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HomeMy WebLinkAbout065-360-057AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE oROVILLE. CA 95965 eG06:)1V of Document Recorded 02 -Dec -2004 2004-0073717 Has not been compared with original 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 permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or .discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Date 10/2.6/04 PROPERTY OWNERS: Gapineri & Vairo Investments, a Galifornia General Partnership Bv A Gale apineri Michael VAiro State of California County of i, -:>,Ab__ On before '� ._`t before me, personally appeared .,_i_< ; L �`� e: �\ ; c`t ._'• t�-1 0 .1 t:.t personally known to me (or proved to me on the 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/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the persons) acted, executed the instrument. WITNESS my ha ind-a-n-d-qfficial seal. _tip r L. BOMAN Signature - Seal: Comm. #1341474 _ A.P. # 065-360-057 `'� NOTARY PUBLIC CALIFORNIA Q 0 BUTTE COUNTY -i My Commission Expires Jan. 27, 2006 EXHIBIT "A" THE LAND REFERRED TO HEREIN. BELOW IS SITUATED UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF' CALIFORNIA AND IS DESCRIBED AS FOLLOWS: Lot 283, as shown on that certain Map entitled, "Sierra Del Oro Estates Unit No. 4", filed in the Office of the County Recorder of Butte County, California, on September 29, 1969, in. Book 35, of Maps, at Page(s) 48, 49 and 50. Excepting and reserving therefrom all valuable minerals beneath the.surface of the said lands, with the right to mine and extract said minerals, it being agreed -and understood 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 the surface area of the above described realty, all as excepted and reserved in that certain Deed from the Maaalia Mining Company, a corporation to E. D.. Stbrts, et ux, recorded September 4, 1947, in Book 423, Page 385, of Official Records., AUG ' 9 290 SITE PLAN REVIEW APPLICATION Date: Permit Number (if applicable) Bin Number APPLICANT INFORMATIONParcel Size: YVI,/Um • �� 2 Owners Name: 0/�/'/L�c . 1 -4— UIEIQ �--°1` Vi E -G A Owners Address: Telephone No.: Situs Address: iltJ'4JE/ Proposed Use: Re dential New Single Family Residential -! ❑ Single Family Addition Mobile Homey o �- 2g6 l k4� V ^_,`�'' ® Residential Accessory --7 0+ 2g6Z k7t ❑Permanent Second Dwelling (o -Z6- 1&tM ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition ®thy gil" Septic ❑ Agricultural Exempt Building ❑ Other: Biief Explanation (if necessary): ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel Well ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A DO NOT WRITE BELOW THIS LINE L rr�in p Yf 7�rT �CFT� T/YC 'c 1nrF0FJ±ATTf)?V (T2r ,Ctaff Tkg) ® Approved 17 Conditionally Approved ❑ Resolve Problems Prior to Approval ,a, -ndt-q Si Ian �S-tta",pedd pproved BY \ J Date Page 1 of 5 ALTJ ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: Snow Load Area:-?S00i = zz r ❑ 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: ?C • Flood Panel No.: _06007111-,OcleoC Index Date: 6 - bO -e' (ey ❑ 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/Mulbeny (See attached standards and requirements)- - C6hasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) ❑ Oroville Enterprise Zone Use Requires: ❑ Use Pen -nit ❑❑ Minor Use Permit ❑ ❑Administrative Permit Minor Variance Variance -------------------------- ------------------------------------------------ ------------------------------------ ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: qT" 1 &hR Applicable Building Setbacks: Front Zoning Code Streets & Highways /Fire Prevention Side' t I Side Street 1 Rear Height ` 'v'v aterway I iv/A N/A \ N/A vision Map ❑ Setbacks drawn on site Plan.Uk CDF approval needed for ne cr-oach�ents into SRA setbacks. C, E o K Page 2 of 5 Applicable Development Fees: Standard Fees Amount Formula ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thennalito Drainage Area ❑ Thermalito Urban Area ❑ Other Subdivision Map Special Fees ❑ Water Tender . ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time the building permit. Parcel Created By ❑ Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Ye Deed of Reference: Legal Access Required ❑ No ❑ Ye Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance/Notice of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 Subdivision Map/Parcel Map: Si (. GE.2v Map Date of Recording:rP°r Lot: Book: 3 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: ❑ Attached ❑ None El 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 131), unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. ❑ Page 4 of 5 0 x a - - - — - Summary -of -Specific Requirements:- -- - -- - ---- - -- This information provided in this summary is based on the application information and on the best available data at the time of review. C:ILarrys\Building Permit Site Plan Reviewl.doc Page 5 of 5 0 fib- BUTTE COUNTY PUBLIC HEALTH DEPARTMENT P. O. BOX 5364 Division Of Environmental Health 411 Main Street�uTrF° 7 County Center Drive Chico, CA 95928 Oroville, CA 95965 (530) 891-2727'Y-te (530) 538-7281 FAX (530) 895-6512 �o�q<�° FAX (530) 538-7785 APPLICATION FOR PERMIT TO. CONSTRUCT A SEWAGE DISPOSAL SYSTEM Owner's Name' !`-q Ij� Assessor's Parcel No. ry: Applicant's Name 4, /\4( tPhone No.�`���` Mailing Address �, `� , ,� 6 r t 1. Construct lorii S� 3 Tb'1,� �. s Pean num a or Ire on an Is nce neares crossroa 2. Lot Size 17-7—L�feet x feet Acres a }� 3. APPLICATION FOR: ` New system for new building ❑ Auxiliary or secondary system ❑ Repair of or addition to old system ❑ New system to replace existing facilities Type of building to be served by proposed system: 2"'MHome (size 6 �7, ) No. Bedrooms El House No. Bedrooms ❑ Other (Specify) 5. Water supply for premises: (Must be safe, potable water) Water supply for adjoining properties: 6. WORKER'S COMPENSATION INSURANCE 7 Garbage Disposal? Garbage Disposal? Community ®`Private Well ❑ Other Community Derivate Well ❑ Other I am aware of thens of Section 3700 of the California Labor Code, which requires every employer to be insured against liability for=,s Compensation. ❑ 1 have placed on file with the County of Butte a Certification of Worker'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 be subject to the Worker's Compensation Laws of California. FURNISHED - Draw to scale on site plan the following: a. Property lines. e. Show direction and approximate amount of slope. b. Location of all proposed and existing buildings, f. Source of water. Structures, driveways and parking area. g. Water lines. c. Location of large trees, rocks, or other obstacles. h. Set back lines and easement. d. Location of any well, spring, creek or other body I. Proposed sewage disposal system and area for of water on the,parcel and within 100 feet of property line. replacement. I hereby state that the information above or attached hereto is correct and true to the best of my knowledge. I understand that the permit must be obtained before any construction is begun either on the building or on the sewage disposal system, and that a satisfactory inspection of the system is required before the new building or dwelling -may be occupied or the system backfille%+ nor p;.,t i^to use. 1 also understand that a safe potable water must be supplied to the new;bu7ilid,n3go dwelling before occupancy can take place. PPSigned 2 Owner 2 ----Authorized Agent ❑ Licensed Contractor ❑ Date �"'—�" t A (An original letter of authorization must accompany this application f In order for an authorized agent to sign). Le al parcel? FOR ®FFICE USE ONLY 9 P Zoning Use permitted? Acc. Nater plans cleared Potable water Receipt No. (r /� % Amount_ L . s s �omment T 1pp/SewDisposal Sys/11 /2003 BUTTE COUNTY A U tri 0 5 200It, C IC , CALIFORNIA AGRICULTURAL BUFFER NOTIFICATION AND/OR UNUSUAL CIRCUMSTANCES REQUEST Butte County requires a 300 foot buffer between neighboring agricultural operations and a residence, This dimension is based on environmental assessments and studies. The Agricultural Commissioner may identify unusual circumstances where the 300 foot buffer cannot be met on existing parcels, This exception is not available for lots being created, divided or subdivided. Owner or Authorized Agent must complete the following and return witil the requirod site plan to: Development Services Department, 7 County Center Drive, Oroville, CA (530) 538-7601 Name: -M - - ( - - - - . h/f� ailing Address:t E -Mail address Assessor's Parcel Number: C� � ��--31� 0 _0y - _. Reason you believe you qualify for the unusual circumstances exception: thorized Agent's signature Elate UNUSUAL CIRCUMSTANCES DEFINITION: An exceptional or extraordinary condition where the existing lot size or shape or an eXIsting improvdment (well, septic systems, structures etc.) does not allow for the standard condition of a 300 -foot buffer zone. SITE PLAN REQUIREMENT: submit 4 copies with this form Refer to the Site Plan Submittal handout for specific requirements ................................................................................................................................................ Internal Dept. Contact Info; 0 Env, Health ❑ Planning Building [I Other _ Contact Person: phone: - _ FORWARD THIS FORM TO LARRY IN DEVELOPMENT SERVICES FOR PROCESSING For Agricultural Commissloner offira use only; (to be completed after submittal) DISCRETIONARY PERMITS (Planning) MINISTERIAL PERMITS (Buildlnq) j Exceptlon recommended LJ Ei:ception Granted with the [� Exception NOT Recommended following conditions: Reason/Conditions/Specific setbacks from adjacent agricultural operations: Agricultural Department Signature: iG'-1 ROS2J 7J 52 GOC 7iu. -- .. -.. , pate: YMC 7/1/03 81����� i� N�t m��i 8� �" V �i i a'"�tia g�ti��= � � ���`• � � �M�s�'����"v{ sr` fl�oy��� �SA n��v���r zi Manl S � �� � ? . �3ogaa�{:y �� i. �•} �'�RM�� ��+�? 7s �' z N�',`ao��A,�$���p8���9 L�Y.r �� m e • i x><,I$ ��'� k o£m'$�.' `� ,y�<�R3���a'<8a f�A�z. 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SPECIAL INSPECTION ITEMS _ VERIFY CHECKED BY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER -OFFICE COPY Address I GAS D,z� �+ Mete y EooT Datl er By JOB FINALED (Date) i 05 Signature 0 = Not OK N01Reativable 8. MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 3. 