulator -Connector
7.
Water and Sewer Connected -C/O to Grade -HD Approval
8.
Gas and Electricity Tagged
9.
Tie Downs -Type -Installation Cert.
10.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
Date
Card B-1 Date
Card B-1
Date
Card B-1 Date
Card B-1
Date
PERM ENT END SYSTEM (ONLY)
Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg-Frg-Bracing
5.
o "ng Requirements -Setbacks -Easements
6.
Carports; Windows -Doors
otings; Size -Spacing -Marriage Line
Electric
8.
00' -BI ckin
9.
Siding; Nailing -Veneer -Stucco -Mesh
a H Test -Demand -Valve
�( lectricity; MH Test
Roof; Shthg-Roofing
11.
6. Water;.MH Test
12.
Braced Wall Panels
Q( ter and Sewer Connected
LX At,00%as and Electricity Tagged
zits
49r 4cense Decals
1VVerify #'s with Office
Date
Card B-1 Date -
Card B-1
Datef
,23 Card B- ,U Date
Card B-1
-T
--
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3.
Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4.
Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
12.
Braced Wall Panels
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5.
Elec.; Pool Lighting; 15 Volts-GFI
6.
Elec.; Enclosures; Conduit Entries -Terminals -Listed
7.
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8.
Elec.; Grounding; Equip, w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures- Panelboards-Ins. to Main Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
12.
Enclosure; Fencing -Alarms
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
J=OK
0 = Not OK
- = Not Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date
UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
Date
2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
Date
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
Date
4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
77. Wtr. Htr; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection -
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
17. Water Htr.; Vent -Access -Combustion Air Baffle
18. Water Pipe; Test & Anchor -Nail Protection
19. D.W.V.; Test Fittings & Anchor -Nail Protection
_
20. Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sixe & Anchors
23. Fire Sprinkler; Test
87. Water Well, Disconnect, Electrical, Plumbing
Date
• Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
24."Fixture & Transformer Clearance -Ins. Protection
25. Elec. Receptacles Spacing -Lights & Switches at Doors
26. Size Boxes & No. of Conductors Stapled
27. Romex Installed Close to Edge of Studs & C.J.
28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29. 2 Appliance Circuits in Kitchen & Conductor Size GFI
Date
30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
Date
31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or All
Insulated Neutral O Yes O No
Date
32. Service -Riser Conductors & Ground Main Disconnect
Comments at Final:
33. Equip. Clearances Panels-Motors-Mech. Equip.
34. Clothes Closet Light -Shower Light -Spa Light
35. Smoke Detector
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
36. A.C. Ducts Insulation & Support
37. Vent Fan, Exhaust above insulation
38. Condensate Drain & Overflow, Size & Grade
39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
40. Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
41. Sills Proper Materials & Anchors
42. Walls Studs -Nailing Spacing & Braces -Plates -Sound
43. Bearing Walls over Girders & Floor Nailing
44. Draft Stop in Walls (rat proof)
45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46. Headers & Beams -Size & Bearing
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng.
49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59. Glazing Area -Glass Protection -Skylights -Plastic
60. Shear Walls; Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
64. Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66. Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71. Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74. Elec. Outlets & Receptacles at Kit. Counter -
75. Garage Fire Door; Swing -Landing -Closure
76. A.C. Duct in Garage -Damper
77. Wtr. Htr; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection -
78. Plb.; Elec. & Mech. Equip. Listed for Location
79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80. Insulation -Foam -Looked in Attic - -
81. Guard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
_
83. Following Instld./Drive O Yes O No/Walks O Yes 0 No/Planters O Yes 0 No
84. Stucco Brown -Finish
85. A.C. Unit Disconnect, Electrical -Plumbing
86. Vents Above Roof, Flbg-Appliance-Fireplace-Clearance to Openings
87. Water Well, Disconnect, Electrical, Plumbing
88. Exterior Elec. Trim, G.F.I. Receptacle -Underground
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
94. Energy Compliance Certificate -Other Certificates
95. Address Posted
96. Fire Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev.12/96) ' APPLICATION AND PERMIT 103 _0 7:70
ASSESSOR PARCEL NUMBER
065-190-048
ZONING
BUILDING PERMIT
OWNER
TEUEPA -
SO. FT. OCC. BUILDING VALUATION
1492 R 80,568
00
OWNERS MAILING ADDRESS
6157 Erir-,q Drive Magalia 95954
CONTRACTOR'S NAME
Executive Homes 891-6992
TELEPHONE
CONTRACTORS MAILING ADDRESS
3042 Esplanade Chico CA 9597-1
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $ 80,56�
no
ARCHITECT OR ENGINEER
LICENSE NO.
Flin Fee
$ 20•00
Permit Fee -544.00/2
Plan Checking Fee
$
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
BUILDING ADDRT4592 Holmwood drive Magalia
l
Energy Plan Checking Fee
$
$
PERMIT FEE
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
1 7.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00 15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: Mh on Perm Fdn 26 X 56
Gas piping system 1 - 5 outlets
15.00 15.00
Building sewer
15.0015.00
Mobile Home I S I G I W
1 920.00
PERMIT FEE
t 65.00
ELECTRICAL PERMIT
Filing Fee 20.00
OOOV0LESS
Main Service zo.A OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No. L2 405 n1:2 )
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ 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.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
/ performance of the work for which this permit is issued.
$L 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance cajjier and policy number are:
carrier P- j�Ll,i(Y�Y
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 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 workers'
compensation laws of California, and agree that if I should become subject to the
'compensation provisions of section 3700 of the Labor Code, I shall
orthcomply ith those provisions.
workIfA
�j
X Date 3 b _
Signa a op a Owner ❑ Contractor ii;x ant
An OSHA permit i r quired for excavations over 5'0" de and demolitio or construction
of structures over tories in heigh .
Main Service 200A TO I000A
46.00 23.00
NEW CONST. DWEWNG OCCUP. SO
OR ADDNS. ( ,%N ACC. Bins. 3.5QFT;
p�Oµq°pT' MULTI.OUTLET
@G 7.50
POWER APPARATUS
a SINGLE OUTLET CIR.
