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068-130-027
kut 1 jl 68-13-27 WILLIAM & KATHRYN-GIESE Fu (2ND DWELLLIG PLACED ON PARCEL) V23/01• . SANITATION • aPLAN 'AN', FOR 068-130-027` x 02=1020 3 BEDROOM,DWELLING REPLACEMNT GIESE, ROGER. ,106 CANYON DR',iOROVI LLE GARAGE-& BEDROOM ADDITION GIESE, ROGER { 2204 '106 CANYON DR., OROVILLEs" Mr TEMP = MOVE ELECTRICAL PANEL'; t} r',k � . `,yp t'F .t ;• 1 t+': w i rt^; 068-:1'36-,027 CsJ' GIESE ROGER s• t 106 CANYON DEMOOSF,+ Y=ti ,rt Sit, t �, ) i �t((r t � (tom � r .p}�i ��., t• `fit y�i�ti'� �"r i 1.i ": .y.r. r, f{ v. •rr.- `r.WM� u w� AN, 1 M . i ,', • Y ,. �. M • ',/_�. �r•4`'(C { +� 068-W130-027 04-0749 .PERMIT RENEWALt,' GIESE, ROGER Da FE: Ia� 106 CANYON DRIVE OROVILLE w.1;N# -�{ q'' • ''ti ' `' "T"`' Cont: OWNER "EXPIRES: ADDITION 2294 SQ PERMIT RENEWAL - DATE: ' �U �o ,• t K' ' BP# EXPIRES: 1 iii .,`' cn BALANCE OF FEES SHEET DATE: PERMIT #: ASSESSOR PARCEL #: OWNER'S NAME: FEES (Amount and Purpose): BALANCE OF FEES: $_ ADDITIONAL FEES: $_ REVISED PLAN CHECK: $_ SHERIFF FEE (commercial only): $_ SRA: $- COPY FEES ($1 or more) $ DRAINAGE $. BC RESIDENTIAL IMPACT County Wide Chico Urban -- EI Medio North Chico Specific_ El $ BASIN WATER TENDER FEES BATTALION # FEMA $ SMIP $ OTHER RECEIPT BUTTE COUNTY DEPARTMENT•OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP040749 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: 05/13/2004 APN• 068-130-027-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 106 CANYON DR ORO Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: ADDITION (2294) Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: GIESE ROGER M & PENNY L to its issuance, also requires the applicant for such permit to file a 106 CANYON DR signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95966-9428 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): fi} 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: GIESE ROGER M & PENNY L owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 2294 S.F. Policy#: Valuation: $149,110.00 p I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. _ Date: c 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 permi is hereby issued under -the pplicable provisions of the Butte County C dP anrVor I hereby affirm that there is a construction lending agency for the of the work for which this is issued (Sec 3097 Civ.) Resolutio s - dmwork i;=for which fees have been paid. performance permit By Date: V Name: PE IT EXPIRES ON: (�U Da e Address: ® 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of a official form or document of Butte County. 1 hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: Ae 5 �% !!;y F -<.-!E Signature: U�Z� Date: 5- P Owner 0 Contractor ❑ Agent for Owner ❑ Agent for Contractor Vr BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 12 1 r� PERMIT NO. BP 646q'o DATE: ` OL APN: U O � ZONING: OWNER'S• LA T NAME: OWNER'S FIRST NAME: PHONE: STREET ADDRESS: V OG e' N o FAX: CITY, ZIP: o.�v LL -g 9S9G� E-MAIL: SITE ADDRESS: CITY, ZIP: NEAREST CROSS STREET: TRACT/LOT #: APPLICANT NAME: PHONE: STREET ADDRESS: V FAX CITY, ZIP: E-MAIL: CONTRACTOR NAME: PHONE: STREET ADDRESS: FAX: CITY, ZIP: E-MAIL: LICENSE NUMBER: LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: FAX: CITY, ZIP: LICENSE NUMBER: E-MAIL: DESCRIPTION OR SCOPE OF WORK: eX'-/ A rftwid-E&M.1 ❑ 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 fees will be required. 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. or office use onl NotFees C6LACLA-(qd�d Wtr(� ' s: I' ✓,-- '�r R 14.Q Application Received by: Date: Receipt number: Amount Received: 7 Master application 3-4-04 S E USE ONLY - Rot Ren Anachad i • Floor Ran Attach, S to 8.o. ! TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner ocation 'AP# Plan Approved for: Sewage Disposal Water Supp y: Public Private Well Clearance for dwelling Other C vii I) 1 0 ' Hold final for: Final clearance O.K. ••for• NOTE: l Environmental Health Specialist Dated ; 8/96 Pa COUNTY OFBUTTE-DEPARTMENrdDEVELOPMENT SERVICES -BUILDING DIVISION ' 7 County Center Drive Oroville CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: /n ASSESSOR PARCEL NUMBER 4 (,F� e� l V V _�a "IdT47 Proposed Building Use: ; % Counter Technician: Date: -f (I/ O I ems equired in order to apply for a permit. All boxes MUST be checked OR marked NA inprder to apply. /7 -7 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. V /}� 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. 6. Energy compliance design and supporting documentation in duplicate. 7. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) 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 / 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chicoo Oroville, as applicabld. 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 cir 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 ..............................7PV6 It 22. City of Chico Plumbing permit .............................. .............. .. ............ 23. California Department of Forestry plan approval Pdpaid. Sent by: ............. 24. Planning approval (A) Use: (B)Parking: (C) Parcel Chec ❑ 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 .......................................... jW-1 31. Owner -Builder Verification (_ Given 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. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter fromgal Owner, ❑ Check to H.C.D. $ r>� 38. Other: rl(,r ,Pr ChOK r�tit� �,otso�' 0Ac�.�4 � ,c7w.Phonec°ei�#N :7f� ❑ 39. Other: When issued Telephone and hold for pickup. 4�ZlL_ ZZ-ff--zas-) I have been informed of the above items and requirements for obtaining a building permit. r Applicant: Date: 1. Index permi(application for the abo a items nKrn eyed: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, Date: Plans reviewed by: Date: Plans approved,by: Date Structural reviewed Date: Structural approved by: Date: Note transfer by: Date.: 00 Yellow: Building Division -5-3-04/t COUNTY OF BUTTE ]DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 u SC DJJLE OF RECEIPT OF FEES OWNER A.P. # O(.E' • oVO✓®� PROPROSED BUILDING USE DATE®/ D� 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) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... 4. URBAN AREA FEES Residential (per unit).. X $0.03 = $ Sq.Ftg. (paid at Building Division) X =$ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Fig. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89W0 (paid at Building Division) 152,q � 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 during oe plan checking process. APPLICANT v ��// 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 (One forrn per Building) -School District (0 t4 i Building Department N . b. Q� -Q 719 A.P. Number06 W-- 13o -OZlurisdiction: City County Property Ow6— — 0 R 41 Property Location/Address /66 rM Subdivision Lot No. Residential Development No of Living Mobile Home Units Installation Commercial/industrial New Addftlon ................................. v ...................................... Sq. Footage Addition/ *Supplemental to (Group R) Conversion Permit # *(No foundation Inspection) ........................................................................ ....................... . .... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Sq. Footage (Including Exterior Roofed Areas) 111 13 - Date District ldentific6iion'No. School District certifies that-. .:Applicant),..::: 3b - (Street Address) (Phone Number) CA (City) (State) (Zip Code) has complied with the requirements of Resolution No. o by payment of $ representing square feet. Q QL.26: $ MITIGATION GATION $ School District Representative Date Paid by Check # Remarks: . cnR o ;V1 4i No You may protest the Imposition of the fen Identified above by submItting a written protest to the District, In connplarra with Government Code Section 66020(a), wtttdn 90 days from the date fees an OW. Failure to submit a timely written protest Will'prohlbit you from chal"Ing the Imposition of the to" In any court action. K, subsequent to the School District Representative signhV "Butts County Schools Impact Fee Certification Form, the School District Is notified bythe appli II Local Planning Agency that Oft project Is being rav{swed under d*CdftriftEnWronnwc"QudRyAd(CE"), Oft project may be subject to addftkmW school fen to fully mtdgate.lts Impact on the school dist kft ad White (applicant),. Yellow (building department), Pink (school district) feeform.)6 (10103)dmm t BALANCE OF FEES SHEET -1 DATE: a5. , PERMIT: ASSESSOR PARCEL #: OWNER'S NAME: �Se� FEES: (Amount and Purpose): BALANCE OF FEES: $ ADDITIONAL FEES: $ REVISED PLAN CHECK: SBERIFF FEE: SRA $ + COPIES $ •.URBAN AREA FEES ' . $ • . CSA 7 (North Chico Spec.) $ ; , �E TEND." FEE $ BATTALION # AGE FEE -�- -� $ VALUATI IF BALANCE OF FEES OR ADDITIONAL FEES: ' T TAL VALUATION: $ DITIONAL VAL: $ (Check one) COUNTY CITY OFBIGGS (Check one), RESIDENTIAL ' COMMERCIAL /\\ -�; County of Butte Oroville, California GENERAL CLAIM CLAIMANT: Roger Giese ADDRESS: 106 Canyon Drive CITY & STATE: Oroville, CA 95966 nATF nF rl Alnn• n7/9n/nA r) la ► /6y SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY AMOUNT Refund Claim - See attached calculation sl APN: 068-130-027 Permit No.: r r 04-0749 PAID RETAINED REFUND DEVELOPMENT SERVICES $ 3,159.85 $ 2,089.62 $ 1,070.23 FIRE PLNG APPL FEE SRA $ 43.00 $ 43.00 SMTP $ 14.91 $ 14.91 TOTAL $ 3,217.76 $ 2,147.53 $ 1,070.23 Ff l`TD:1�THCOD T ACCUU A 4ii.vi3P�� Bld Ins ctn 0010 440-001 4210500 1011001 $ 1,070.23 TOTAL $ 1,070.23 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. Dated this Toto - day o 2004, at �/ �� Calif. G Sign ture of laimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Check one for the same. Dated this day of, 2004, at Oroville Cal' . Department Hea uthorized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY EPT & SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT. 4 Butte County Department of Development Services YVONNE CHRISTOPHER, DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile ADMINISTRATION * BUILDING * GIS * PLANNING July 20, 2004 Roger Giese 106 Canyon Drive Oroville, CA 95966 RE: Permit No. 04-0749 APN#068-130-027 Owner: same 7/am/ay On 3/16/04, a deposit was made in the amount of $3217.76, of which $2147.53 was retained. The remaining fees will be reimbursed to you. Please sign, date, and return the enclosed claim form to this office. Once we receive the claim form, we will then process your refund in the amount of $1070.23. Should you have any questions, please contact this office Monday through Friday, 8:00 a.m. to 4:00 p.m., at 538-6869. Sincerely, Diane Lewellen , OA III Administrative Division enclosure 04-0749.1tr CLAIMANT Reason for Refund Name Roger Giese Dept. overcharged. Address 106 Canyon Drive City/State/Zip Oroville, CA 95966 Date of Claim 05/13/04 APN 068-130-027 Permit No. 04-0749 RECEIPT INFO Receipt No. 395211 - Receipt Date 03/16/2004 Issued to (Name) Roger Giese Check Number Amount 3217.76 Date of Fiscal Processing 06/15/2004 . PAYMENT DETAIL PAID RETAIN . REFUND BLDG v, Time . 