1. Zoning Requirements -Setbacks -Easements Elec.; Receptacles and Lighting, Distance-GFI 2. Soils; Special MH Support Sketch Card B-1 Date Card B-1 3. Sewer; Location -Test -Fall -C/O -Concrete Card B-1 Date Card B-1 4. Water; Location -Test -Easement Needed (Sketch) 9. 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete Plumb.; Cir. Test -Water Supply Test 6. Gas; Location -Test-Wrap;-/ /" L 'ft. / P Nat. or / /" L "ft./ P LPG 12. 7. Well Clearance & Disconnect MISCELLANEOUS Date -DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s L_-Zi5-nbgRequirements-Setbacks-Easements noting ; Soils Size -Depth -Spacing -Connectors -Steel 3. DeckgGirders and/or Joists -Decking -Bracing -Stairs -Rails 4. - od Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carp, §; Windows -D> rs 7. rfectric- _ , ung.; Sills-iK�ichors-Studs'Rftrs-Trusses L.G�;�� -/ Siding; Nailing;Veneer-Stucco-_Mesh _ Roof; Shtiq=Roofing iii Wall Panels Date ✓ Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 8. Utility Clearance 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI Date Elec.; Pool Lighting; 15 Volts-GFI Card B-1 Date Card B-1 Date 7. Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 9. 1. Zoning Requirements -Setbacks -Easements Plumb.; Cir. Test -Water Supply Test 2. Footings; Size -Spacing -Marriage Line 12. 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date -DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s L_-Zi5-nbgRequirements-Setbacks-Easements noting ; Soils Size -Depth -Spacing -Connectors -Steel 3. DeckgGirders and/or Joists -Decking -Bracing -Stairs -Rails 4. - od Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carp, §; Windows -D> rs 7. rfectric- _ , ung.; Sills-iK�ichors-Studs'Rftrs-Trusses L.G�;�� -/ Siding; Nailing;Veneer-Stucco-_Mesh _ Roof; Shtiq=Roofing iii 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- Enc losures- Panel boards- 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 ,1=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL, (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel- Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 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 72. Elec. Outlets at Wood Panel, Int. & Ext. Date 73. Card B-1 Date Card B-1 Date 74. Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Garage Fire Door; Swing -Landing -Closure 24. Fixture & Transformer Clearance -Ins. Protection A.C. Duct in Garage -Damper 25. Elec. Receptacles Spacing -Lights & Switches at Doors Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 26. Size Boxes & No. of Conductors Stapled Plb.; Elec. & Mech. Equip. Listed for Location 27. Romex Installed Close to Edge of Studs & C.J. Elec. Receptacles in Garage (F.FI.)-Romex Protection 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Insulation -Foam -Looked in Attic 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI Guard Rails & Deck Construction -Post Caps 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes U No Clearance Looked under Floor ❑ Yes 32. Service -Riser Conductors & Ground Main Disconnect Following Instld./Drive O Yes O No/Walks O Yes ❑ No/Planters O Yes O No 33. Equip. Clearances Panels-Motors-Mech. Equip. Stucco Brown -Finish 34. Clothes Closet Light -Shower Light -Spa Light A.C. Unit Disconnect, Electrical -Plumbing 35. Smoke Detector Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 90. 36. A.C. Ducts Insulation & Support 91. 37. Vent Fan, Exhaust above insulation 92. 38. Condensate Drain & Overflow, Size & Grade 93. 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 94. 40. Attic Access & Platform if Furnace in Attic Date Address Posted Card B-1 Date Card B-1 Date Fire Sprinkler Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Date 41. Sills Proper Materials & Anchors Date 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound Comments at Final: 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 `w 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.FI.)-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 ❑ No/Planters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: 'n FRNH -vomic-A FAX TO !670 SZS 4366 1990,10-30 10:17pm #001 P.01/01 —I ' OACY4MENT PIERMIT ENCR Cc)unty of. Butte Dep art Of J)Ublic WOrks ?Count Center CA 95965 Dopficineutt000li(530) 539-71-57 lixt.2016 Fax: 030) 539-4356 miload FDrms'www.bntY,ne�t/put-illoworkSIfOrnis-btlflI jq6T—fFy"��UN-11'24 HOURS aFsF'01(l'- w phone (S-10) 538,7157 EXt. fis -'ro BE DON 19 APPLICATION to da �foliomug work OD&Z or over 's I a Qmtwy N gml- 11�1 �'A 19 — , r *r It , . " - ` 4 c� j ?d C TS Ac&tion of work to. DODO cL215 L -Mao NVO-RMATION CONTRACTOR'S I eflcL 5., f U -SF 11. Fax., 00 C) TID yes V4 :NO: AudhOMM A9011V) c YPE OF WORK TO BY, ONE p{ SeCiitxk: T ffv�'V� By M Typt: > curb: naM7rd' L ) No k-1 so DTW—, 19, rimns A pIrItMIT GRANYED W -Wg— TnIaGivn is 27 mm,daQi _gr'lilt work shall conform W ac*')mpanying: Detail Of plans Sptzj&j Collditions pato Oaewtf CZ - -42�z- 2 U16jit Plld.7F 6rc--- D c� N I iD, aVvD )3y: 1�e -crump, Dirooter of FU omp OK 29. Final MOMiOn DOC: Inn4ct Y: AM CWnty :Onlr-commejots: edu tit wc'a ;.-n—fib b ff'T'56, lltc� C41% he de' y P b-, Ifpermlis te fmod to RDY MIMbc' Is' cvWllleiid -Not Oy- , "'-W j,---- .00ATION: DATE: '� l EDGE OF EXISTING PAVEMENT (EP) T• k� 'OREMAN: MIN. DISTANCE: )!STRICT: _ -------------- _ 'ERM1Tm: • -------------- SPEED LUIT OF ROADWAY 3 DRIVEWAY LOCATION:,_ DISTANCE TO NEAREST INTERSECTION: z w J 12' MIN. AREA SIGHT DISTANCE 2I' MAX_ GO00 TO 8E ❑ POOR PAVED IF POOR - RECOMMENDATION TO IMPROVE: R/W ❑ CUT BANK ❑ REMOVE VEGETATION (TEMPORARY) - - ❑ OTHER (EXPLAIN) 10' MIN. ADJACENT TOPO �•FFAT ❑ CUT SLOPE FT. ❑ FILL SLOPE FT. • 1 ❑ CURB AND GUTTER _ ❑ AC DIKE NOTE: ❑ EXIST. DIST. I TO EP FT. tF GREATER THAN 107. UP* OR DOWN DRAINAGE RECOMMENDATIONS. REFER TO ENGINEERING. ❑ NONE ❑ Sw�E IULVERT MAX. 1 FOOT VERT. RISE -OR DROP PER 10 FEET HORIZ. DISTANCE - , MIN. DIST. FT. MIN. DEPTH TO FT. EP DIAMETER J LENGTH FT. EXIST. DIST. MIN. DIST. I ❑ OTHER (EXPLAIN) I 2% I NOTE: PAVEMENT TO EXTEND AT j% C.RDS SLQP� _ OR MATCH EXISTING ROADWAY CROSS MIN. DEPTH KT.B. UAX 109; PRIVATE DRIVEWAY FIELD REVIEW RECORDING-REQC�C, STED BY: _ 1 AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 Recorded Official Records County Of BUTTE CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 11:28AN 07—Apr-2005 7- ' � I/%I "moi REC FEE 10.00 CONFORM 1.00 COPIES 2.50 Kathy Page 1 of 2 SPACE A13OVE 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. CAPINERI AND VAIRO INVESTMENTS REAL PROPERTY OWNER/LESSOR 6272 VIRGINIA WAY MAILING ADDRESS PARADISE BUTTE CA. 95969 CITY COUNTY STATE ZIP 14844 CRESCENT WAY INSTALLATION MAILING ADDRESS, IF DIFFERENT MAGALIA BUTTE CA. 95954 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also propeny owner, write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE "ZIP 04-2861 530 538-7541 BUIL INL PERMIT NO, TELEPHONE NUMBER/ 05— (GN URE OF LOCAL AG VY OFFICIAL U TE NONE DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO. ANDREW KARSTEN CO 2004 KS52001F MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMB/NUMBER KCCAOI J32074A/B 52'X 27' RAD 1413861/2 SERIAL NUMBER(S) LENG-HI X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIP'T'ION SEE ATTACHED ASSESSOR'S PARCEL NUMBER 065-360-057 HCD FORM 433(A) REV. 8/91 WRITE - County Recorder CANARY - IiCD PINK- Applicant GOLDENROD - Building Dept. Escrow -No.: 04 -307267 -MB Locate No.: CAFNT0958-0958-0003-0000307267 Title No.: 04-307267 EXHIBIT "A" THE LAND REFERRED TO HEREIN BELOW IS SITUATED UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF' CALIFORNIA AND IS DESCRIBED AS FOLLOWS: Lot 283, as shown on that certain Map entitled, "Sierra Del Oro Estates Unit No. 4", filed in the Office of the County Recorder of Butte County, California, on September 29, 1969, in. Book 35, of Maps, at Page(s) 48, 49 and 50. Excepting and reserving therefrom all valuable minerals beneath the surface of the said lands, with the right to mine and extract said minerals, it being agreed and understood 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 the surface area of the above described realty, all as excepted and reserved in that certain Deed from the M,agalia Mining Company, a corporation to E. D. Storts, et ux, recorded September 4, 1947, in Book 423, Page 385, of Official Records. r RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 07 -Apr -2005 2005-0019509 Has not been compared with original BUTTE COUNTY RECORDER SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. CAPINERl AND VAIRO INVESTMENTS REAL PROPERTY OWNEPULESSOR 6272 VIRGINIA WAY MAILING ADDRESS PARADISE BUTTE CA. 95969 CITY COUNTY STATE ZIP 14844 CRESCENT WAY INSTALLATION MAILING ADDRESS, IF DIFFERENT MAGALIA BUTTE CA. 95954 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 04-2861 530 538-7541 BUILDING PERMIT NO. TELEPHONE ER /� `)j^ iGN URE OF LOCAL AGEVY OFFICIAL D&E NONE DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO. ANDREW KARSTEN CO 2004 KS52001F MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER KCCAO1J32074A/B 52'X 27' RAD1413861/2 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER 065-360-057 HCD FORM 433(A) REV. 8/91 WHITF - County Recorder CANARY - HCD PINK - Aoolicant GOLDENROD - Buildine Deot. BUILDING PERMIT NUMBER: 04-2861 Address or location of unit: 14844 CRESCENT WAY, MAGALIA, CA. 95954 Legal Description of Real Property: AP#: 065-360-057 SEE ATTACHED (x) Mobilehome/Manufactured Home O 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: CAPINERI & VAIRO INVESTMENTS Owner's address: 6272 VIRGINIA WAY, PARADISE, CA. 95969 INSIGNIA OR HUD NUMBER: RAD1413861/2 SERIAL NUMBER OR V.I.N.: KCCAO1K32074A/B MANUFACTURER'S NAME: ANDREW KARSTEN CO. YEAR: 2004 OFFICIAL APPROVING INSTALLATION: A �` R f DATE:� PHONE: (530) 538-7541 H.C.D. 513C M RECORDING REQUESTED BY: Fidelity National Title Company of California Escrow No.: 04 -307267 -MB Locate No.: CAFNT0958-0958-0003-0000307267 Title No.: 04-307267 When Recorded Mail Document To: Charlotte Lytton & George Losada 14848 Crescent Drive Magalia, CA 95954 APN: 065-3(�0 057 ®® SH ORT FORM loo 4 - cbL4'3:� 4�p SPACE ABOVE THIS LINE FOR RECORDER'S USE DEED OF TRUST AND ASSIGNMENT OF RENTS THIS DEED OF TRUST, made 3uly 15, 2004 , between Capineri & Vairo Investments, a California General Partnership herein called TRUSTOR, whose address is 6272 Virginia Way Paradise, CA 95969, Fidelity National Title Company of California, a California corporation, herein called TRUSTEE, and Charlotte Lytton, an unmarried woman and George Losada, an unmarried man, as joint tenants herein called BENEFICIARY, WITNESSETH: That Trustor IRREVOCABLY GRANTS, TRANSFERS AND ASSIGNS to TRUSTEE IN TRUST, WITH POWER OF SALE, that.property in Butte County, California, described as: SEE EXHIBIT "A" ATTACHED ,HERETO AND MADE A PART HEREOF "THE BENEFICIARY HEREIN, PROVIDED THAT AN UNRESCINDED NOTICE OF DEFAULT UNDER THE TERMS HEREOF DOES NOT APPEAR OF RECORD, AGREES TO SUBORDINATE THIS DEED OF TRUST TO A FUTURE LOAN NOT TO EXCEED $195,000.00 FOR THE PURPOSE OF CONTRUCTION OF A SINGLE FAMILY RESIDENCE." Anything herein to the contrary notwithstanding, in the event of a voluntary sale, transfer or conveyance of all or any portion of the property described herein, any indebtedness or obligation due under the Note secured hereby, shall at the option of the holder hereof, immediately become due and payable. TOGETHER WITH the rents, issues and profits thereof, SUBJECT, HOWEVER, to the right, power and authority given to and conferred upon Beneficiary by paragraph .