�0 @ 1.0000
Ej(, OCCU OUTLET OR FIXTURES
Ex. Occup. oUr ED ARID.°� 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $ 43.00
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ -428.00
HAZ. D. FEES IMP I FLOOD OF PARCEL PD HD UE
This permit is hereby issued under the
of the Butte County Code and,/pr
indicat ab ve r hich fees ave
By
PERMIT EXPIRES ON
applicable provisions
Resolutions to do work
been paid.
ate ll
I.01 �
Defe
Receipt No. �% 3 ,�
WHITE-D.D.S.-B.D. CANAR - SOR PINK -I ECT R G L OD -APPLICANT
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541
aev.12/96) 1 APPLICATION AND PERMIT '3
AS SESaORPARCEI HUMBER iotdon
c
COMw0R'S NAME L ,
CONSTRUCTION LENDER 1
LENDER'S AWUNG ADDRESS
ARCHITECT OR ENGINEER
Ln BUILDING VALUATION
HOTotal Valuation
Fling Fee
Permit F J`
NC
E
$ 20.00
V 131
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kfw,A ,,td f .� - ®c�
mom
0 / 5—� 3 5> ow—
Lenercn�
i ervice
to OA OR LESS
ee -
y
20.A To I000A
BUILDING ADDRESS
NEW CONST:
Plan Checking Fee
Energy
b
DR (DONS. (
l ACC. BLD8
I 3.5('FT.
Plan Checking Fee
E
@7.50
S
LDrNO. sueorvsnNswLME
PERMIT FEE
_�Y
PAACE
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
Each Trap
7.00
Solar or heat pump water heater
23.00
SF Q Duplex ❑ Mobilehome
Other
Water piping
15.00
sPECIFr
Each gas water heater or vent
15.00
TYPE OF WORK
New Addition ❑ Remodel
❑ Utilities ❑ hstellation p Other Q
Gas i In stem t - 5 outlets
1 5.00 ,
Describe Work: 26" ��/5(0�
Building sewer
S G
15.00 % f
Y71C1,V1 �� O
Mobile Home W
@20.00
�l �nl""
a-L—,k . N,,
PERMIT FEE
S-
-
ELECTRICAL PERMIT
Fling Fee 20.00
_
RA.;' S 000V OR LESS
V 131
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L.�� -, X C� �,)
'mow►;
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O 4-htor'
kfw,A ,,td f .� - ®c�
mom
0 / 5—� 3 5> ow—
Lenercn�
i ervice
to OA OR LESS
23.00
Main S ice
20.A To I000A
46.00
NEW CONST:
DWELUNGI OCCUP.
50
DR (DONS. (
l ACC. BLD8
I 3.5('FT.
O
NOKRESID.
MULTHOUIIET
� �
@7.50
EX. OCCU OUTLET FIXTURES
20 0 1.00
SAL SO
EX. OCCU F LEO A OR
ovnErS RESID.
5.00
Temeorary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00_4 /elpso-D
PERMIT FEE S
MECHANICAL PERMIT Filin Fee 20./00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt S
Mobile Home Installation Fee S
Energy Inspection Fee $
occ colsT. nPE O AL FEE $
""1= ., � HD BSU
This permit is hereby Issued,//nder the applicable provisions
of the Butte County Code and/or Resolutions to do work
Indicated above for which fees have been paid.
BY
Date
PERMIT EXPIRES ON
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: J , ASSESSOR PARCEL NUMBER
Proposed Building Use: Counter Technician: Date: �•
Items required in order to apply for a permit. 1 boxes MUST be checked OR marked NA in order to apply.
1.. Plot plans, 3 or 4 sets, signedty the preparer of the plans.
27 Complete plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 4. Engineered truss details and layouts in duplicate. No faxes!
❑ 5. Energy compliance design and supporting documentation in duplicate.
Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or
foundation plans, all in duplicate.
❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate.
(D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer.
Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be
indexed and returned to the plan review line-up when required items are received.
Date Received By
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................
❑ 9. Plot plan and business license approval from the City of Biggs ....................................
❑ 10. Letter of intent for non-residential buildings......................................................:..
❑ 11. Detached Accessory Building Form filled out by the owner .....................................
e.. Hazardous Materi 1 For r�.;2...............................................
ther I vV
r
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
,V4 es as shown on the attached Schedule of Fees Due Sheet ....................................... 3atement of Intent for Non -heated and A/C Buildings...........................itation and plot plan approval from the Environmental Health Department in 3 ,Cf3S
❑ 17. City of Chico Plumbing permit....................................................................
California Department of Forestry plan approval paid. Sent_ b::..: G
4�11
9. Planning approval for (A) Use: �' K (B)Par ing: (C�Check: 20_1 k4D
❑ O. Contact Land Development about ❑ Improvements, ❑ Drainage ...............................
1. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 22. Pre -Inspection for required ................
❑ 23. Contractor's license information. (Number, Name Style, Classification) ......................
❑ 24. Worker's Compensation Carrier and Policy Number ..............:..............................
❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) .....................
26. Letter of Signature authorization....................................................................
27. Recorded copy of Agricultural Acknowledgment Statement. lN2aor,....................... —`�
❑ 28. Manufactured home utility clearance................................................................
❑ 29. _Wng violations a�or expired en it ................................... z.
O rant Deed, 2 M.H. Title/ tatement of Facts ❑ Letter from Legal O er, C ec o C.D.
1. Other: eW W d' �e 1*4W ,FGa.u0i'ol �O�wS l9lL (/s<ioT�l-D3
ued Telephone / — (� 17 - and hold for pickup. -
I have been informed o above ite s and requirements for obtaining a building permit.
pplicant:
Index permit application for the above i ms u b e P1arr Check`L
2. Additional items required
Contrac , designer, owner, was advised cf t e a e da by hone; ❑ mail, ❑ counter, by 12,6 _Date:
ontractor, designer, owner, was advised of the above data by ❑ phone, ❑mail, ❑counter, by Date:
Plans reviewed by: [LU, Date: y— /O— d 3 Plans approved by:
Structural reviewed by: Date: Structural approved by:
Note transfer by: Date:
Vellnw' Rnilrlino r) 66nn
Date:
Date:
03-0'770
E.H. USE ONLY
Piot Plan Attached
Floor Man Attached
Sent to B.D.
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
CNA
S �� ��► �w (�(�� - lav -v
w,her location AP#
Plan Approv f Sewage Disposa� Water Supply: Public Priv to Well
AClearance for welling. Other 1�ppe-),zeD
Hold final for:
Final clearance O.K. for:
NOTE:
8/96
Date
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVELLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541
SCHEDULE OF FEES DUE
OWNER A.P. #
BUILDING USE DATE 1�
RECEIPT # DATE REC.