109.98 `1979.64 ; Filing from Plan Check 0.00 0.00 Plan Check/Filing 0.25 0.00 791.86 791.86 0.00 Inspection 0.00 1187.78 1187.78 0.00 BLDG FEES OTHER BLDG SRA - Bldg Inspec Fee Overcharge REFUND PROCESS FEE 54.99 109.98 109.98 0.00 1070.23 1070.23 0.00 BUILDING TOTAL ' 3159.85 ° 2089.62 •1070.23 FIRE PLNG AP PL FEE (SRA) SMIP 43.00 14.91 $ 3,217.76 43.00 14.91 $ 2,147.53 0.00 0.00 0.00 0.00 $ 1,070.23 Date Reviewed by BO: 6/17/04 Michael Viera G 9 CL I oO03TrF0 Butte County Department of Development Services C Building Division o o 7 County Center Drive c�UN'�y Oroville, CA 95965 (530) 538-7541 REFUND REQUEST APPLICATION REFUND POLICY - Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the fees, whose name is on t he receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt. 2. The request must be made within two years from the date of fee payments on permits not issued, and two years from the date of permit issuance for permits issued -if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees paid to other Countv Departments are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the Check those fees which you wish to have considered for refund: =Building Permit Fees =Sheriff Fees =Other (specify): =SRA Fees (CDF Fire Planning) Plans for cancelled permits will be disposed of within 10 working days upon submission of a Request for Refund. If you want the plans, you may pick them up prior to that time. Srgnatur Date K:/Forms/Refund Application 082203 0 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP 646q'A DATE: _� APN: o ZONING: -1 OWNER'S LAST NAME: OWNER'S FIRST NAME: PHONE-- HONESTREET STREETADDRESS: 106 .e N CP FAX CITY.,E-MAIL: aZIP:� e�LLg 9s9G SITE ADDRESS: CITY, ZIP: �/ P NEAREST CROSS STREET: -,4&'W o �� TRACT/LOT t APPLICANT NAME: -' PHONE: STREET ADDRESS: FAX CITY, ZIP: E-MAIL: CONTRACTOR NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: E-MAIL: LICENSE NUMBER: LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: FAX: CITY, ZIP: LICENSE NUMBER: E-MAIL: DESCRIPTION OR SCOPE OF WORK: i e&/ LP/%v s " ❑ 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 fees will be required. 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. For office use only: ���� C���C���GL 1� G� LliMAC�► r� Notes: J� ��� o•. s'1z 141015 .9 Application Received by: Date: Receipt number: Amount Received: P;�,qq �qqq-bq c5r'M P 1q .q I � 1� o PERMIT - - • Bin JWAPN LAST NAME FIRST m—ENSITITTEM • CONTRACTOR EMUCITY/CTY STREET JY WSTREETNAME • CITY 101001TWIN USE TYPE REMARKS ' 00 BE P E E M 25 char. max VALUATION FLOOD FEES PAID• M RECEIPT APPLIED FEES 2 RECEIPT 2 ISSUED FEES 3 1 RECEIPT 3 FEES 4 RECEIPT 4 FINA LED PLAN CHECK ACTIVITY Plan Chk1�: Chkd By -1: Return- - 11: Str Chk-1: Plan Chk-2:Chkd _By -2: Return, 2. Str Chk_2: Plan Ch013: Chkd By -3: _ Approved: Str Appr: Comments: 255 char. max NER HAS CHECKED OUT 2 SETS OF PERMITS 5-3-04 TP 7E TRANSFER, INDEX FOR FEES. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 068-130-027 ZONING AR 1 BUILDING PERMIT OWNER GIESE ROGER TELEPHONE 589-9189 SO. FT. OCC. BUILDING VALUATION Je6E''CMT"D` RIVE OROVILLE, CA 95966 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 15.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 106 CANYON DRIVE OROVILLE CA 95966 Energy Plan Checking Fee $ $ PERMIT FEE $ 35.00 LOT NO. SUBDN610N'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF 10 Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap7.00 Solar or heat um water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: DEOM SF 576 SQUARE FEET PER ASSESSORS INFO Gas i in system 1 - 5 outlets 15.00 Buildin sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service '*.A oR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service 200A TO unwA 46.00 NEW CONST. DWELUP. LING OCC OR ADDNS. ( 8 ACC. S. SO 3.5¢FT: NOµq DSID. MULTI -OUTLET 97.50 POWER APPARATUS & SINGLE OUTLET CIR. Ex, Occup. OUTLET OR FIXTURES 20 @ 1.00 BAL @ .50 Ex. Occup. OUTLEEDTSA(RRESID°FR.a 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE _ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEL: $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 1)1- 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwi omply with those provisions. r-- X _ _ _ Date dl X� g- ,0.3 Signature of Appli6arit - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or constructio of structures over 3 stories in height. TBy Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 35.00 _HA71). FEES IMP I FLOOD I COF PARCEL I PD I HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have PERMIT EXPIRES ON L the applicable provisions Resolutions to do work been paid. Date Y/ Date Receipt No. 376283 / $ 35.00 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-750 PERMIT NC (Rev.12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER G CJ zDNI _ BUILDING PERMIT OWNER �` �[^ 9 i C. J �i TEtZP¢HOHE_ j 37 / S0. FT. OCC. BUILDING