(10) of the provisions incorporated herein by reference to collect and apply such rents, issues and profits. For the Purpose of Securing: 1. Performance of each agreement of Trustor incorporated by reference or contained herein. 2. Payment of the indebtedness evidenced by one Promissory Note of even date herewith, and any extension or renewal thereof, in the principal sum of $55,000.00 executed by Trustor in favor of Beneficiary or order. 3. Payment of such further sums as the then record owner of said property hereafter may borrow from Beneficiary, when evidenced by another note (or notes) reciting it is so secured. INITIALS: /" 1 FD -221C (Rev. 9/94) SHORT FORM DEED OF TRUST WITH ACCELERATION Page 1 of 4 (deedofta)(09-03) APN: 065-360-057 DO NOT RECORD The following is a copy of provisions (1) to (14), inclusive, of the fictitious deed of trust, recorded in each county in California, as stated in the foregoing Deed of Trust and incorporated by reference in said Deed of Trust as being a part thereof as if set forth at length therein. TO PROTECT THE SECURITY OF THIS DEED OF TRUST, TRUSTOR AGREES: (1) To keep said property in good condition and repair; not to remove or demolish any building thereon; to complete or restore promptly and in good and workmanlike manner any building which may be constructed, damaged or destroyed thereon and to pay when due all claims for labor performed and materials furnished therefore; to comply with all laws affecting said property or requiring any alterations or improvements to be made thereon; not to commit or permit waste thereof; not to commit, suffer or permit any act upon said property in violation of law; to cultivate, irrigate, fertilize, fumigate, prune and do all other acts which from the character or use of said property may be reasonably necessary, the specific enumerations herein not excluding the general. (2) To provide, maintain and deliver to Beneficiary fire insurance satisfactory to and with loss payable to Beneficiary. The amount collected under any fire or other insurance policy may be applied by Beneficiary upon any indebtedness secured hereby and in such order as Beneficiary may determine, or at option of Beneficiary the entire amount so collected or any part thereof may be released to Trustor. Such application or release shall not cure or waive any default or notice of default hereunder or invalidate any act done pursuant to such notice. (3) To appear in and defend any action or proceeding purporting to affect the security hereof or the rights or powers of Beneficiary or Trustee; and to pay all costs and expenses, including cost of evidence of title and attorney's fees in a reasonable sum, in any such action or proceeding in which Beneficiary or Trustee may appear, and in any suit brought by Beneficiary to foreclose this Deed. (4) To pay: at least ten days before delinquency all taxes and assessments affecting said property, including assessments on appurtenant water stock; when due, all incumbrances, charges and liens, with interest, on said property or any part thereof, which appear to be prior or superior hereto; all costs, fees and expenses of this Trust. Should Trustor fail to make any payment or to do any act as herein provided, then Beneficiary or Trustee, but without obligation so to do and without notice to or demand upon Trustor and without releasing Trustor from any obligation hereof, may: make or do the same in such manner and to such extent as either may deem necessary to protect the security hereof, Beneficiary or Trustee being authorized to enter upon said property for such purposes; appear in and defend any action or proceeding purporting to affect the security hereof or the rights or powers of Beneficiary or Trustee; pay,.purchase, contest or compromise any incumbrance, charge or lien which in the judgment of either appears to be prior or superior hereto; and, in exercising any such powers, pay necessary expenses, employ counsel and pay his reasonable fees. (5) To pay immediately and without demand all sums so expended by Beneficiary or Trustee, with interest from date of expenditure at the amount allowed by law in effect at the date hereof, and to pay for any statement provided for by law in effect at the date hereof regarding the obligation secured hereby any amount demanded by the Beneficiary not to exceed the maximum allowed by law at the time when said statement is demanded. (6) That any award of damages in connection with any condemnation for public use of or injury to said property or any part thereof is hereby assigned and shall be paid to Beneficiary who may apply or release such moneys received by him in the same manner and with the same effect as above provided for disposition of proceeds of fire or other insurance. (7) That by accepting payment of any sum secured hereby after its due date, Beneficiary does not waive his right either to require prompt payment when due of all other sums so secured or -to declare default for failure so to pay. (8) That at any time or from time to time, without liability therefore and without notice, upon written request of Beneficiary and presentation of this Deed and said note for endorsement, and without affecting the personal liability of any person for payment of the indebtedness secured hereby, Trustee may: reconvey any part of said property; consent to the making of any map or plat thereof; join in granting any easement thereon; or join in any extension agreement or any agreement subordinating the lien or charge hereof. (9) That upon written request of Beneficiary stating that all sums secured hereby have been paid, and upon surrender of this Deed and said note to Trustee for cancellation and retention and upon payment of its fees, Trustee shall reconvey, without warranty, the property then held hereunder. The recitals in such reconveyance of any matters or facts shall be conclusive proof of the truthfulness thereof. The Grantee in such reconveyance may be described as "the person or persons legally entitled thereto." Five years after issuance of such full reconveyance, Trustee may destroy said note and this Deed (unless directed in such request to retain them). (10) That as additional security, Trustor hereby gives to and confers upon Beneficiary the right, power and authority, during the continuance of these Trusts, to collect the rents, issues and profits of said property, reserving unto Trustor the right, prior to any default by Trustor in payment of any indebtedness secured hereby or in performance of any agreement hereunder., to collect and retain such rents, issues and profits as they become due and payable. Upon any such default, Beneficiary may at any time without notice, either in person, by agent, or by a receiver to be appointed by a court, and without regard to the adequacy of any security for the indebtedness hereby secured, enter upon and take possession of said property or any part thereof, in his own name sue for or otherwise collect such, rents, issues, and profits, including those past due and unpaid, and apply the same, less costs and expenses of operation and collection, including reasonable attorney's fees, upon any indebtedness secured hereby, and in such order as Beneficiary may determine. The entering upon and taking possession of said property, the collection of such rents, issues and profits and the application thereof as aforesaid, shall not cure or waive any default or notice of default hereunder or invalidate any act done pursuant to such notice. (11) That upon default by Trustor In payment of any indebtedness secured hereby or in performance of any agreement hereunder, Beneficiary may declare all sums secured hereby immediately due and payable by delivery to Trustee of written declaration of default and demand for sale and of written notice of default and of election to cause to be sold said property, which notice Trustee shall cause to be filed for record. Beneficiary also shall deposit with Trustee this Deed, said note and all documents evidencing expenditures secured hereby. INITIALS: FD -221C (Rev. 9/94) SHORT FORM DEED OF TRUST WITH ACCELERATION Page 3 of 4 (deedofta)(09-03) APN: 065-360-057 DO NOT RECORD After the lapse of such time as may then be required by law following the recordation of said notice of default, and notice of sale having been given as then required by law, Trustee, without demand on Trustor, shall sell said property at the time and place fixed by it in said notice of sale, either as a whole or in separate parcels, and in such order as it may determine, at public auction to the highest bidder for cash of lawful money of the United States, payable at time of sale. Trustee may postpone sale of all or any portion of said property by public announcement