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Home My WebLink About066-360-049BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION **PLEASE PRINT CLEARLY** OWNER Last Name� (/ 1 Firs�N� �� Address ,7e> E30 IF 7q{� City t�RG.4ila Stioe I City Phone S � 9- 73 -/�Ryt Fax E-mail "� I'S !/SN 0 L Co ^1 APPLICANT NAME CONTRACTOR Name f ry A/ Address WORKER'S COMPENSATION City Fax State Zip -Phon 5 v _ _ 7/ fa E-mail Date Approved: Lic.�77�?s— Class APPLICANT NAME ARCHITECT/ENGINEER Name J Address WORKER'S COMPENSATION City Fax State Zp Pho?30 S/3 l F 30 87Z Q E-mail Date Approved: State License Number APPLICANT NAME Name L D /Q 4 DA cl Address-,-- ddress;- city City kJ -1 A 6-4 C - :,g Stat AL WORKER'S COMPENSATION Phone,,?U_, 7 / k y Fax E-mail r.4UiS USN0 cG� APPLICANT SIGNATURE X cid---��— For office use only.. AP# r f Zoning lood Zone SRA 1r ' No Occ. WORKER'S COMPENSATION Type konst. Subdivision Name If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 PERMIT NO. h- :�3/ LOCATION AP# r f Property Address If 1A Ci ` C 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 Mame Address Description or Scope of Work: I Sq. Footage cry' I o O- �, rL ❑ Proposed Change of Occupancj (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 ager 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:. Amount: l� '-Z r7 Bldg SRA Receipt #: " / "5'Sheriff C �- 18190 SMTP I I Date: SO/-/ &3 Total I I REV 7-27-04 BUTTE COUNTY SCHOOLS; IMPACT FEE C I ERTIFICATION FORM for yer Building) School District Pa.0- 0- JC- Building Department No. iokl- 33/3 A.P. Number 4 (e —3 0 1*) q jurisdiction: city County Property Owner .64 L" A Property Location/Address 5? 7— rQ A t r a Ir GcJu 1/1 A 4 1 Subdivision Lot No. ... . ....... . .................................. .................................. Residential Development Sq. Footage No of Living Mobile Home Addition/ *Supplemental to (Group R) Units Installation = Conversion Permit # ........................................................................ *(No foundation Inspection) ! .. .................. . ..... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial Q Q Sq. Footage Now Addition (Including Exterior Roofed Areas) JA LO 5 - Building Department Representati4e Date District Identification No. 313 uVa School District certifies that Vy"Vel (Applicant) lo (Street Address) (Phone Number) c4f (City) (State) (Zip Code) has complied with the requirements of Resolutidn No. by payment of $ 07-j representing square feet. JAB 2926 $ IFULL Mff[GATION $ ietved� School District RelpreseViv,4r' Date Paid by Checks Remarks: Nofts: You may protest the Imposition of the ton Identified above by submitting a written protest to the District. In compliance with Gov munent Code Secdon 66020(a), within 90 days from the data ton are paid. Failure to submit a timely written protest will'proliltilt you from challenging the Imposition of the tan In any court action. If, subsequent to the School District Represents&* signing this Butte County Schools Impact Fee Certification Form, the School Dis ' Met Is ndfl- by the applicable Local Planning Agency Me Oils Project Is being ravlAw-med under the Calffornia Envlmnmi;�;i-iiuilty Act (CEQft fhb project may be subject to additional school fees to fully mitigate. Us Impact an the school dhddcft schools. White (applicant), Yellow (building department), Pink (school district) %efwm.xis (10/03)dmm BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM ` (One form per Building)�,� School District Building Department No. A.P. Number (p D -f 9 Jurisdiction:. • City County