VALUATION OWNERS MAIUNO ADD C _ CONTRACTOR' /MAILING TELEPHONE CONTRACTORS ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation S ARCHITECT OR ENGINEER LICENSE Fee $ 20.00 —Filing Permit Fee L ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS / , 1 ^ Energy Plan Checking Fee S ' S PERMIT FEE LOT NO. SUBDIVISIONS NOME PARCEL MAP PLUMBING PERMIT Filing 9 Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other sPIEC" Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.001 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ InstallationlI,❑ Other 13 Describe Work: _�e�eQ J C� �� <� Gas piping system' 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service xw oa mss 23.00 e SPS >� O � AW660A ��s, c © Main Service 200A TO 1000A 46.00 NEW CONST: pWELL1N0 OCCUP. OR ADDNS. 6 ACC.:9S. I so. 3.5¢ FT. CONS I. MULTFOLm.ET NON•RESID. @7.50 POWER APPARATUS 8 SlNA1 F 011RET Cr L OUTLET OR FnUREs EX. OCCU OULT 20 1.00 y SAL .S0 INS Ex. Occup. =PL.M.D1L 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEL= S Mobile Home Installation Fee $ Energy Inspection Fee $ oc` CONST. TYPE TOTAL FEES 3S ' Z. D. FEES. I IMP I FLOOD I CST PARCEL PD HDI ISSUE co�u�cr This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have,been paid. By PERMIT EXPIRES ON Date _ COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT n2 -22o/1 ASSESSOR PARCEL NUMBER 068-130-027 ZONING BUILDING PERMIT OWNER ROGER GIESE TE E SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 106 CANYON DR 0 CONTRACTORS NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ PERMIT FEE $ LAT NO. SUBDNISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF EX Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities IN Installation ❑ Other ❑ Describe Work: MOVE PANEL TO TEMP LOCATION UNTIL CONSTRUCTION ON $P 1020 COMPLETED Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service .OA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class LIC. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors license Law for the following reason: W- I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A To 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( & ACC. BLDS. SO 3.5QFT. T. rN,lOµpEOSID. RANCHO CIRCUITS 97,50 POWER APPARATUS 8 -SINGLE OUTLET CIR. EX. OCCU OUTLET OR FIXTURES B20 @ I..00 SO Ex. Occup. OUTLETS RESID.OEA 5.00 Temporary Service 23.00 13.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 0 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the wor mpensation provisions of section 3700 of the Labor Code, I shall I with ply with those provisions. r� p- ` X Date O �ly�O c— S nature o Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE 43.00 TOTAL FEE $ HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE XX This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated ab for which fees have been paid. to ` l PERMIT ES ONITE-D.D.S.-B.D. Date rReceiptNo. 360945/$43.00 CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF 13UTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 tRev.12/96)APPLICATION AND PERMITPERMIT "` AS$j25011 PARCEL wLbQ i- �CSZ � .,;50. tJBUILDING PERMIT OwwE e Q� SO. FT. OCC. BUILDING VALUATION NA51 owwEllt lA C. cover RACTOR's wort i ���•� " cowarlNjtflOw LEMOER LENOERS LWLNC ADDRESS AACMRECT OR ENOINEER ARCHITECT OR ENOPMAS LVAJNO ADORESS auA.Dr1G ADORESf 16119 r ' I fLxSON6K1wS 1LALLE PARCEL MAY USEOFSTRUCTURE SF Duplex O Mobilehome O Other nvecsv TYPE OF WORK New O Addition O Remodel 0 UEli6es, 1 installation 0 Other p Describ Work: 'i�erw,;} �et76ud 4 s1�AS-ppo 44 -me - women � f Aww"A TXCciVd � r Nk�1W w►bt1lr��'�4b 6C..Ofbt"1' ih�a C+o1Y�'�t�1"rPr Fireplace Total Valuation E Filing Fee S Main Service "OVOV OOA FXEO OUT ETS.00Tem 20.00 Permit Fee E Main Service Plan Checking Fee S - Energy Plan Checking Fee i S PERMIT FEE t PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat um water heater 23.00 Water piping 15.00 he Each as water ater or vent 15.00 Gas piping system t - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE I f ELECTRICAL PERMIT I Filing Fee 20.00 Main Service "OVOV OOA FXEO OUT ETS.00Tem LPss 23.00 Main Service 20" To t000A 46.00 NEW C01JST: OIL ADDwf. OwE UP. \ 1 3.5ee I ° I t:X. OCCU OVnET OR FDmlRES Io ro 1.00 j Eull .>0 . EX. OCCU FXEO OUT ETS.00Tem orn Service ���235 .00 J Mobile Home Facilities 20.00 PERMIT FEE I i `7 ,J MECHANICAL PERMIT Flina Fee 1 20.00 6.50 PERMIT FEIE f Mobile Home Installation Fee $ Energy Inspection Fee i «r CONST.TYPE TOTAL FEE $ NAz. 10. FEE$ I MAP I FLOOD coF PAR a I PO I to i gMUC This permit Is hereby Issued under the appricable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date _ PERMIT EXPIRES ON 'r. O.B.- O`VNER-BUILDER VERIFICATION A:tencion Property Owner: An "owner-buildef building permit has been applied for in your name and bearing your si8mptt+e. Please complete and return this information at your earliest opportunity to avoid delay in processing and issuing your building permit. No building permit will be issued uUM -this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES ❑ NO z 2 I HAVE— HAVE NOT ❑ signed an application fora building permit for the proposed WO& I I have contracted with the following person (firm) to provide the proposed eonstruedo�: NAME: ADDRESS: Cal Y: PHONE: CONTRACTOR'S 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: NALNJ E: ADDRESS: CITY: PH0NNE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contacted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYO SOCIAL. SECURITY NUNMER: DATE: % e7l-� ROTE: This Owner -Builder Perification is required by Section 198.11 and 198.31 oVde California Health and Safety Code. This verification must be completed Md returned to our office before we are permitted to issue the permit OVER T- I .