at such time and place of sale, and from time to time thereafter may postpone such sale by public announcement at the time fixed by the proceeding postponement. Trustee shall deliver to such.purc.haser its deed conveying the property so sold, but without any covenant or warranty, express or implied. The recitals in such deed of any matters or facts shall be conclusive proof of the truthfulness thereof. Any person, including Trustor, Trustee, or Beneficiary as hereinafter defined, may purchase at such sale. After deducting all costs, fees and expenses of Trustee and of this Trust, including cost of evidence of title .in connection with sale, Trustee shall apply the proceeds of sale to payment of: all sums expended under the terms hereof, not then repaid, with accrued interest at the amount allowed by law in effect at the date hereof; all other sums then secured hereby; and the remainder, if any, to the person or persons legally entitled thereto. (12) Beneficiary, or any successor in ownership of any indebtedness secured hereby, may from time to time, by instrument in writing, substitute a successor or successors to any Trustee named herein or acting hereunder, which instrument, executed by the Beneficiary and duly acknowledged and recorded in the office of the recorder of the county or counties where said property is situated, shall be conclusive proof of proper substitution of such successor Trustee or Trustees, who shall, without conveyance from the Trustee predecessor, succeed to all its title, estate, rights, powers and duties. Said instrument must contain the name of the original Trustor, Trustee and Beneficiary hereunder, the book and pages where this Deed is recorded and the name and address of the new Trustee. (13) That this Deed applies to, inures to the benefit of, and binds all parties hereto, their heirs, legatees, devisees, administrators, executors, successors and assigns. The term Beneficiary shall mean the owner and holder, including pledgees, of the note secured hereby, whether or not named as Beneficiary herein. In this Deed, whenever the context so requires, the masculine gender includes the feminine and/or neuter, and the singular number includes the plural, (14) That Trustee accepts this Trust when this Deed, duly executed and acknowledged, is made a public record as provided by law. Trustee is not obligated to notify any party hereto of pending sale under any other Deed of Trust or of any action or proceeding in which Trustor, Beneficiary or Trustee shall be a party unless brought by Trustee. INITIALS fit_/ REQUEST FOR FULL RECONVEYANCE Fidelity National Title Company of California, a California corporation, TRUSTEE: The undersigned is the legal owner and holder of all indebtedness secured by the within Deed of Trust .All sums secured by said Deed of Trust have been fully paid and satisfied; and you are hereby requested and directed, on payment to you of any sums owing to you under the terms of said Deed of Trust, to cancel all evidences of indebtedness, secured by said Deed of Trust, delivered to you herewith, together with the said Deed of Trust, and to reconvey, without warranty, to the parties designated by the terms of said Deed of Trust, all the estate now held by you under the same, Dated By: By: Please mail Reconveyance to: Do not lose or destroy this Deed of Trust OR THE NOTE which it secures. Both original documents must be delivered to the Trustee for cancellation before reconveyance will be' made. STATE OF CALIFORNIA COUNTY OF ON before personally appeared personally known to me (or proved to me on the 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/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 FD -221C (Rev.. 9/94) SHORT FORM DEED OF TRUST WITH ACCELERATION Page 4 of 4 (deedofta)(09-03) APN: 065-360-057 To Protect the Security of this Deed of Trust, Trustor Agrees: By the execution and delivery of this Deed of Trust and the note secured hereby, that provisions (1) to (14), inclusive, of the fictitious Deed of Trust recorded in Santa Barbara County and Sonoma County October 18, 1961, and in all other counties October 23, 1961, in the book and at the page of Official Records in the office of the county recorder of the county where said property is located, noted below opposite the name of such county, viz: COUNTY BOOK PAGE COUNTY. BOOK PAGE COUNTY BOOK PAGE COUNTY BOOK PAGE Alameda 435 684 Kings 792 833 Placer 895 301 Sierra 29 335 Alpine 1 250 Lake 362 39 Plumas 151 5 Siskiyou 468 181 Amador 104 348 Lassen 171 471 Riverside 3005 523 Solano 1105 182 Butte 1145 1 Los Angeles T2055 899 Sacramento 4331 62 Sonoma 1851 689 Calaveras 145 152 Madera 810 170 San Benito 271 383 Stanislaus 1715 456 Colusa 296 617 Marin 1508 339 San Bernardino 5567 61 Sutter 572 297 Contra Costa 3978 47 Mariposa 77 292 San Francisco A332 905 Tehama 401 289 Del Norte 78 414 Mendocino 579 530 San Joaquin 2470 311 Trinity 93 366 EI Dorado 568 456 Merced 1547 538 San Luis Obispo 1151 12 Tulare 2294 275 . Fresno 4626 572 Modoc 184 851 San Mateo 4078 420 Tuolumne 135 47 Glenn 422 184 Mono 52 429 Santa Barbara 1878 860 Ventura 2062 386 Humboldt 657 527 Monterey 2194 538 Santa Clara 5336 341 Yolo 653 245 Imperial 1091 501 Napa 639 86 Santa Cruz 1431 494 Yuba 334 486 Inyo 147 598 Nevada 305 320 Shasta 684 528 Kern 3427 60 Orange 5889 611 San Diego Series 2 Book 1961, Page 183887 which provisions, identical in all counties, (printed on the attached unrecorded pages) are hereby adopted and incorporated herein and made a part hereof as fully as though set forth herein at length; that Trustor will observe and perform said provisions; and that the references to property, obligations and parties in said provisions shall be construed to refer to the property, obligations, and parties set forth in this Deed of Trust. The undersigned Trustor requests that a copy of any Notice of Default and of any Notice of Sale hereunder be mailed to him at his address hereinbefore set forth. STATE OF CALIFORNIA COUNTY OF _Butte ON 7/16/04 before me, Marion L. Becker, notary personally appeared Galen Capineri and Michael Vairo personally known tome (or proved to me on the 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/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 Signatur Capineri & Vairo Investments By: Galen neri By: A7A_0 yaa Michael Vairo MARION L. BEGKER (� Comm. #1299521 NloTARY PUBLIC, CALIFORNIA O (� p BUTTE COUNTY 1 F My Commission Expires Apr. 13, 2005 INITIALS FD -221C (Rev. 9/94) SHORT FORM DEED OF TRUST WITH ACCELERATION Page 2 of 4 (deedofta)(09-03) Escrow No.: 04 -307267 -MB Locate No.: CAFNT0958-0958-0003-0000307267 Title No.: 04-307267 EXHIBIT "Arl THE LAND REFERRED TO HEREIN BELOW IS SITUATED UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF CALIFORNIA AND IS DESCRIBED AS FOLLOWS: Lot 283, as shown on that certain Map entitled, "Sierra Del Oro Estates Unit No. 4", filed in the Office of the County. Recorder of Butte County, California, on September 29, 1969, in Book 35, of Maps, at Page(s) 48, 49 and 50. Excepting and reserving therefrom all valuable minerals beneath the surface of the said lands, with the right to mine and extract said minerals, it being agreed and understood 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 the surface area of the above described realty, all as excepted and reserved in that certain Deed from the Magalia Mining Company, a corporation to E. D. Storts, et ux, recorded September 4, 1947, in Book 423, Page 385, of Official Records. Initials V RECORDING REQkAESTED BY: Fidelity National Title Company of California Escrow No.: 04 -307267 -MB Locate No.: CAFNT0958-0958-0003-0000307267 Title No.: 04-307267 When Recorded Mail Document and Tax Statement To: Capineri & Vairo Investments 6272 Virginia Way Paradise, CA 95969 APN: 065-360-057 GRANT DEED SPACE ABOVE THIS LINE FOR RECORDER'S USE The undersigned grantor(s) declare(s) Documentary transfer tax is $60.50 [ X ] computed on full value of property conveyed, or [ ] computed on full value less value of liens or encumbrances remaining at time of sale, [ ] Unincorporated Area City of /unincorporated area, FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Charlotte Lytton, an unmarried woman and George Losada, an unmarried man hereby GRANT(S) to Capineri & Vairo Investments, a. California General Partnership the following described real property in the City of /unincorporated area, County of Butte, State of California: SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF DATED: July 15, 2004 STATE OF CALIFORNIA COUNTY OF Butte ON 7/16004.. _ before me, Charlotte Lytton L. Boman, notary personally appeared Msada�� Charlotte Lytton and George Losada eorge personally known to me (or proved to me on the 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/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 mMT! seal. Signature L. BOMAN @r " Comm. #1341474 C) CALIFORNIA �� NOTARY PUBLIC Q ( BUTTE COUNTY27, 2006 Jan, ��y O�rnrdcsion MAIL TAX STATEMENTS AS DIRECTED ABOVE FD -213 (Rev 7/96) GRANT DEED (grant)(3-04) STATE OF CALIFORNIA - BUSINESS, TRANSPORTATION AND HOUSING AGENCY ARNOLD SCHWARZENEGGER, Governor - DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT &)SING Division of Codes and Standards O 0 IN oil Title Search Date Printed: 03/31/2005 DE Decal #: LBG6511 Use Code: SFD Manufacturer: THE ANDREW KARSTEN CO INC Original Price Code: AQJ Tradename: VILLA Rating Year: Model: KS52001F Tax Type: LPT Manufactured Date: 10/18/2004 Last ILT Amount: Registration Exp: Date ILT Fee Paid: First Sold On: 11/10/2004 ILT Exemption: NONE Serial Number HUD Label / Insignia Length Width KCCAOIK32074A RAD1413861 52' 1316" KCCAOIK32074B RAD1413862 52' 131611 Registered Owner: CAPINERI AND VAIRO INVESTMENTS 6272 VIRGINIA WAY PARADISE, CA 95969 Last Title Date: 12/13/2004 Last Reg Card: 12/13/2004 a Sale/Transfer Info: Price $68,520.00 Transferred on 11/10/2004 Situs Address: 14844 CRESCENT DR MAGALIA, CA 95954 Situs County: BUTTE Title Searches: FIDELITY NATL TITLE CO 6141 CENTER ST PARADISE, CA 95969 Title File No: 307967MB * * * END OF TITLE SEARCH G e--------------- ry 2 zz� PERMIT NO.—'065-360-037 - - --- -04-2861 r— CAPINERI& \/AIRO INV[STOIZS. 