1. UILDING PERMIT FEES
Balance Due ....................... $
Additional Fees Due ................. $
Additional Fees Due ................. $
Revised Plan Checking Fee .......... $
Jig, SCHOOL DISTRICT FEES Pa"/1 Gt
paid at District Office) (Available after Plan Check)vv�,
3. HERIFF FEES (paid at Building Division) �7
(//b -
Residential ...................... x $360.00 = $ 3-7 l
Units
Commercial (sq. ft.) ............... x $0.03 = $
Sq. ft.
4. URBAN AREA FEES (paid at Building Division)
Residential ................... -x-=$
# Units Amt.
Commercial (sq. ft.) ............ -x-=$
Sq. ft. Amt.
5. RECREATIONAL DISTRICT FEES
(paid at District Office) (Available after Plan Check)
6. THERMALITO DRAINAGE DISTRICT FEES
$510.00 (paid at Building Division)
7
SRA FIRE INSPECTION AND PLAN CHECK
$89.00 (paid at Building Division)
8. WATER TENDER FEES (Battalion # )
$200.00 (paid at Building Division)
9. CSA 87 TRAFFIC FEE
$2500.00 (paid at Building Division)
10. OTHER
At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees
may be changed during the plati)checking process.
DATE ✓ /e��
Pursuant to Government Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 8, 9, and 10 above may have been
imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned
items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a).
Original - Buiding Div. 2nd Copy - Applicant 3rd Copy - Owner
(Rev. 6/00)
r
v
V -
BUTTE.COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
j (One form per Building)
School District`" Building Department No.
A.P. Number 57/90 no Jurisdiction: City County
VC C -A- .C-..- /
Property Ownerf
Property Location/Address
Subdivision Lot No.
Residential Development
Commercial/Industrial
63-0770
............................................................................................... [/ C�
0 Sq. Footage
No of Living Mobille Home Additiord *Supplemental to (Group R)
Units Installation Conversion Permit #
'(No foundation inspection):
€...................................................................................................................
0
New Addition
OYIIVIIILJ LJCPdILTTICTII T[CPTC,CTILd LIVC
Floor Plans reviewed by School District
District Identification No.
/11Ir /
F,r, =4 94&
.3 Oq�,- �
(Street Address)
r -,A
(City)
has complied with the requirements of Resolution No.
representing / square feet.
School District Representative
Paid by Check #� / ��f� Remarks:
District certifies that
(State)
Sq. Footage
(Including Exterior
Roofed Areas)
Date Z4
(Applicant)
(Phone Number)
7
(Zip
by payment of $
B 2926 $
FULL MITIGATION $
Date
Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with
Government Code Section 660201x), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit
you from challenging the imposition of the fees in any court action.
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is
notified by the applicable Local Planning Agency that this project is being reviewed under the Califomia Environmental Quality Act (CEQA),
this project may be subject to additional school fees to fully mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeform.xls 00/98)dmm
Date:
SITE PLAN REVIEW APPLICATION
ro3 AP# S =t ?o
Permit Number (if applicable) C!rS—
APPLICANT INFORMATION Parcel Size:
Owners Name:
--
Owners Address:
Gxcs�G. N S
Telephone No.: �'� c� _ e:), Cj
Situs Address: loo 6 l7 w A-41) f— &M Zo 19 Q
Proposed Use:
Residential
10 New Single Family Residential
❑ Single Family Addition
❑ Mobile Home
❑ Residential Accessory
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie)
❑ Temporary Travel Trailer
❑ Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
❑ Single Family Remodel
❑ Commercial Remodel
❑ Industrial Remodel
Other
IN Septic ❑ Well
❑ Agricultural Exempt Building
❑ Other:
Brief Explanation (if necessary):
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SERVICES INFORMATION (For Staff Use)
® Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
Site Plan Stamped Approved
By Date
Page 1 of 5
ALL ITEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In:
IM Snow Load Area:
❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract
❑ Nitrate Action Plan (See Environmental Health for standards)
Watershed Protection Overlay Zone (See attached standards and requirements)
❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required)
SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain: (See attached) .
• Flood Zone:
• Flood Panel No.: O l O'O Index Date:
❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements)
❑ Chapman/Mulberry (See attached standards and requirements)
❑ Cohasset Area (See attached standards and requirements)
❑ Grading Zone (See attached handout)
Use Requires:
❑ Use Permit ❑ Minor Use Permit
El Minor Variance El Administrative Permit
❑ Variance
------------------------ - _ _____ _
❑ Detached Building Use Form ❑ Encroachment Permit
❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement
Zoning: ,R -T —i — A
Applicable Building Setbacks:
ZNningCode-Streetsl Highways Fire Prevention Subdivision Map
Front 5SideSide StreetRearHeight
Waterway /A T N/A
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Applicable Development Fees:
Standard Fees Amount
❑ Fire
❑ School*
❑ Parks/Recreation
❑ Roads
❑ Sheriff
❑ Drainage
❑ NCSP/CSA 87
❑ Chico Urban Area — Road
❑ Thermalito Impact
❑ Other
Formula
----------------------------------------------------------------
ubdivision Map Special Fees
❑
Water Tender
❑
Road Improvement
❑
North Oroville Area
❑
Other (per map)
* Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of
the building permit.
Parcel Created By
M Deeds:
Date of Creation: Legal Access Provided: ❑ No Yes
Deed of Reference: Legal Access Required ❑ No ❑Yes
Parcel Frontage on Publicly Maintained Road: ❑ No Yes, Road Name: }I oL3-r��„� oma. � e
Complies with County Standards for Deed Creation: No
Comments: - 1 q 7 22— 9 S0 2❑ E] Yes
Parcel Deemed to be legal
❑ Verify Legal Parcel ❑ Verify Legal Access ❑Provide Deed of Creation
❑ Obtain a Certificate of Compliance
❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment
❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23).
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current Environmental Health Department requirements
Page 3 of 5
Q Subdivision Map/parcel Man:
Map Date of Recording:
Lot: Book: Page:
❑ Use Permit/Minor Use Permit
Permit Number:
Date of Approval:
Parcel Map/Subdivision Map/Use Permit Conditions
❑ Comply with the following Conditions of Approval:
❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290
❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the
National Fire Protection Association Standard for installation of sprinkler systems in one
and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized
community water system, with hydrants that meet the Fire Department specifications, serves
the parcel.
❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission
requirements of the California Clean Air Act of 1988, as amended.
❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan
must be prepared by a registered civil engineer or other qualified professional and be
submitted to and approved by the Department of Public Works.
❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate
Battalion Water Tender Fund may be required.
❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil
construction associated with residential development. Approved dust control measures are
found in the fugitive dust control plan for the site approved by the Butte County Air Quality
.Management District, a copy of which can be obtained from the Butte County Department
of Development Services, Building Division."
❑ Engineered foundations are required.
❑ Class A roofs are required.
❑ Property owners responsible for roa
0
Page 4 of 5
IN
Summary of Specific Requirements:
This information provided in this summary is based on the application information and on the best available data at the time
of review.
CM.a"ABuilding Permit Site Plan Reviewl.doc
Page 5 of 5
,'t,_. n
Watershed Protection Overlay Development Standards
Firhaven Creek, Paradise Reservoir and,Magalia Reservoir Watersheds
Land Use
1. Current lot or parcel sizes in the Watershed Overlay Zone shall be stringently maintained. No
further division of lots or parcels shall be permitted.
2. Current zoning shall be maintained, other than to allow the consideration of zoning proposal to
a larger minimum parcel size.
3. No change in zoning shall be made and no use permit shall be issued unless and until the
individual and cumulative impact of additional sewage disposal and surface water runoff
created by new development which such zone change or use permit might allow can be proven
to the approving authority by the applicant(s) to have no adverse effects upon the water quality
of the watershed.
Sewage Disposal
1. A 100 -foot sewage disposal setback from a perennial stream, a 50 -foot setback from an
ephemeral stream or drainageway, and a 200 -foot setback from a lake or reservoir shall be
strictly enforced, regardless of the date the lot or parcel was created.
2. Appendix VII of the Butte County Improvement Standards for Subdivisions and Parcel Maps
and Site Improvements pursuant to Chapter 20 of the Butte County Code which now applies
only to single-family residential lots or parcels created after April 4, 1974, shall also apply to
all other development, including multi -family residential, commercial, and industrial, on all
lots or parcels regardless of date of creation.
The gallonage of sewage application shall be pro -rated in proportion to the useable area of the
lot or parcel as determined in accordance with Appendix VII, using the Table I value of 350
gallons/day area requirement.
a. A variance may be granted only on an existing lot or parcel when special circumstances are
applicable to the property involving the soil characteristics, topography, or surrounding
property characteristics. Variances may be granted only to the useable area requirements
of Appendix VII, Table I. Cumulative effects within the hydrologic basin shall be
considered prior to issuance of any variance. In no event shall a variance be granted that
would provide less useable area than the requirements of Butte County Code, Chapter 19,
Section 19-12.
b. An application for a variance shall be made in writing on a form prescribed by the health
department. Upon receipt of the application, the Health Officer together with the Manager
of the Paradise Irrigation District, and the Chairman of the Water Committee of the Upper
Ridge Coordinating Council, shall make an investigation to determine whether a variance
should be granted. At the conclusion of the investigation, the Director of Environmental
Health shall prepare a written order granting or denying the variance, and shall include in
such written order specific findings of fact and reasons for its granting or denial.
c. If the Environmental Health Division of the Health Department denies the application for
Variance, the applicant may file an appeal with'the State Regional Water Quality Control
Board within ten (10) days after denial. The decision by the State Regional Water Quality
Control Board shall be final.
Erosion Control Measures
1. All roadways or driveways for new home sites on new or existing lots shall be surfaced with at
least 2 inches of class 2 aggregate base, unless required to be developed to a higher standard.
2. All roads and driveways shall meet the minimum requirements as prescribed by Public
Resources Code 4290 and 4291 and Butte County Fire Safe Regulations, or as prescribed by
the Butte County Department of Public Works.
3. Erosion and sediment control plans prepared by a qualified professional shall be submitted
with all building permits, discretionary development projects, and grading plans. All
construction activities shall comply with the provisions of the erosion and sediment control
plan. The plans shall include both temporary (first year) and permanent erosion control
protection measures that prevent sediment and other pollutant discharges from reaching
watershed drainages and streams. At the end of construction, and prior to building occupancy,
the qualified professional shall certify to the Planning and Building Divisions that construction
was in accordance with the erosion and sediment control plan.
4. The erosion and sediment control plan shall include the time of year for construction activities.
No construction shall occur after November 15 or before April 1 unless the preparer of the
erosion and sediment control plan certifies that the conditions are suitable for such construction
activities. Should grading be permitted during the rainy season, the smallest practicable area
of erodible land shall be exposed at any one time during grading operations, as directed by the
qualified professional, and the time of exposure shall be minimized. All areas where land
clearing has been completed between April l and November 15 shall be stabilized and/or
planted no later than November 15.
5. No structures shall be placed within 200 feet of the high water mark of the Paradise or Magalia
Reservoirs or within 50 f6et of the top of the bank of any perennial or ephemeral water course,
as shown on the most recent edition of USGS 7.5 minute topographic maps, in the Firhaven
Creek, Paradise Reservoir, and Magalia Reservoir watersheds. This provision shall not
preclude development on a parcel that would otherwise become undevelopable due to this
provision, provided that a variance is obtained.pursuant to Section 24-50 of the Butte County
Code:
6. The location of homesites (building envelopes) shall be shown on all future parcel and
subdivision maps located in the Watershed Protection Overlay Boundary.
7. Erosion and sediment control plans shall be prepared by a qualified professional involved in
the preparation of erosion control plans and shall be submitted for all three -acre conversion
exemption timber operations within the Watershed Protection Overlay Boundary.
8. Three -acre conversion timber harvest operations shall not be conducted in the Watershed
Protection Overlay Boundary during the period from November 15 to April 1.