--- I- I OWNER BUILDER INFOPUNLATION Cea: Proper^i Oµ -e" 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 parry of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family. and the work (including materials and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractors or subcontractors. then you may be an employer. ♦ If you are an employer, you must register with the State and Federal 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 contnbutioas. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious V with respeyt to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, i f you wish, the U.S. Small Business Administration). For more specific information about your obligations under Sate Law, contact he 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 "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 10=0 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. NiI rely, otic el C. Vi ira, C.B.O. t ger, Building inspection NOTE: Tbir Ow ter -Builder information is required by Section 19810 of the California Health and So coda OVER COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 P-Rr�u,T y (Rev.12/96) APPLICATION AND PERMIT �a�� �` (� ASSESSOR PARCEL NUMBER 068-130-027 ZONINCI AR -1 BUILDING PERMIT OWNER GIESE, ROGER TELEPHONE SO. FT. OCC. BUILDING VALUATION 1 0 R 631720.00 DWNER 6gNGCANYON DR. , OROVI= CA 95966 840 U 15 120.00 CONTRACTORS NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 78084 .00 ARCHITECT OR ENGINEER UCENSE NO. Filing Feb $ 20.00 Permit Fee $ 545400 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $354.25 BUILDING ADDRESS 106 CANYON DR. OROVE-LE Energy Plan Checking Fee $ 23.00 $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7 1 7.00 Solar or heat pump water heater 23.00 Water piping 15.0019-00 Each as water heater or vent 15.00 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: GARAGE & BEDROOM Gas piping system 1 - 5 outlets 1 5.00 15.00 Building sewer 15.00 15 . QQ Mobile Home I S I G I W @20.00 PERMIT FEE $ 129. ELECTRICAL PERMITFling Fee 20.00 800VMain Service 200A OR LESS 23.00 i LICENSED CONTRACTOR'S DECLARATION L I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class LIC. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: 9-- I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. I am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that f I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall fo 'fnply with those provisions. n. Date As: -:v _ nature of Ap icant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 2ooA To +000A 1 46.00 NEW CONST. DWELLING OCCUP. SO /� OR ADDNS. ( 8 ACC. BLOS. 3.50FT. 70.70 NOµHESID. MULTI.OL . @7.50 POWERNGLE 011RET APPARATUS CIR. 8 SI 20 @ +.00 Ex. Occup. ourLJ=T OR FocruREs SAL @ .50 Ex. Occup. o xtmFEDrs Ao .OEw 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE s 113.70 MECHANICAL PERMIT Fling Fee 1 20.00 Heating extend 1 115.00 15.00 Cooling Hood 6.50 Ventilation PERMIT FEE S 39.50 Mobile Home Installation Fee $ Energy Inspection Fee $ c co T. TOTAL FEE $ E IMP FL O F PARC PD D SUE I /I This permR is he issued under the of the Butte County a and/or indicated ab for c ee have By PERMIT EXPIRES ON applicable provisions Resolutions to do work been paid. Date l Date Receipt No. 353321 .457.25 .0 WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR IFGOLDENROD-APPLICANT COUNTY OF BUTTE-DEPARTMENTOF*VELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, OrovilleACA 9965 Phone (530)538-7541 Fax (530)538-2140 t PERMIT APPCICAIT'ION DATA SHEET OWNER: I e� 6 — 150 _ Q �1 �,,� �,� ASSESSOR PARCEL NUMBER Proposed Building Use: a S Counter Technician: `+' Date: g a 5-/0 a , Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in ord to apply. pPlot plans, 3 or 4 sets, signed by the preparer of the plans. Complete plans, 3 or 4 sets, signed by the preparer of the plans. 9-5" Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 1.4 -Engineered truss details and layouts in duplicate. No faxes! JIJV5. Energy compliance design and supporting documentation in duplicate. 4;;1-6''Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. 9-7'"Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed -,,,in duplicate ................................ f' ❑ 9. Plot plan and business license approval fig' the City,'of Biggs ................. .... ::..... r.:.... ❑ 10. Letter of intent for non-residential buildins .......... :.......:,y. x................, ❑ 11. Detached Accessory Building Form filled outtby the owner... '?..; .......................... ❑ 12. Hazardous Material Form ...................... . =........'............................................ f 17 13. Other i I i l= ,Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 14. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... ❑Statement of Intent for Non -heated and A/C Buildings ..........................................:. Sanitation and plot plan approval from the Environmental Health Department in ❑�7. City of Chico Plumbing permit .........................