1yF4yV _CRESENT WAY, MAGALIA Cone: G',N(� NEW N4H/ NEW SITE 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). (2) STATEMENT OF FACTS (ONLY ON NEW MH'S). INSPECTOR TO VERIFY SERIAL & LABEL #'S. SPECIAL CONDITIONS CHECKED /SRA BY FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. — SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER IJOIB FINALED (Dat Signature s. J=OR 0 = Not OK Not . NotReadyable MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except#'s Zoning Requirements -Setbacks -Easements 1. Zoning Requirements-Setbacks-Easements Footings; Soils -Size -Depth -Spacing -Connectors -Steel 2. Soils; Special MH Support Sketch Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 3. Sewer; Location-Test-Fall-C/O-Concrete Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 4. Water; Location-Test-Easement Needed (Sketch) Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 5. Electricity; Location -Clearances-Grnd-/ /Amp-Concrete Carports; Windows -Doors 6.:.•Gas. Location-Test-Wrap;-/ P' L 'ft. P Nat. or./ /" L "ft./ P LPG 7. 7.~ Well. Clearance& Disconnect 8. 8_,:? UtilityClearance 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing Date 11. Card B-1 Date Card B-1 Date 12. Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements-Setbacks-Easements Card B-1 Date Card B-1 2. Footings; Size-Spacing-Marriage Line Card B-1 Date Card B-1 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 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date 11. Card B-1 Date Card B-1 Date 12. Card B-1 Date Card B-1 Date PERM NT END SYSTEM (ONLY) Date ng Requirements-Setbacks-Easem nts Card B-1 Date Card B-1 Date ngs; Size-Spacing-Marriage Line V4. U• Card B-1 Date Card B-1 locking 4. Gas; MH Test-Demand-Valve 5. Electricity; MH Test H _\�idGater; MH Test ater and Sewer Connected 8. Ga d Electricity Tagged '9'- Exits 10. Li e Decals 41'/erify #'s with Office Dat �7 :,O Card B-1 i =Date Card B-1 Date Card B-1 Date Card B-1 LoLA f -Pv D j Lt 13, 2- r 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- Panel boards- Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J= OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel - Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 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 72. Elec. Outlets at Wood Panel, Int. & Ext. Date 73. Card B-1 Date Card B-1 Date 74. Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Garage Fire Door; Swing -Landing -Closure 24. Fixture & Transformer Clearance -Ins. Protection A.C. Duct in Garage -Damper 25. Elec. Receptacles Spacing -Lights & Switches at Doors Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 26. Size Boxes & No. of Conductors Stapled Plb.; Elec. & Mech. Equip. Listed for Location 27. Romex Installed Close to Edge of Studs & C.J. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Insulation -Foam -Looked in Attic 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI Guard Rails & Deck Construction -Post Caps 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or AI Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral ❑ Yes ❑ No Clearance Looked under Floor ❑ Yes 32. Service -Riser Conductors & Ground Main Disconnect Following Instld./Drive D Yes O No/Walks U Yes ❑ No/Planters ❑ Yes ❑ No 33. Equip. Clearances Panels-Motors-Mech. Equip. Stucco Brown -Finish 34. Clothes Closet Light -Shower Light -Spa Light A.C. Unit Disconnect, Electrical -Plumbing 35. Smoke Detector Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 90. 36. A.C. Ducts Insulation & Support 91. 37. Vent Fan, Exhaust above insulation 92. 38. Condensate Drain & Overflow, Size & Grade 93. 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 94. 40. Attic Access & Platform if Furnace in Attic Date Address Posted Card B-1 Date Card B-1 Date Fire Sprinkler Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Date 41. Sills Proper Materials & Anchors Date 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 D Yes O No/Walks U Yes ❑ No/Planters ❑ Yes ❑ No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: 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.netlidds PERMIT NO. BP042861 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: 12/02/2004 APN: 065-360-057-000 the Business and Professions Code, and my license is in full force and�� effect./}may License Class: License Number: Site Address: Date: Contractor: Map Index: Description: NEW MH PERM FNDN NEW SITE (1410) 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: CAPINERI 8rVAIRO INVESTMENTS, 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 CALIFORNIA GENERA 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 6272 VIRGINIA WAY she is exempt therefrom and the basis for the alleged exemption. Any PARADISE, CA 95969 violation of Section 7031.5 by any applicant for a permit subjects the five hundred (530 ) 877-2752 applicant to a civil penalty of not more than dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: CAPINERI &VAIRO INVESTMENTS, A owner of property who builds or improves thereon, and who does pp such work himself or herself or through his or her own employees, CALIFORNIA GENERA 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 6272 VIRGINIA WAY proving that he or she did not build or improve for the purpose of PARADISE, CA 95969 sale.). (530) 877-2752 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.). Contractor: ❑ I am Exempt under Article 3 of a Bu 'ness and Professions Code ��pt�� L4;�ZE�� Date: Owner: — WORKERS' COMPENSATION DECLARATION I 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 #: workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Total Square Ft: 1410 S.F. Policy a. I certify that in the performance of the work for which this permit is Valuation: $91,650.00 issued, I shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall /r -O (/A forthwith comply with those provisions.�— ) Date: Applicant: WARNING: Failure to secure workers' compensation coverage is/ unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor / code, interest, and attorney's fees. / CONSTRUCTION LENDING AGENCY This permit is eby issued and lic.2 le provisions of the Butte County Code anrUor I hereby affirm that there is a construction lending agency for the r ni' t rove Resolutions do wo d ich fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By. '��' Date: Address: PERMIT EXPIRES ON: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification 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 an official form or document of Butte County. I hereby authorize representatives of Butte County toenter upon the above mentioned property for inspection purposes. � Print Name: \ (�'tt \ a1 Signature: ) 1 Date: .*Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor REQUEST FOR ADDRESS VERIFICATION DATE: /2 OWNER'S NAME 6tr�F1>1,1cr-�1- OWNER'S PHONE # OWNER'S MAILING MAILING ADDRESS o12-72- PA 12-%ZP /sr- cam- �5`7�g PRESENT ADDRESS OF BUILDING(S) 1. 2. 3. 4. ASSIGNED ADDRESS(S) ly�Yy G,�c'� WPI /��6zrLi/} 2. 3. 4. OWNER Las Mame, �I ) KN V` First Name Add res �;- 1 City t Sta i Phon�O g_�5— cv^��// 11 Fax / 9_Q ` CI` / E-mail j 'RA , 5 ' APPLICANT SIGNATURE X For office%rse only: CONTRACTOR Name Type Const. Address Map Book City \ State Zip Phone Address n Fax E-mail Lic. # Class APPLICANT SIGNATURE X For office%rse only: ARCHITECT/ENGINEER Name Type Const. Address Map Book City \ t Zip Phone Address n Fax E-mail State License Number APPLICANT SIGNATURE X For office%rse only: APPLICANT NAME Name- .� Type Const. Address Map Book City Lot # `Stat`_ Zip Phone Address n Fax E-mail APPLICANT SIGNATURE X For office%rse only: Zoning " Flood Zone SRA s No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: Oi LOCATION API 6 (' rodpy ress L1 Cross Street 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 n OVER FOR SUBMITTAL REQUIREMENTS It K:IFORMSIBUILDING FORMS1BldgApplSubRgmts.doc Page 1 of 2 Desc i tion or Sc a of Work: jJeA-Jc v q. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: 21 Amount: 54G. 9 y Bldg Receipt #: ,2 Date: q. 30.04. ..22 0/�`��i}-. q g SRA �" Sheriff SMIP Total REV 7-27-04 k SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) ❑ .5. Statement of Intent for -Non -heated and A/C for Non -Residential Buildings. ❑ ­6.� Manufactured homes: (A) Data sheets and installation. inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in'triplicate. (D) Floor" plans in triplicate. All of these must be stamped and wet -signed by the.engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). ❑ 13. Sanitation and site plan approval from the Environmental Health Department. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of 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. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional. information regarding this process, contact a Permit Application Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 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: &r2- r •i'W,Y4 ASSESSOR PARCEL NUMBER cad;g,5 5 6e • ©5 7 Proposed Building Use: KI C- vv t -i w 1Ilr✓yv s rTE Pt at_4 Counter Technician: r ("` Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. �5 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. U 't- 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential •� tags.`~ ❑ 8. Manufactured homes: (/),Data sheets and installation inst, ( ,Marriage line in o, (�C^J.Floor Plan, (3) -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. Site plan and business license approval from the City of Biggs Ilk ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form ,©% 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. El 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ -19. Soils Report and/or Engineered Foundation required ........................................... ........ O 20. Erosion Control Plan Required........................................................................ ........ ❑r `21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit ...........................� .....A.................... ... (�Jji 23. California Department of Forestry plan approv I C7 pard. Sent by: `....4.0.., yi6q ��t7A 24. Planning approval (A) Use: FA& (B)Parking: C�Parcel Check: 25. Contact Land Development about _ Improvements, _ Drainage ......................... tRi26. NPDES Form............................................................................................. 27. Encroachment Permit for driveway from the Public Works Dept ........................... 