National Pollutant Discharge Elimination System (NPDES) Phase II &
SWPPP Non -Certification for Project # ,6 3-D -7 7 y for Butte
County Storm Water Permit Compliance
By signing below, I, the project architect/engineer of record, indicate that I am aware that a
construction project that disturbs more than 1 acre of land requires a Construction Storm Water
Permit from the State Water Resources Control Board. I, additionally, understand that it is the
project owner's/owner's agent's responsibility to submit a Notice of Intent (N.O.I.), a Storm
Water Pollution Prevention Plan (SWPPP) and a fee of $700.00 to the State Water Resources
Control Board to obtain such a permit. I, further, certify that this project will not disturb more
than 1 acre of land. I have also reviewed the Best Management Practices Handbooks, California
Storm Water Quality Task Force, Sacramento, CA. I certify that appropriate BNIPs will be
implemented to effectively minimize the negative impacts of this project's construction activities
on storm water quality. I acknowledge that it is my obligation to make the project owner and
contractor aware that the selected BMPs must be installed, monitored, and maintained to ensure
their effectiveness. If, at any time, site conditions and/or observations by a County official
warrant reevaluation and revisions of the chosen BNTs, the appropriate changes will be made
without unnecessary delay. I am aware that failure to properly implement and maintain the
BMPs necessary to prevent the discharge of pollutants from this project during construction
could result in significant penalties and/or delays.
Signed:
Title:
Date:
By signing below, I, the project owner/owner's agent, certify that I am aware that a construction
project that disturbs more than 1 acre of land requires a Construction Storm Water Permit from
the State Water Resources Control Board and that it is my responsibility to submit a Notice of
Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP) and a check for $700.00
made payable to the State Water Resources Control Board to obtain such a permit, if my project
disturbs more than 1 acre of land. I, further, certify that this project will not disturb more than 1
acre of land. This document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified individuals properly
gathered and evaluated the information submitted. Based on my inquiry of the person or persons
directly responsible for gathering the information, I certify, to the best of my knowledge and
belief, that the information submitted is true, accurate, and complete.
Signed:
Title:
Date:
-/ - ii --rv>
NPDES & SWPPP Non -Compliance Certification Draft
Butte County Stormwater Plan
Wo 0 D 6t/ 19 A D ./4Uc
9
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FLEET WaOD.
Anniversary Series Model 45636
?-.Bedrooms • 2 Baths • 1,492 Square Feet
96'd
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1. Owner's Name: L CC.
I
2. Assessor's Parcel Number: C)(OS — N 9 0 -- 0 4<
3. Installer's Name: C' X P_ n o r 1% i% 44, rn n, C
4. Is the site currently under permit? Yes[ ] No[V(Pernnit No.
V
5. Is the site an existing site? Yes[ ] No[ ] (If yes, furnish two plot plaits).
6. What is the electrical rating of the mobilehome? / 00 Amperes.
7. What is the mobilehome site circuit breaker rating? a2C Amperes.
8. What is the electrical rating of the mobilehome site? c5�00 Amperes.
9. Is the main service remote from the mobileliome site? Yes[t,�No[ ] If it is, what is
the rating? Amperes.
10. Is there any other electric load to be served by the mobilehome site electric service
(i.e. well, garage etc.)? Yes[ ] No[V) If yes, please identify the load and size:
a) The mobile home site:
Load- Amperes -
b) The main service:
Load- Ainperes-
11. Type of gas service at mobilehome site: Natural[ ] Propane[/A None[ ]
12. Size of gas pipe at the mobilehome site from the meter or
tank:inches.
13. What is the gas pipe length from the meter or tank to the mobilehome
14. What is the mobilehome gas demand? V_`� ,A B.T.U.*
*(This information is not required if the pipe length is less than 6 feet on natural gas or
less than 50 feet on propane).
THE OTHER SIDE OF THIS FORM MUST BE COMPLETED IN ORDER TO
PROCESS`THIS PERMIT APPLICATION
i
BUTTE COUNTy
WHIM PA Rnmomms 'on
May 1995 A P P R ON E. 1)
8.5
Mobilehome Manufacturer:e t' W C:C Y - Manufacture Year: 200 3
If other than single wide, furnish Setup Model Number: 45L-
Width:�(ft.) Length: T (ft.) Tagalong or Expando SIZ-ft.)
On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's
installation manual and structural setup sheets.
FOOTINGS: Wood pressure treated or foundation grade[X] Other:
SUPPORTS: Concrete block Other:
Provide Tie Down Specifications for all Mobilehomes:
Pier Footings Sizes and Location
SINGLE WIDE MiULTI-WIDE
Line 1 Line 1
Line 2
Line 2
.
................................................ :........................
Line 2 t
Main Beams.........................................e 2
Line ILine 3
Line 2
...............................................................................................Main Beams
...............................................................................................Line 2
Line I
.................................................ine S
Tag or Triple ine 4
rine 1
I
Line 1 Piers:
Size minimum: rZ"i x Zy
Spacing maximum: n
From ends -maximum: \j ` V1
Line 2 Piers:
Size minimum: x
Spacing maximum: `, ` O`
From ends -maximum: N ` o
Line 3 Roof Loads:
Size minimum
Location (from front):
Line 5 Roof Loads:
Size minimum:
Location (from front):
(z7) W)
Line 1 Openings
Size minimum:kx ].
Each side of openings
with width over: `
Line 4 Piers:
Size minimum: [ ] xx ].
Spacing maximum:
From ends -maximum: `
-V4 x7o
N1 xZo
Z`I,.'3o
36x3
36,.3
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CDF FIRE SAFE REQUIREMENTS
6 "�-_(5_49 03-0-?-10 - (�74TC--C&m r uY T?,,vrr-
AP# PERMIT # NAME
Under authority of PRC 4290, the following checked items are required
by the Butte County Fire Department and are made apart of this permit.
These requirements are minimums and will be superseded by Butte County
local regulations which equal or exceed these standards. Field
inspections will be made by the Butte County Building Department for
compliance.
[x] 1272.00 Maintenance of Defensible Space. To ensure continued
maintenance of properties in conformance with these
standards and measures and to assure continued avail-
ability, access and utilization of the defensible space
provided for in these standards, annual maintenance
must be provide for by the land owner.
Driveway Standards
[ 1273.02 Surface. All driveway surfaces and structures (bridges,
1273.07 culverts and other appurtenant structures which supple-
ment the roadway bed or shoulders) shall provide unob-
structed access to conventional drive vehicles, includ-
ing sedans and fire apparatus weighing up to 40,000
pounds.
[�r4 1273.03 Grade. Not to exceed 16 percent unless paved.