�. C 18. California Department of Forestry plan approval ❑ paid. Sent by: �3_(D.......... ❑ 19. Planning approval for (A) Use: (B)Parking: _ (C) Parcel Check: ❑ 20. Contact Land Development about ❑ Improvements, ❑ Drainage ............................... ❑ 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy,), ❑ 22. Pre -Inspection for <. required :................ ❑ 23. Contractor's license information. (Number, Name Style, Classification). ❑ 24. Worker's Compensation Carrier and Policy Number .......:......:...:........................:: ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization.................................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance............................................................... ❑ 29. Existing violations and/or expired permits......................................................... . ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone - and hold for pickup. I have been informed oft a above items'and requirements for obtaining a building permit. Applicant: Date: 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required t Contractor, designer,,owner, was advised of the above data by ❑ phone, -❑ mail, ❑ counter by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ c r, by Date: I_ Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division ' Ip{` E.H. USE ONLY Plot Plan Attached Floor Plan Attached J .y Sent to S.D. v TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance mesa, & 'b �� - 3L) -a� Owner Location AP# Plan Approved for: Sewage Disposa� �,A Water Su ly: Publi Private Well Clearance for dwelling. Other _3 � LTD✓ -,SLI ) L1 I AC D W�� 11 Hold final for: Final clearance O.K. for: NOTE: _ I S 1 Y'1 C Environmental Health Specialist 8/96 �- aD-a Date rw vC ;iv�+�-•'4 Y.r'• .`.k.--..r...,--r-^ .,.w+�., 1.. �..�. -t��.�,."�'..^Yii� - .. �....,v��: i•.._ •... ^-.�;'4..�.. � .. _. - ,. .. BUTTE, COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM co� ' (One form per Building) School District �J ( (� (f IY� � iP. (�'� Y� It'� g Building Department Not �p� /V 0 A.P. NumberJurisdiction: 0 city County Property Owner / S 9 Property Location/Address, /(,)(/-7 ( "// (/`j(���)j4 Ar� ( 1 ou I I I t Subdivision v r' Lot No. .................................................................................................................. 9 Residential Development Sq Footage No of Living Mobile HomeAddit l •Supplemental to (Group R) Units Installation Conversion Permit # *(No foundation inspection): .................................................................................................................. Commercial/Industrial New Addition Sq. Footage (Including Exterior Roofed Areas) Date moor rians reviewed by Scnool uistnct Personnel) District Identification No. y , . Q•,Lt School District certifies that n (�v (Applicant) (Street Address) (Phone Number) (City) (State) (Zip Code) has complied with the requirements of Resolution No. �9 -QO 0.� by payment of $! representing " O square feet. School District: Representative - Paid by Check # AB 2926 $ FULL MITIGATION $ 5 /,2g Date Remarks: + 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(a), 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 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete andreturn 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 Q 110 11 2. I HAVE)k HAVE NOT 0 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. 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: PHONE: CITY: CONTRACTOR'S LICENSE NO. 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: RO s DATE: NOTE. This Owner -Builder Verification is required by Section 198.31 and 19832 of go California Health and Safety Code. This verification must be compkNd and returned to our office before we are permitted to issue the permit OVER OWNER BUILDER INFORMATION Dear Properri Owner: An application for a building permit has been submitted in your name !'sting 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: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is S300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ If you are an emplover, 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. ♦ 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. 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 perforin 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 "owner buildee' 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 1030 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. Irely, el C. Vi ICd, C.B.O. ger, Building Inspection NOTE: Tlrir Owner -Builder Information is required by Section 198jo of the California Health and Safety Code. OVER S COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 �U APPLICATION AND PERMIT �ae:v 1-196 A:SESSOR PARCEL NUMBER I J 0 --. ^� _°"""° Af .I BUILDINGPERMIT ��-- ow R— l� TELEPHONESO. �. I OCC. BUILDING VALUATION _ M. i2�> OWNER VMAJUNQ ADDRESS C Ni MOTORS NAME , ' I TELEPHONE COPITRACTCRs MAILING ADORESS C3NS TRUCT,ON LENDER LEADER S MAILING ADDRESS ARCHITECT OR ENGINEER UCENSE NO ARCHITECT OR ENGINEERS MAILING ADDRESS aLILOn+G ADDRESS r Lit LOT NO. I SU13ONEi10NS NAME PARCEL MAP USEOFSTRUCTURE SF K Duplex ❑ Mobilehome ❑ Other svEclFr TYPE OF WORK New Addition PQ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work:R.. , " PERA T FEE PA20 SRA • . SHERIFF OTHER AAkbVNT RECEMb "RBC�IP'i' NVMSlR 3S 3 I " TO " IVT 2"T0 CON MIR Fireplace Total Valuatlon S Filing Fee S 20.0 Permit Fee S Plan Checking Fee $ }, Energy Plan Checking Fee S 23 S PERMIT FEE _ �Sr PLUMBING PERMIT Fling Fee( 20.00 Each Trap ? 