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... 31. Owner -Builder Verification ( ___�.Glven to owner, _Mailed to owner) ..................... q 32. Letter of Signature authorization.................................................................... 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... 0 35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction ........................... :...................................... I .............. I....... ❑, 37. ®'!Grant Deed, 19 H. Title/Statement of Facts, A,Atter from Legal Owner, ❑ Check to H.C.D. $ p�- 38. Other: ❑ 39. Other: When issued Telephone A 7 7. 3 7 5 and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: / r4 -.,U %_ I -�► E 1. Index permit application for-the•above.items.numbe er d 2. Additional items required `- Contractor, designer, owner, was advised of the above data by one, ❑ mail, ❑ counter, by Contractor, designer, owner, was advised of the above data by EYlphone, ❑ mail, ❑ counter, by Plans reviewed by: n(i Date: f b ` 1 Plans approved by: Structural reviewed by: Date: Structural approved by: Note transfer by: Date: Yellow: Building Division _ Plan Check Letter Date: V' o 'A_`` lC Date: • I -OV firs to 14.0 Date : ,✓'' 30 CL,� _ Date:ff 4 I E.H. USE ONLY Slot Plan attached Floor Man Attached — Sent to S.D. TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owne Location AP# Plan Approvef r. Sewage Disposal ter uppl Public -11— Pri toTell Clearance forwelli } Oto er S Hold final for: Final clearance O.K. for: NOTE: Envir nme t ealth Specialist 8/96 ;IZ 01l Date COUNTY OF BUTTE ' DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER A.P. #`�`�'��. PROPROSED BUILDING USE DATE RECEIPT # DATE REC. 1. BUILDING PERMIT FEES --- Balance Due ..................... $ --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (fo ailable pfter Pl n eck) � n)v 3. SHERIFF FEES (paid at Builm Division) -� Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Ftg. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES j4�$510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK FEE 1 $.8-9:OO1(paid at Building Division) ( �p •$ C -Q 2©`f•I g V�" 8. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... X = $ Sq. Fig. Amt. 10. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed durine plan checking process. APPLICANT DATE Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM }}qq PSN ! (One form per Building) School District 11�v1 g Building Department No. ,... a ,.. A.P. Number U / o� • J� V° 6-5/1 Jurisdiction: City ®County n. Property Owner Property LocationA Subdivision Residential Development ® ............................................................... :...................................... Q Sq. Footage 1 4 e b No of Living Mobile Home Addition/ 'Supplemental to (Group,R) Units Installation Conversion Permit # .................................................................................................... *(No foundation inspection)i Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial 0 Q r Sq. Footage New Addition \ (Including Exterior Roofed Areas) Building Department Representative r Date District Identification No. School District certifies that (Applicant) 97 7- z 71 1 (Street Address) U �% (Phone Number) (state) has complied with the requirements of Resolution No. representing WV square feet. r School District Representative V Paid by Check # Remarks: (Zip Code) by payment of $ ��� 7%l AB 2926 $ FULL MITIGATION $ ��- Zz7Z�/y Date Noace: You may protest the Imposition of the fess Identified above by submitting a written protest to the District, In compliance with Govemmont Code Section 66020(a), within 90 days from the date fess 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 Fes Certification Foran, the School District Is mol fied by the applkaMe Local Planning Agency that this project Is being reviewed under the California Environmental Quality Act (CEQA), +.. this project may be subject to additional school fees to fully mitigate its Impact on the school district% schools. ' .. White (applicant), Yellow (building department), Pink (school district) feeform.xlsfto/03►a6rr f °k- Department of Public Works CO C o u m y o f B u t t e 0 G LAND DEVELOPMENT DIVISION ). Michael Crump, Director Storm Water. Management Program C 7 County Center Drive / Oroville. CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase 11 Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement ILESS THAN 1 AC Project Description: � v 01615-rA �05J Project Location and/or Parcel Number: By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: Date: UJf-� Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX DE'T'ACHED ACCESSORY BUILDING OWNER'S STATEMENT OF USE Plan review will not be started until this form is completed, signed by the property owner, and returned to the Butte County Building Division. Attached Accessory Buildings and Additions will be checked for residential use. Exception: Garages and Carports. Owner:—�1L\���irt `�—V �i� —K`t V 1 --Phone: Mailing Addri Site Address: Assessor's Parcel Number:ry ���) Zone: Please answer questions 1-16, and explain any yes answers for questions 2-14 in the space provided on page 2 of this form GENERAL IINFOILMATION: 1. Is there a primary dwelling on the property? Yes ❑ No B—�- 2. Is the structure already built, under construction, or under notice of code violation? Yes ❑ No B-- 3. Will items produced in this building be offered for sale? Yes ❑ No 4. Will the public have access to this building? Yes ❑ No 5. Will any advertising, on or off site, be associated with the use of this building? Yes ❑ No ©� SITE CONDITIONS: 6. Is the structure foundation within 5' of septic tank or 10' of leach lines? Yes^ El 7. Is any portion of the structure located closer [hart 20' to your front property line? Yeso to S. Do you plan to add a driveway or modify existing access to a county maintained road? Yes 9. Will the proposed structure encroach within any recorded easement? Yes No CONSTRUCTION FEATURES: 10. Will this building have insulated floor, walls, or ceiling? Yes 0 No 11. Will this building be heated or cooled? Yes ❑ No 0� 12. Will this building have a water closet/toilet? Yes ❑ No 13. Will this building have a sink? Yes ❑ No 14. Will this building have a water heater? Yes ❑ No �/`l, L 15. What type of floor covering gill the building have? - 16. What type of ti,�all covering will the building have? 7/ _ OVER 1 of 2 a PROPOSED USE: (check only one box) 1. ❑ Residential Storage Shed – I will be storing in this building and it will not used for any other purpose (no bathroom and no heating or cooling). 2. ❑ Pivate Garage – "A building or a portion of a building not more that 1,000 square feet (3,000 by exception) in area in which only motor vehicles used by tenants of the building or buildings on the premises are stored or kept" A garage door is required. 3. ❑ Residential Carport – A covered structure intended for parking of vehicles. Two or more sides must be entirely open. 4. ❑ Residential Occupancy – Structures meant to be occupied, as opposed to a storage shed, garage, or carport If you checked 94, please check the uses below which best fit this building. ❑ GuestHouse ❑ Pool House ❑ Studio Apartment ❑ In-law quarters ❑ Recreation Room ❑ Game Room ❑ Study ❑ Library ❑ Bonus Room ❑ Playroom ❑ Den ❑ Studio ❑ Artist Studio ❑ Hobby Room ❑ Craft Room ❑ Sewing Room ❑ Canning Kitchen ❑ Music Room ❑ Family Room ❑ Sun Room ❑ Private Office ❑ Workshop 1 ❑ Home Occupancy 2 ❑ Other – Use = 1. Describe type orw ( 2. Must be approved by the Butte Cotatty Plarming Divisiot>_ Explanations: This area is for explanation of any "yes" answers on questions 2-14..jPlease'indicate the question ,Xumb A-1 Ir,J e explanation t- C-�i t C ,lam— - t A ) ` Additional Information: Plan review will, not be started until this form is completed and received. A Plans Examiner will contact the owner with specific requirements per the use indicated. I hearby affirm under penalty of perjury that the above information is true and correct. I understand that any changes to the use, or character of use, of this building will require permits from the permitting authority. I understand that Real Estate Disclosure laws require disclosure of this information if or when the property is offered for sale. Owner's Name: Please Print ���~j �{ �a�"rj O mer's Signature: Date: v 2 of 2 O.B.-1 <;::iWN '?i;Y[iii>?�ii:iiasi�?i:;_2i;`i:i:i>:��<2ii:ii?ii�tii i>i�``:iii: <`s:'`??i�'><�`::F''a:'�`+>'. >:.>:: VU Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 6 I personally plan to provide the major labor and materials for construction of the (� proposed property improvement: YES[—J--NO[ ]. 2. I HAVE[ HAVE NOT[ ] signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. S.. 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 SIGNED: PROPERTY O DATED NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. May 1995 2.26 o.B.-1 Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you pian 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: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. 0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned.. C. Viei4 C.B.O. Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. May 1995 2.27 O.B.- I <:<�� .�::: �: ::::::�>. ``{ ``"�` ��.. `'i::::,>i?i:i i..,������. . ..., �.,. ,�.�>� :.:.::. Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed prope improvement: YES[vf NO[ ]. *2. I HAVE[ HAVE NOT[ ] signed an application for a building permit for the proposed work. I have contracted with the following person (fi.^n) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 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 SIGNED: * PROPERTY OWNER: *DATE: '/ NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. May 1995 2.26 Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. 0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. '. Vieiifa, C.B.O. Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. May 1995 2.27 Department r n u n t' J. Michael Crump, Director SUN" Avetic wo�,�5 Public f B u t Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase 11 Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement jLESS THAN 7 ACRE Project Description: Project Location and/or Parcel Number: By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: Date: Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program STATE OF CALIFORNIA ' BUSINESS, TRANSPORTATION AND HOUSING AGENCY. DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPENT DIVISION OF CODES AND STANDARDS ` REGISTRATION AND TITLING PROGRAM STATEMENT OF FACTS This unit is a: ErMobilehome 0 Commercial Coach 0 Floating Home 0 Truck Camper Decal (License) No.(s) I/We, the undersigned, hereby state: Oje- Avv_ Trade Name Serial No.(s) 1WE I/We further agree to indemnify and save harmless the Director of Housing and Community Development, State of California, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the above-described unit in California, or from issuance of a California certificate of title covering the same. I/We certify under penalty of perju that thej foregoing is true and correct. Executed on ar I �I (Date) Sign ture(s) (City) Printed name(s) r CA (State) AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 Recorded Official Records I REC FEE 10.00 I CONFORM County Of 1,00 I BUTTE CANDACE J. 6RUBBS Recorder I ROSEMARY DICKSON 1 Assistant I Jason 09:05AN 02 -Dec -E004 I Page I of 2 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: JEc A -j1 Date 10/26/04 PROPERTY OWNERS: Capineri & Vairo Investments, a California General Partnership Gale44pineri Michael VAiro State of California County of On O r1(-0 `O L` before me, personally appeared � V , n e r` t <' 4 1\ rcL, e. � ) a personally known to me (or proved to me on the 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/her/their signature(s) on the instrument, the persons) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand -an -d ficial seal. �.� A .Lo.,. L. BOMAN Signature Seal: r- _'' W o Comm. #1341474 _ NOTARY PUBLIC CALIFORNIA 0 lJ P BUTTE COUNTY —� A.P. # 065-360-057 My Commission Expires Jan. 27, 2006 EXHIBIT "A" THE LAND REFERRED TO HEREIN. BELOW IS SITUATED UNINCORPORATED AREA, COUNTY. OF BUTTE, STATE OF CALIFORNIA AND IS DESCRIBED AS FOLLOWS: Lot 283, as shown on that certain Map entitled, "Sierra Del Oro Estates Unit No. 4", filed in the Office of the County Recorder of Butte County, California, on September 29, 1969, in. Book 35, of Maps, at Page(s) 48, 49 and 50. Excepting and reserving therefrom all valuable minerals beneath the.surface of the said lands, with the right to mine and extract said minerals, it being agreed and understood 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 the surface area of the above described realty, all as excepted and reserved in that certain Deed from the Magalia Mining Company, a corporation to E. D. Storts, et ux, recorded September 4, 1947, in Book 423, Page 385, of Official Records. 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 ADMINISTRATION * BUILDING * PLANNING September 24, 2008 TO: Building Manager FROM: Mark Michelena, Butte County Planning Division SUBJECT: Request for Comments on a Development/Land Use Application APPLICANT: KOHLER, RONALD, VAR08-0001 APN: 065-360-057 DATE OF Inter -Departmental Review: October 8, 2008 IDR RESPONSE REGARDING October 7, 2008 COMPLETENESS OF APPLICATION DUE BY: AGENCY/DEPARTMENT CONDITIONS/MITIGATION MEASURES DUE BY: October 20, 2008 The Planning Division has received a project application as described below. This application is being provided to you for review. This is your opportunity to make comments regarding the completeness of this application, to be determined at the Inter -Departmental Review (IDR) Committee meeting on October 8, 2008, and/or to recommend conditions and/or mitigation measures relevant to your agency's/department's area of expertise and jurisdiction. PROJECT DESCRIPTION: A request for a variance for a deck that was extended and partially covered. The deck and covered portion is 2.5 feet from the property line. The parcel is located at 14844 Crescent Drive, Magalia. COUNTY SUPERVISOR DISTRICT NO.: 5 ZONING: RT- 1-A (Minimum Density Residential Trailer), GENERAL PLAN: LDR If a response cannot be submitted prior to the due dates listed above, please call Mark Michelena at 530-538-7376 or send him an email at mmichelena(cr�,buttecounty.net . You do not have to respond to this request if you have no comments to include. Thank you for your attention to this matter. Please return response to project planner. IDR COMMITTEE — APPLICATION COMPLETE ❑ No Name: Date: ❑ Yes Name: Date: F:\Planning\PROJECTS\Trakit Merge Documents\REQUEST FOR COMMENTS.doc AGENT AUTHORIZATION To Butte County, Department of Development Services: X. Print Name of Agent Phone Number Mailing Address is hereby authorized to process this application on my/our property, �f identified as Butte County Assessors Parcel Number(s) g This authorization allows representation for all applications, heari , appeals, etc. and to sign all documents necessary for ord title interest. said processing, but not including document (s) relating to record Owner(s) of Record (sign and print name) /Z kOA) ik 0� 9 4e 11 9k'04 I r Prin ame ; Pn t Name Signature Signature Print Name Print Name Signature �r' Signature I Print Name of Applicant (if other than owner) Signature of Applicant (if other than owner) r" r i Print Name of California Civil Engineer/Land Surveyor Phone Number i i i Mailing Address Email Address APPLICANT: Ronald Kohler AGENT: FILE #: VAR08-0001 BUTTE COUNTY STANDARD CONDITIONS FOR VARIANCE DATE: September 18, 2008 APN: 065-360-057 PLANNER: Mark Michelena PROJECT DESCRIPTION: A request for a variance for a deck that was extended and partially covered. The deck and covered portion is 2.5 feet from the property line. The parcel is located at 14844 Crescent Drive, Magalta Those items checked are conditions of approval. PLEASE CONTACT THE PUBLIC WORKS DEPARTMENT FOR COMPLIANCE WITH THE FOLLOWING CHECKED CONDITIONS: A. STREETS ❑ 1. Prior to the issuance of building permits, obtain encroachment permit for all new or existing driveway approaches and construct them to County standards, as specified in County Improvement Standards. ❑ 2. Prior to the issuance of building permits, deed to Butte County, in fee simple, _ feet of right-of-way from the centerline of . The right of way shall be sufficient for the installation of Standard No. S-5 at all street intersections. ❑ 3. Prior to the issuance of building permits, submit road and drainage improvement plans for the installation and construction of the street frontage improvements on to Standard, including but not limited to P.C.C. curb, gutter and sidewalk and the required street section for parcels with gross acreage of one acre or less. Construct or install the required improvements. ❑ 4. Prior to the issuance of building permits, dedicate a one foot "no access strip" or relinquish abutters rights to Butte County, along the frontage of parcels , except at approved access points. B. DRAINAGE ❑ 1. Prior to the recordation of the issuance of building ,permits, a plan for a permanent solution for drainage shall be submitted to and approved by the Department of Public Works. The drainage plans shall specify how drainage waters shall be detained on site and or conveyed to the nearest natural or publicly maintained drainage channel or facility and shall provide that there shall -be no increase in the peak flow runoff to said channel or facility. ❑ 2. Prior to the issuance of building permits, establish 100 year floodplain elevations and the lowest floor elevations for any structures. Show on the site plan map for building permits the elevations (by contours) and the location of an accepted NVGD benchmark and a temporary benchmark on-site. C. LEGAL LOT STATUS ❑ 1. Prior to the issuance of the Use Permit, prove, to the satisfaction of the Director of Public Works, that the parcel of the subject application is a legal parcel. BUTTE COUNTY STANDARD CONDITIONS FOR VARIANCE APPLICANT: Kohler, Ronald DATE: September 18, 2008 AGENT: APN: 065-360-057 FILE #: VAR08-0001 PLANNER: Mark Michelena PROJECT DESCRIPTION: A request for a variance for a deck that was extended and partially covered. The deck and covered portion is 2.5 feet from the property line. The parcel is located at 14844 Crescent Drive, Magalia. Those items checked are conditions of approval. PLEASE CONTACT THE ENVIRONMENTAL HEALTH_DIVISION FOR COMPLIANCE WITH THE FOLLOWING CHECKED CONDITIONS: D. SEWAGE DISPOSAL AREAS ❑ 1. Prior to the issuance of a building permit, the applicant shall meet the sewage disposal requirements of Butte County Code Section 26-26 for the installation of sewage disposal systems within a flood plain/floodway. ❑ 2. Prior to the issuance of a building permit, those wells indicated on the site plan that are proposed to be destroyed in order to provide required usable sewage disposal areas, shall be destroyed under a valid Butte County Environmental Health Division permit. ❑ 3. In the nitrate area record executed Future Sewer Service and Storm Drainage Agreements. ❑ 4. Prior to the issuance of a building permit, meet the requirements of the (Watershed Protection Zone) (Villa Verona Moratorium Area) (Cohasset Specific Plan). E. INDIVIDUAL WATER SUPPLY ❑ 1. Prior to the issuance of a building permit, provide a source of domestic water for the building on (lot) (parcel) ❑ 2. Prior to the issuance of a building permit, verify that domestic water can be provided to meet minimum standards for and other suspected contamination. F. PUBLIC WATER SUPPLY ❑ 1. Prior to the issuance of a building permit, verify that domestic water can be provided to meet minimum standards for and other suspected contamination. G. EXISTING COMMUNITY SEWER 7' 1. Prior to the issuance of a building permit, under a permit issued by the Environmental Health Division, abandon the septic tank and connect the dwelling(s) on (lots) (parcel(s)) to public sewer. APPLICANT: Kohler, Ronald AGENT: FILE #: VAR08-0001 BUTTE COUNTY STANDARD CONDITIONS FOR VARIANCE DATE: September 18, 2008 