1273.04 Driveway Radius
�( 1. No roadway shall have a horizontal inside radius of
I curvature of less than 50 feet and additional sur-
face width of 4 feet shall be added to curves of 50-
100 feet radius; 2 feet to those from 100-200 feet.
] 2. The length of vertical.curves in roadways exclusive
of gutters, ditches and drainage structures designed
to hold or divert water shall be not less than 100
feet.
1273.05 Turnarounds. If required, will have a minimum turning
radius of 40 feet from the center of the road.
[ 1273.05 Turnouts. Shall be a minimum of 10 feet wide and 30
�1 feet long with a minimum 25 foot taper on each end.
[!"] 1270.10 Width. All driveways shall provide a minimum 10 foot
traffic lane and unobstructed vertical clearance of 15
feet along its entire length.
Page 1 of - 3•-.
r4m /o/ TAMP/—
AP # PERMIT # NAME
[�] 1273.10 Turnouts. Driveways exceeding'150 feet in length, but
less than 800 feet in length, shall provide a turnout
near the midpoint of the driveway. Where a driveway
exceeds 800 feet, turnouts shall be provided no more
than 400 feet apart.
[ 1273.10 Turnaround. A turnaround shall be provided at all
building sites on driveways over 300 feet in length and
shall be within 50 feet of the building.
1273.11 Gates
[�] 1. Gate entrances shall be at least two feet wider than
the roadway it serves.
[�1 2. The gates must be located at least 30 feet from the
roadway and shall open to allow a vehicle to stop
without obstructing traffic on that roadway.
lNl 3. Where a one-way road with a single traffic lane
provides entrance, a 50 foot turning radius shall be
used. <
Fuel Modification
1276.01 Setback for Structure Defensible Space.
[ ] 1. All parvels 1 acre and larger shall provide a mini-
mum 30 foot setback for buildings and accessory
buildings from iA1] property lines and/or the center
of the road.
b(] 2. For parcels less than 1 acre, local jurisdiction
�� shall provide for the same practical effect. See
Other Requirements below.
1276.02 Disposal of Vegetation and Fuels. Disposal, including
/_ chipping, burying, burning or removal to a landfill site
approved by the local jurisdiction, of flammable
vegetation and fuels caused by site development and
construction, road and driveway construction and fuel
modification shall be completed prior to completion of
road construction )r f_:ial inspection of a building
permit.
Page 2. of 3
AP #
PERMIT # NAME
Other Requirements
[ ] If Building Setback is 15 to 30 Feet:
- Class A or B roof
- Enclosed eaves
( ] If Building Setback is Less Than 15 Feet
Choose any 3 of the following:
- Metal or no doors on side toward property line with insuffi-
cient setback
- Class A or B roof with enclosed eaves
- Interior automatic sprinkler system per NFPA 13D
- Glass area not to exceed _0% of wall area toward property
line with insufficient setback
- Siding from the following list:
Stucco - 3 coat
Hardi-Board or Plank
Masonry
Masonry veneer
Metal
Other Butte County Fire Department approved materials
UtU
Date Signature
Page 3 of 3
SPACE ABOVE THIS LINE FOR RECORDER USE ONLY
NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH,
INSTALLATION ON A FOUNDATION SYSTEM
Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code
Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit
described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document
shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to
its contents to all persons thereafter dealing with the real property.
LARRY R. SMITH
REAL PROPERTY OWNER/LESSOR
6157 ERICA DRIVE
MAILING ADDRESS
MAGALIA BUTTE CA 95954
CITY COUNTY STATE ZIP
14592 HOLMWOOD DRIVE
INSTALLATION MAILING ADDRESS, IF DIFFERENT
MAGALIA BUTTE CA 95954
CITY COUNTY STATE ZIP
SAME
UNIT OWNER (if also property owner, write "SAME")
SAME
MAILING ADDRESS
BUTTE COUNTY BUILDING DIVISION
LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY
7 COUNTY CENTER DRIVE
MAILING ADDRESS
OROVILLE BUTTE CA 95965
CITY COUNTY STATE ZIP
03-0770 530 538-7541
BUHAIbr, PERMIT NO. l TELEPHONE NUMBER
4-28-03
SIGNATURE OF LOCAL AGENCY OFFICIAL DATE
EXECUTIVE HOMES
DEALER NAME (if not a dealer sale, write "NONE")
92081
DEALER LICENSE NO.
CITY COUNTY STATE ZIP
UNIT DESCRIPTION
FLEETWOOD 2002 ANNIVERSARY / 4563B
MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAT'IFJNIJP'B3ER
LENGTH X WIDTH INSIGNLVLABEL NUMEER(S)
REAL PROPERTY t EGAL DES RIPTION ASSESSOR'S PARCEL NUMBER AP # 065-190-048
SEE ATTACHED
— V HCD FORM 433(A) REV. 8/91
WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD -Building Dept.
RECORDING. REQUESTED BY:
2 0 0 3-12!�
7 9
Recorded
I REC FEE 10.00
Official Records
I COPIES 2,50
County Of
I
BUTTE
I
CANDACE J. GRUBBS
I
AND WHEN RECORDED MAIL TO:
Recorder
I
ROSEMARY DICKSON
I
Assistant
I Alyce
BUTTE COUNTY BUILDING DIVISION
02:54PM 29 -Apr -2003
I Page 1 of 2
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
SPACE ABOVE THIS LINE FOR RECORDER USE ONLY
NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH,
INSTALLATION ON A FOUNDATION SYSTEM
Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code
Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit
described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document
shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to
its contents to all persons thereafter dealing with the real property.
LARRY R. SMITH
REAL PROPERTY OWNER/LESSOR
6157 ERICA DRIVE
MAILING ADDRESS
MAGALIA BUTTE CA 95954
CITY COUNTY STATE ZIP
14592 HOLMWOOD DRIVE
INSTALLATION MAILING ADDRESS, IF DIFFERENT
MAGALIA BUTTE CA 95954
CITY COUNTY STATE ZIP
SAME
UNIT OWNER (if also property owner, write "SAME")
SAME
MAILING ADDRESS
BUTTE COUNTY BUILDING DIVISION
LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY
7 COUNTY CENTER DRIVE
MAILING ADDRESS
OROVILLE BUTTE CA 95965
CITY COUNTY STATE ZIP
03-0770 530 538-7541
BUHAIbr, PERMIT NO. l TELEPHONE NUMBER
4-28-03
SIGNATURE OF LOCAL AGENCY OFFICIAL DATE
EXECUTIVE HOMES
DEALER NAME (if not a dealer sale, write "NONE")
92081
DEALER LICENSE NO.