7.00; (`� Solar or heat pump water heater 1 I 23.001-~ Water piping I 15.00 Each gas water heater or vent I IS -00! Gas piping system t - 5 outlets I { 15.00 Building sewer I 15.00 S Mobile Home 1 S I G I W I @20.00' EX. OCCU OUTLET OR FOCTVRES PERMIT FEE I S �Gl, 6p ELECTRICAL PERMIT j I Fling Fee: 20.00 Main Service mOOOV w oROR 's u:ssS 23.00; Main Service ( 200A TO 1000A _ I 46.00 NEW CONST. OR ADONS. ( DWSLING OCCUP. A ACC. BLDS. 3.Sc , I Rso.; NEW CONS NO N•RESIO. MULTI -OUTLET RAAI.rN r.e.. ^^ ^ ) I 97.50: EX. OCCU OUTLET OR FOCTVRES I 2d -W I. IAL . .y0 i Ex. Occup. OFlXtlT ETS R DOEEA 1 I S.00! Temporary Service I 23.001 Mobile Home Facilities j 20.00: Misc. Wirinq I I 23.00 PERMIT FEE 1 $ 11 �5, Vu MECHANICAL PEWIT Filing Fee 1 20 00 Heating Cooling I Hood j 6.50 ; Ventilation 1 1 1 V jM i .5;b PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee I $ occ CIO'ST- TYPE TOTAL FEES ca. "AZ. I D. FEES I IMP IFLOOD I COF I PARCEL I PO 1 HO : 6SL= This permit is hereby issued under the applicable provisions of the Butte County Code end/or Resolutions to do work indicated above for which fees have been paid. By Receipt No. PERMIT EXPIRES ON WHITE-O.O.S.-S.0. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROO•APPLICANT Date COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE-.OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 SCHEDULE OF FEES DUE OWNER PROPOSED BUILDING USE _ ��y F 1. BUILDING PERMIT FEES p (2 , �� Balance Due ....................... $ 0 J Additional Fees Due ................. $ Additional Fees Due ................. $ Revised Plan Checking Fee .............$ 1 2. SCHOOL DISTRICT FEES �VtSI) l 1 2l/l'l (paid at District Office) (Available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential ...................... x $360.00 = $ Units Commercial (sq. ft'.) ............... x $0.03 = $ Sq. ft. 4. URBAN AREA FEES (paid at Building Division) Residential ................... —x—=$ # Units Amt. Commercial (sq. ft.) ............ —x—=$ Sq. ft. Amt. 5. RECREATIONAL DISTRICT FEES (paid at District Office) (Available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER A.P. # DATE C) RECEIPT # DATE REC. At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during4he plan checking process. r— APPLICANT DATE y' 2--! -d �L Pursuant to Government Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original - Buiding Div. 2nd Copy - Applicant 3rd Copy - Owner ' (Rev. 6/00) i LAND OF NATURAL WEA.LT.H AND BEAUTY PLANNING C0MMISSIO:N CERTIFIED -RET_ N RECEIPT 7 COUNTY.CENTER DRIVE O'R'OVILLE, CALIFORNIA95965 • _ PHONE:.. 534-46G.1. October 1Z,.-'1984 Wi-11iam. and Kathryn Giese 106 Canyon. Drive Or6v .11e, CA. 95965 Re.: AP .68-1.3-.. 27. 'D e at Mr:. & Mrs. Giese It has been brought to. my attention that a second dwelling. (motii a home) has. been placed on your referenced parcel. This use i.s a violation of the Butte County Zoning Ordinance Section 24.-87.2. 'AR -1 .(Agr.icultural-Res idential). Zone which states:. Ai Use Permitted ,I : (1):: One single-family dwelling per parcel not in-cludirig 'ten.ts,.trailers or.mobile homes Please be aware that the above. illegal.use.may. incl, de 'vi':o.latons of other Butte County.. agencies. As --the owner of this parcel, the. abatement of this use is.your .responsibility. Ther efore.1 you are instructed to either remove the extra 'dwelling (mobile home) or disconnect all --utilities arid park the mobile in dead storage.. Failure t -o follow the above instructions wit.hn.30'day.s of the receipt of. this letter -will result in the :matter being forwarded for appropriate .Legal action. If you have any questions, please contact this office. Sin .1 Vincent Anzalon Zoning Investigator VA: db. . cc:. Planning Director. County Counsel Erivironmental Health; .Orovi.11e filding Department . O.B.-1 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. GI personally plan to provide the major labor and materials for construction of the proposed property improvement: YES ❑ NO Ja QI HAVE .❑ HAVE NOT ®-signed an application for a building permit for the proposed work. 3. I have contracted with the following person (fum) to provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'S 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: ork:NAME: ADDRESS: PHONE: CONTRACTOR'S 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 NOTF: This Owner -Builder Verification is required by Section 19531 and 19832 of the California Health and Safety Codes This verification must be completed and returned to our office before we are permitted to issue the permit. OVER OWNER BUILDER INFORMATION 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 yourprotection, you should be aware that as "owner -builder" you are the responsible party ofrecord on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $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 inchidmg state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ 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 