APN: 065-360-057 PLANNER: Mark Michelena PROJECT DESCRIPTION: A request for a variance for a deck that was extended and partially covered. The deck and covered portion is 2.5 feet from the property line. The parcel is located at 14844 Crescent Drive, Magalia. Those items checked are conditions of approval. PLEASE CONTACT THE BUILDING DIVISION FOR COMPLIANCE WITH THE FOLLOWING CHECKED CONDITIONS: H. BUILDING PERMITS ❑ 1. Building Permits Required. Prepare 4 sets of construction plans and make an application for permit. Construction shall comply with federal, state, and local regulations. Plans shall be prepared, sealed and signed by a California Licensed Architect or Registered Engineer for non-residential buildings and certain residential buildings. ❑ 2. Proposed improvements constitute a "change in use" or "change in the character of use" as stated in the building code. Improvement plans shall incorporate all code -required elements for the new use. ❑ 3. All structures shall be made accessible to the disabled. Disabled accessible parking and an accessible path of travel shall be provided. ❑ 4. Proposed improvements shall comply with Title 24 energy conservation regulations. Appropriate compliance forms (two sets) shall be submitted indicating compliance with those standards. ❑ 5. Proposed improvements shall comply with Butte County Code and FEMA Flood Hazard Prevention regulations. A FEMA Elevation Certificate, prepared by a qualified professional, shall be completed and submitted with improvement plans for the Building Division. ❑ 6. Proposed improvements shall comply with recorded map conditions applicable to construction. ❑ 7. Proposed improvements shall comply with Public Resources Code 4290 Fire Safe Construction standards. ❑ 8. Development fees for the proposed residential or non-residential improvements shall be paid prior to the issuance of building permits. The fees shall be those in effect at time of application, and shall include, but not be limited to, School Fees, Park and Recreation District fees, Water and Sewer Service Fees, Permit and Plan Check fees, and Fire Protection Fees. I. EXISTING STRUCTURES ❑ I. Comply with the Uniform Building Code for property lune clearances considering use, area and fire - resistiveness of existing buildings. ❑ 2. Existing building(s) shall be made to comply with current Building and Zoning regulations for the intended new use of the building(s) or the existing building(s) shall be demolished. APPLICANT: Kohler, Ronald AGENT: FILE #: VAR08-0001 BUTTE COUNTY STANDARD CONDITIONS FOR VARIANCE DATE: September 18, 2008 APN: 065-360-057 PLANNER: Mark Michelena PROJECT DESCRIPTION: A request for a variance for a deck that was extended and partially covered. The deck and covered portion is 2.5 feet from the property line. The parcel is located at 14844 Crescent Drive, Magalia. Those items checked are conditions of approval. PLEASE CONTACT THE BUTTE COUNTY FIRE DEPARTMENT FOR COMPLIANCE WITH THE FOLLOWING CHECKED CONDITIONS: J. FIRE CLEARANCE ❑ 1. Construction, installation or development of buildings and/or roads, driveways, gates and bridges on parcels/lots shall comply with the latest California Fire Safe Regulations—Public Resources Code 4290, 4291 and current Butte County Improvement Standards, whichever is stricter. ❑ 2. Prior to construction, a pressurized community water system for fire protection is required. Bonding may be allowed with the approval of the County Fire Chief. Average required hydrant spacing is feet, hydrant size inches, and residual fire flow of GPM. Fire hydrant identification, road reflectors or post reflectors acceptable to the County Fire Chief shall be installed or bonded, prior to Parcel or Final map recordation. Submit plans to the Fire Department for review and approval prior to construction. ❑ 3. Place a note on a separate document and recorded concurrently with the Parcel, Final map or an additional map sheet stating that "Fire suppression sprinkler systems shall be installed in. all new residential dwellings in accordance with NFPA Standard 13D, unless a pressurized community water system with hydrants that meet Fire Department specifications serves the property." A note stating "Automatic Fire Sprinklers conforming to NFPA Standard 13D required" is to be added to all affected building plans. ❑ 4. In lieu of hydrant installation, prior to recordation of the Parcel or Final map, payment shall . be made into the hydrant fund at the current rate per lineal foot of street frontage. ❑ 5. Prior to building construction, provide an all weather access of at least 10 feet wide and vertical clearance of 15 feet that will allow for ingress and egress and accommodate a 40,000 -pound fire apparatus to within 150 feet of all structures. ❑ 6. Place a note on a separate document, which is to be recorded concurrently with the Parcel or Final map, or on an additional map sheet stating, "Building identification and/or addresses shall be installed in conformance with Public Resources Code 4290 and shall be posted at the time of permit issuance and maintained continuously thereafter. U 065-360-057 r I � I IF 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.netWds PERMIT NO. BP042862 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: 12/02/2004 APN: 065-360-057-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: ,t [L,O '� &PvT Site Address: 11115,119` Date: Contractor: Map Index: Description: GAR (648) DET DECK (150) 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: CAPINERI & VAIRO INVESTMENTS 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 6272 VIRGINIA WAY 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 PARADISE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95969 violation of Section 7031.5 by any applicant for a permit subjects the 530-877-2752 applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: CAPINERI & VAIRO INVESTMENTS A pP - owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). O, 1, 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.). Contractor: ❑ 1 am Exempt under Article 3 of the Business and Professions Code Dat- Owner: WORKERS'COMPENSAf1lON 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 License #: workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Total Square Ft: 798 S. F. Policy #: I certify that in the performance of the work for which this permit is Valuation: $17,052.00 issued, I shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall /7 forthwith comply with those provisions.% v Date:�- Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is reby i sued under the a ble provisions of the Butte County Coda and/or I hereby affirm that there is a construction lending agency for the Resolution o do work i ov for whiyih fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By Date: PERMIT EXPIRES ON: la Date Address: ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ 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 official form or document of Butte County. I hereby authorize representatives of Butte County enter upon the above mentioned property for inspection purpo Print Name: =j�� %\ Signature: 'A�f l I �— ` Date: �L v 1 Xowner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY c PERMIT DEPARTMENT OF DEVELOPMENT SERVICES O. BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 BF OFFICE #: (530) 538-7541 IN A FEE WILL BE REQUIRED AT TIME OFAPPLICATIONjb **PLEASE PRINT CLEARLY** gamw APPLICANT NAME OWNER Las�.Name City ' First Name Addrbs4 4 1 City i Star., i PhoneO L a 1, Fax )—?a- � E-mail E-mail r > (-C-- State License Number r� t CONTRACTOR Name Address City State Zip Phone Fax E-mail Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City ' Address ........_._.... Zip City Fax State Zip Phone Address Fax �. E-mail State License Number APPLICANT NAME Name Address City ' -State`q Zip Phone Fax E-mail APPLICANT SIGNATURE X For office -Us e onl Zoning ` _ y Flood Zone SRA No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: 43 LOCATION c�: I AP# / Prop y Address Cross Street 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 15o q. rootage 1 ❑ Structure Built wtnoug uml]L ❑ 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. OVER FOR SUBMITTAL REQUIREMENTS II K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Re*L&� ceip -f- Sheriff Other / - (P REV 7-27-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION '1 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 n PERMIT APPLICATION DATA SHEET OWNER: P ne'v 1ASSESSOR PARCEL NUMBER UCP ' ,-36 �d /, Proposed Building t7seJ� { Ci `��- Counter Technician: J]/ Z Date: Items required in order to apply for a permit. AllToxes MUST Be checked OR marked NA in order to apply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. t 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. --�j 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or 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. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form mil 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ___*❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 20. Erosion Control Plan Required........................................................................ ........ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. 22. City of Chico Plumbing permit ......... ........ ...............:.......h...:-,.................... o/ 23. California Department of Forestry plan approval Z paid. Sentfby�� 14* 4,1 rk ! b �­0 24. Planning approval (A) Use: 6f (B)Parking: (C) Parcel Check: �- t9--7 - lco c d' ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... 31. Owner -Builder Verification (iGiven to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization.................................................................... ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ 35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. 11Grant Deed, 11M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other. ❑ 39. Other: �. When issued Telephone d / ' d r and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: / 1 Date: 1. Index permit application for the above items numbered: Plan Check Letter 2. 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