CITY COUNTY STATE ZIP
UNIT DESCRIPTION
FLEETWOOD 2002 ANNIVERSARY / 4563B
MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAT'IFJNIJP'B3ER
LENGTH X WIDTH INSIGNLVLABEL NUMEER(S)
REAL PROPERTY t EGAL DES RIPTION ASSESSOR'S PARCEL NUMBER AP # 065-190-048
SEE ATTACHED
— V HCD FORM 433(A) REV. 8/91
WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD -Building Dept.
BUILDING PERMIT NUMBER: 03-0770
Address or location of unit: 14592 HOLMWOOD DR., MAGALIA CA 95954
Legal Description of Real Property: AP # 065-190-048
SEE ATTACHED
(x) Mobilehome/Manufactured Home
() Commercial Coach
Has been affixed to the real property above by installation on a foundation system
pursuant to Health and Safety Code Section 18551.
Owner's name: LARRY R. SMITH
Owner's address: 6157 ERICA DR., MAGALIA CA 95954
INSIGNIA OR HUD NUMBER: APS0795816
SERIAL NUMBER OR V.I.N.: CAFL 217 A/B 26158-AV12
MANUFACTURER'S NAME: FLEETWOOD YEAR: 2002
OFFICIAL APPROVING INSTALLATION:(�,> /
DATE: 4-28-03
PHONE: (530) 538-7541
H.C.D. 513C
LEGAL DESCRIPTION
A.P.# 065-190-048
All that certain real property situate in the County of Butte, State of California, described as follows:
THE NORTHERLY ONE HALF OF THE FOLLOWING DESCRIBED PARCEL OF LAND; LOT
426, AS SHOWN ON THAT CERTAIN MAP ENTITLED "FIR HAVEN SUBDIVISION",
WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF
BUTTE, STATE OF CALIFORNIA, MAY 19, 1955 IN BOOK 21 OF MAPS AT PAGES 31, 32,
33, 34, AND 35.
LEGAL DESCRIPTION
A.P. # 065-190-048
All that certain real property situate in the County of Butte, State of California, described as follows:
THE NORTHERLY ONE HALF OF THE FOLLOWING DESCRIBED PARCEL OF LAND; LOT
426, AS SHOWN ON THAT CERTAIN MAP ENTITLED "FIR HAVEN SUBDIVISION",
WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF
BUTTE, STATE OF CALIFORNIA, MAY 19, 1955 IN BOOK 21 OF MAPS AT PAGES 31, 32,
33, 34, AND 35.
FILE No . 378 02/26 '03 P.M 04:47 1 D :EXECUTIVE HOMES FAX : 530 891 8753 PAGE 2
L444Y. ItT
STATE OF CALIFORNIA t' NUMBER: : ~ 6L
I 'BUSINESS, TRANSPORTATION AND HOUSING AGE
DEPARTMENT OF HOU81NO AND COMMUNITY DEVELOPMENT
® DIVISION OF COOPS AND STANDARDS8697368
MANUFACTURED HOUSING PROGRAM
"°fv� MANUFACTURER CERTIFICATE OF ORIPIN
RECHECK IF THIS IB A DUPLI ATE MCO -ENTER ORIGINAL MCO NO.
UFACTURED HOME OR M! IL71-I IN!T maw IlrA =.0RED
HOUSING
NUMBER OF 2
SFO (SINGLE FAMILY DWELLING) ❑ MUMH (MULTI -UNIT MANUFACTURED HOUSING TRANSPORTABLE SECTIONS
COMMERCIAL COACH: .�
OCCUPANCY GROUP
MANUFACTURER NAME:
FLEETWOOD HOMES OF CALIFORNIA, INC. MANUFACTURER LICENSE NUMBER:
9534
PO SOX 1308 WOODLAND CA 95776 SUOGESTEDRETAILPRICE:
street 1
MANUFACTURER TRADE NAME: CII - t Stele
(ZIP)
MOUEL NAME AND/OR NU RER: GATE OF MANUFACTURE:
ANNIVERSARY 4563B 2003 12/11/2002
NABJCURYrY j�((1(F_HNII a EFT NSFERRED TO):
crn 1ivCC
CALIF. DEALER NUMBER OR
DATE OF TRANSFER:
DSAI EXECUTIVE HOMES
TRANSFEREE DESIGNATION:
92081
12/11/2002
DEALER OR TRANSFEREE ADDRESS: '
3042 ESPLANADE
(Street)
CHICO
CA
95973
INVENTORY CREDITOR NAME
(CIN)
(State)
(Zip)
BOMBARDIER CAPITAL INC
INVENTORY CREDITOR ADDRESS:
261 MOUNTAIN VIEW DR
Street
COLCHESTER
VT
05446
CII
(ZIP)
SECTION MANUFACTURER smAL NUMBER
1a
HCO INSIGNIA OR NW LABEL NUMBER
LENGII1
INCHES
WIDTII WE10HT
INCHES POUNDS
1 CAFL217A26158-AV12
PF80795815
672
160 28,600
2 CAFL217826158-AV12
FFS0795816
.
672
160 23,300
TRANSPORTER NAME:
D� rs R TRANSPORT 1
TRANBPORTERADDRE88:
P: -O. BOX 179 DURHAM
91ree1C1, CJ1 2 95939
tltete
OEBTINA'f ION FOR UNIT DESCRIBED ABOVE:
NAME 91ro6I
Cb State'. ZI
I certify under penalty of perjury under the Iowa of the Biele of CYllfornle (het the above tact@ are bus n.d aorrenl. 'IM�
12/11/2002 WOODLAND YOLO
Executed on al
(Dais) .. (01 'Y) CA
) (County) (stele)
SIGNATURE OF AUT140RIZEU AGENT: -
AIBTRIRU910N: ORIGINAL (PINKI FORWAR T r14E INVENTORY CREDITOR. UNLESS THSRB IS NONE, THEN FORWARD TO 411E PURCHASER (DEALER OR'TRANSFEREE)•
COPY 1 (WHITE) FORWAq T THE DEPARTMENT AT P.O. BOX 1020. SACRAMENTO, CA 94812-1828. WITHIN FIVE (0) OAYB OF RELEASE.