Property Owner Property Location/Address 1519 Subdivision Residential Development ED No of Living Units ' .Y is f '•"a Comrtlercial/Industrial Building Department Lot No. ................................................................................................................... Sq. Footage Mobile Home Add'dioN *Supplemental to Installation Conversion Permit # `(No foundation inspection): Irnoor rrianns' reviewed Dy Scnooi uistrictyersonnel No. School District certifies that (City) has complied with the requirements of Resolution No. representing blW square feet. (State) Paid by Check # _ Remarks: Sq. Footage 43 0 0 (Group R) ;Including-Exterior, Roofed Areas) Date , (Applicant) / 701 7�� (Phone Number) 9�12� (Zip Code) by payment of $ AB 2926 $ FULL MITIGATION $ Date 4. Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(x), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls (10%98)dmm IF COUNTY OF BUTTE - Dei riment of Public Works r 7 County Center Drive, Oroville, CA 95965 Phone: 916-5J8_7341 OWNER -BUILDER VERIFICATION 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 majorlabor and materials for construction of the proposed property improvement (yes or no) 2. I.(have/have not) y 4 /4 'signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm)"to provide the proposed construction:, Name' 4V_0 0"'eAK Address City _ Phone Contractors License No. 4. I plan to provide portions of this work,'but I have hired the following person to coordinate, supervise, and provide the major work: Name t/► 1 D /!E -Address City Phone Contractors License No. I 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone- Type of Work Signed:�✓ Property Owner 0eut' C Social Security Number Date /-27 -� y NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned toour office before we are per- mitted to issue the permit. Ir, .1 COUNTY OF BUTTE - Department,of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION 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 property improvement (yes or no) S 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. -- 4.•-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 Contractors License No. 5: I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: Property Owner a-•-�� Social Security Number Date .2- /- 7� NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the -.California Health and -Safety- Code-.- This ode This verification must be completed and returned to our office before we are per- mitted to issue the permit. � . . . �� -- D ildio� Deparcmau� �O� u ' i� Sec�ioo ` �8� D�ive�a� Clearauce . � - -' . / �v /' z' L/'/ ' -�_ /� /l ''� --- - /` lnca�ioo ~---- `_'/ ' �. . bao baeu ioocad tor �ba above proyez�y' �` � -- ' ' /!~ � /�'� / � / r/^',. � /- ^^-/ � �^� � � 6u�e � o�o�a�ure � . ,_. �� .'` . .. � �', /r � /��~ /�- ' A� " '� -�u' ' ��/ / �� /l '�{� �- ' . v ] �p L/ ', � '� *v ' / 0 � ��/ , pr � / �� ' ' /l~ /l ' �| ` �~ i/ �' ' �� .� �\r . �` ' ^ ' , .__ � -.� �-- A COUNTY OF BUTTE - Department,of Public Works 7 County Center Drive, Oroville, CA 95965 OWNER -BUILDER VERIFICATION Attention Property Owner: Phone: 916-538-7541, 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 property improvement (yes or no) 5 2. I (have/have not) /7``JJ/4 VIC. signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. 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 Contractors License No. 5.-1 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: i Property Owner Social Security Number Date 112 -2-1 —!jZ_ NOTE: This Owner-Builder.Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION 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 property improvement (yes or no) 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. 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 Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed Property Owner Imo- vim-� Social Security Number - Date 7 —�—/ NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: _ An 'owner -builder" building permit has been applied for in your name and bearing your signature. s 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 to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) �',4 signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. ,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 Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: �� J Property Owner Social Security Numberc� Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. Received The Sum For szl� Received: COUNTY OF BUTTE 353790 OFFICIAL R EIPT^ � 20_ n OFFICE OR DEP MENT ISS ING RECEIPT A b(, -- a. --&(1 '7 CASH ❑ CHECK DAVCO BUSINESS FORMS • (916) 7058511 � l/N miL� Tg /V/MS/a�K/ ROAD PLANNING DIVISION - BUILDING PUN APPROVAL Use: Date: 12--4e Parldng: Landscaping: Other. A I l/N miL� Tg /V/MS/a�K/ ROAD PLANNING DIVISION - BUILDING PUN APPROVAL Use: Date: 12--4e Parldng: Landscaping: Other. A a 4 N 6730 -8?3- /8 I v ( U - w (w Oy 36, / q 5 38 0r.RHr. b'Go Sq�L:tuiwc. L►v 11 SF_Av C.l� PECK S�ncF Qsqflim .1 rx / ,<< �(p' 6 O 0 t Lt N c_' To p 'D 10011 C, 40'-0" 0 O N 4 0 N EXISTING FIRST FLOOR r� SYMBOLS KEY: = WALL LINE % \� =SHEAR WALL SCH. \J ; = CROSS SEC. IF PG NUM. 32'-011 8,_011 w O 3 z O.H. D SDI Z PHD2 b PROPOSED ADDITION ,2070 CTITLE A = FOUNDATION WALU DETAILS PGS =CONST. DETAIL ! PG # .ter. -.-i-•- .. ��. r.r -...-_ -- J.11EPOPLEM IDES/GINS Y • CAD GENERATED HOUSE PLANS • RVTER. /EXT. 3.0 VEAW AVAIL. • DESIGNED AS YOU LIKE JIM PEPPLER (530) 872-1344 FX10F. (530) 514-3991 CELL P.O.BOX 1646 PARADISE CA 95967 i t s Q o p M l - I 1' I - l Or �7 � 1 �r r.. r� SYMBOLS KEY: = WALL LINE % \� =SHEAR WALL SCH. \J ; = CROSS SEC. IF PG NUM. 32'-011 8,_011 w O 3 z O.H. D SDI Z PHD2 b PROPOSED ADDITION ,2070 CTITLE A = FOUNDATION WALU DETAILS PGS =CONST. DETAIL ! PG # .ter. -.-i-•- .. ��. r.r -...-_ -- J.11EPOPLEM IDES/GINS Y • CAD GENERATED HOUSE PLANS • RVTER. /EXT. 3.0 VEAW AVAIL. • DESIGNED AS YOU LIKE JIM PEPPLER (530) 872-1344 FX10F. (530) 514-3991 CELL P.O.BOX 1646 PARADISE CA 95967 i s o p t (D I Or r� SYMBOLS KEY: = WALL LINE % \� =SHEAR WALL SCH. \J ; = CROSS SEC. IF PG NUM. 32'-011 8,_011 w O 3 z O.H. D SDI Z PHD2 b PROPOSED ADDITION ,2070 CTITLE A = FOUNDATION WALU DETAILS PGS =CONST. DETAIL ! PG # .ter. -.-i-•- .. ��. r.r -...-_ -- J.11EPOPLEM IDES/GINS Y • CAD GENERATED HOUSE PLANS • RVTER. /EXT. 3.0 VEAW AVAIL. • DESIGNED AS YOU LIKE JIM PEPPLER (530) 872-1344 FX10F. (530) 514-3991 CELL P.O.BOX 1646 PARADISE CA 95967 _v v i SCALE: 1/4 " = 1 IFT. FLOOR PLANS e4 I --fl 1 s p (D Or Q i iii S = CD M i W Q CL to Q co C JUC-)),oc N L 9 sic ti y CL 0 U Q I O •� 1 W � Q Q Q O O � III: Za N '" o=_ A.P. NUM. Lc) 066-360-049 REVISIONS t _v v i SCALE: 1/4 " = 1 IFT. FLOOR PLANS e4 I --fl 1 . ill IT 11. � I I I .1 " ',- . , , , , , , 1- ,;, �� - j 1"ll1l.;t � 4i,',�l ': �)T�1.:� , - `F;ti, ` , ,� , - I& , , � " 1 � -4l, � , ,,� �, � , 'T, ;�'--" � ", ',)�i, �, 1, , I ,1�1 �A iF ,-I�", � 1� ,)) ,��7 "-,"r I I I , , � I I I , �, �,A,, I I ll� Rf -`- � , , t'T 4 , � � ll,,� 'll I -ti, .l, i 1, � ; ) i-, ,� I � � I - , ` " , ,�, I I I I I "" U;, 1'� 1. "l ,T , , " �- "'' , if ,�, V, : ,, , - , I iIi ,� 'T , � -! 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