COPY 2 (YELLOW) DF.I.IVP,R THE TRANSPORTER TO ACCOMPANY THF. UNIT' T01'1'B DESTINATION.
COPY 3 (GOLDENROD) TO RP- RETAINED BY THE MANUFACTURCR.
HCD 483.0 - Side 1 • (7/07)
W,5121103 11:28
B I DWELI., j.I TLE 4 530 891 8753
RECORDING REQUESTEb BY:
Fidelity National Title Company of
'Caftrnia
Escrow No. 3044664ML13
Title Order No. 00304466
When Recorded Mail Document
and Tax Statement To:
Mr. Larry R. Smith
6167 Erica Drive
Paradise, CA 96969
GRANT DEED
' N0.821 P002
go Z3
1111!l1111lIIlJ1�l!l1111lIJ1l11p.
Recorded
official Ret:ard5 11 RX.FFJE
1®•00
Coeni;yEOf 78
CRNI)ACE JI.� BRUM j
ROSEMARY b1CH&W I
11:24AMi�ant I PP�tel1 of 2
web -2003
The undersigned grantor(s) declare(s)
bocurnentary transfer tax Is $18.70
( X ! computed on full value of property conveyed, or
] computed on full value less value of liens or encumbrances remaining at time of sale,
i Unincorporated Area City of /unincorporated area
FOR A VALUABLE CONSIDERATION, raeeipt of which Is hereby acknowledged, Alan S. Gates
of The Gates Family Trust dated 08/07/96, as to a undivided 100% interest .Successor Trustee
hereby GRANT(S) to Larry R. Smith, An Unmarried'Man
the following describad real property in the City of /unincorporated area
County of Butte, State of California:
SEE EXHIBIT ONE ATTACHED HERETO AND MADE A PART HEREOF
DATED: January 28, 2003
STATE OF G,r4W{ RN; ., LrT-p }}
COUNTY OF SAtj"r gky-i✓
ON �111Vva 3D0
before
ers pally appeared
r" SATS
gsrsbnaRy known to me (or proved to me on the basis
:of satisfactory evidence) to be the person($) whose
name(s) is%are subscribed to the within instrument and
acknowledged to me that he/she/they executed the
same in his/her/thelr authorized capacity(les), and that
by his/her/their signature(s) on the instrument the
Person(s), or the entity upon behalf of which the
person(s) acted, executed the instrument.
Witness my hand and official seal.
Signature
Alan S. Gates, Successor Trustee of The Gates Family
Tru d ad 08 7/
Alan S. Gates, Tru e
NOTARY 011 wo
j JOHN DRUMMOND I
+ $00 goo East f
84x70
1� MY Cammkslon..y �.ea-_D`ae. t64 2006
FD-2MAIL TAX STATEMENTS AS DiRECTEA ABOVE
13 1pov 7/9st
onnwT o�co
W-5/21/03 11:29
I -
! E6craw No. 304468•MLO
Title Ordor NO, 00304469
B I DWELiUi,..11 TLE � 530 891 8753
I.
EXHIBIT ONE
NO.821 P003
The Northerly fine -half of the following described parcel of land:
Lot 426, as shown on that certain Map entitled, "FIR HAVEN SUBDIVISION", filed in the Office of the County Recorder
of Butte County, California, on MAY 19, 1955, in Book 21, of Maps, at Page(s) 31, 32, 33, 34 & 35.
EXCEPTIN G THEREFROM all the valuable minerals beneath the surface of said lands, with the right to mine and extract
said minerals, it being understood and agreed that in all mining operations the surface of sold lands will be protected
against damage, and that all such mining shall be carried on from tunnels, shafts or drifts having their orifices outside
of the surface area of the above described realty, all es excepted and reserved in the Deed from the Magalia Mining
Company, a Corporation, to E.d. Starts, at ux, recorded September 4, 1947, in Book 423, Page 385, Official Records
of Butte County.
SECURITY MOBILE ROME SHOW/NORTH, INC.
EXECUTIVE HOMES
3042 ESPLANADE PH. 530-891-6992
O CA 95973
PAY
TO THE —#tel , _� (L,,
ORDER OF i 0—`�-
22967
'l-421'4095
1210
Wells Fargo Bank, N.A: _ DOLLARS LJ
California
° www.welisfargo.com
FOR
0 2 291; 7 e -+-1 �
. � 2 10 4 288 2�:0 b 700 7 600 411'
NAME:
AN:
DATE:
A'
J
COPY of Document Recorded
AND WHEN RECORDED MAIL TO:. 09 -Apr -2803 2003-0022220
BUTTE COUNTY BUILDING DIVISION Hae not been compared with
7 COUNTY CENTER DRIVE original
OROVILLE, CA 95965
BUTTE 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
pen -nit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes,
and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals,
including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations
including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm
operations.
All that real property situate in the County of Butte, State of California, described as follows:
The Northerly one-half of the following described parcel of land:
Lot 426, as shown on that certain Map entitled, "FIR HAVEN SUBDIVISION", filed in the Office of the County Recorder of
Butte County, California, on MAY 19, 1955, in Book 21, of Maps, at Page(s) 31, 32, 33, 34 & 35.
EXCEPTING THEREFROM all the valuable minerals beneath the surface of said lands, with the right to mine and extract said
minerals, it being understood and agreed that in all mining operations the surface of said lands will be protected against
damage, and that all such mining shall be carried on from tunnels, shafts or drifts having their orifices outside of the surface
area of the above described realty, all as excepted and reserved in the Deed from the Magalia Mining Company, a Corporation,
to E. d. Starts, et ux, recorded September 4, 1947, in Book 423, Page 385, Official Records of Butte County.
Date , p c PROPERTY OWNERS:
Aark R. Sn�, /A
Statc of Ca ' or► y )
County of , ;(� )
On Oberch W� before me,/'(1�� lCl J0hvlsx,� ` - bNiAJb1 'G
personally appeared "-` � ��y(�] , m ,-Tk .-ie— personally
known to me (or proved to me on he basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized
capacity(ies), and that by his/leer/their signature(s) on the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
CYNTHIA JOHNSON
Signature COMM. 11335942
L� m• NOTARY PU
Seal: COUNTY OF BUTTEu
Comm. Expires Dec. 22.2005
A.P.# 046--/46
AZO
03°