conditions. , without a. licensed contractor or subcontractor, only under limited A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building pemut, 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. re'Y' lytic 1 C. Vi ira, C.B.O. '- er, Building Inspection NOTE: Y'lls Owner Builderinfomu on is required by Seddon 19830 of the Cal forma Health and Safety Code OVER 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 www.buttecount_V.net/dds OWNER: ASSESSOR PARCEL NUMBER r�� :11:19;16 Proposed Building Use:t�(� S`� (i� otl -(7 /9q C1(Q( Permit Technician: (� , Date: 7Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply - 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 faxesl ❑ 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) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Hazardous Material Form. ❑ 12. Acknowledgement of building permit application without required clearances. ❑ 13. Other R,eDAining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 14. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable 15. Fire Sprinklers ❑ 16. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office ❑ 17. Soils Report and/or Engineered Foundation required. ❑ 18. Erosion Control Plan Required. iAINk 19. Fees as shown on the attached Schedule of Fees Due Sheet. ❑ 20. City of Chico Plumbing permit. ❑ 21. Site plan and business license approval from the City of Biggs. ❑ 22. California Department of Forestry plan approval ❑ paid. Nd10 23. Planning approval for (A) Use: ��)Parking: (C) Parcel Check: (�j, tA, a�lO 16 ❑ 24. Contact Land Development about _ Improvements, _Drainage. ❑ 25. Fire Marshall Review (commercial projects only). ❑ 26. NPDES Form ❑ 27. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 28. Contractor's license information. (Number, Name Style, Classification). ❑ .29. Worker's Compensation Carrier and Policy Number. ❑ 30. Owner -Builder Verification (_ Given to owner, _ Mailed to owner). ❑ 31. Letter of Signature authorization. ❑ 32. Recorded copy of Agricultural Acknowledgment Statement. ❑ 33. Existing violations and/or expired permits. ❑ 34. Deed Restriction. ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ❑ 36. Other: ❑ 37. Other: When issued Telephone 0530) 51n - q l C/01-11 Owner and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 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, and other department costs are not refundable. Original -Applicant K/Building/Plan Check/Data Sheets/data sheet page 1 9.27.05 ;���.;�.. .. .. . , �. _ . �sr�`-'fir--w�� .,fir w,..�"• •r' y#�,rr..-.-...e...1-. �.t .�r,�.-•..• . .. , ,=s.-._ ,r- -". t 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: _tsk ASSESSOR PARCEL NUMBER M19- - i sO ` o I Proposed Building Use: Or r;(; Permit Technician: VI-�, Date: J 6 Ites required in order to apply for a permit... All boxes MUST be checked OR marked NA in order to apply. �d 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. Ng!bW 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 faxesl ❑ 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 AIC for Non -Residential Buildings. o 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Hazardous Material Form ❑ 12. Acknowledgement of building permit application without required clearances. Ga ❑ 13. Other Reff6ining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) U Ail . 14. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 15. Fire Sprinklers............................................................................................ ❑ 16. Agricultural Buffer clr and site plan apt from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... 018. 'Erosion Control Plan Required........................................................................ def,, 19. Fees as shown on the attached Schedule of Fees Due Sheet .............................. t ❑ 20. City of Chico Plumbing permit........................................................................ ❑ 21. Site plan and business license approval from the City of Biggs .............................. ❑ 22. California Department of Forestry Ian approval ❑ paid. Sent by: .. i 23. Planning approval for (A) Use:(B) Parking: (C) Parcel Check:.........I ❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 25. Fire Marshall Review (commercial projects only). Sent by: ...................... ❑ 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ .29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( ) _Given to owner, _Mailed to owner ..................... ❑ 31. Letter of Signature authorization ............... ........................................... ...`�..... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ........................... ❑ 33. Existing violations and/or expired permits ..................................................... ❑ 34. Deed Restriction..!...................................................................................'.... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: 1 ❑ 37. Other: i When issued Telephone (SS) 5211 - q I q9 DwnW and hold for pickup.. I have been informed of the above items and requirements for obtaining a building permit. ti Applicant: Date: 1. Index permit application for the, above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner; was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05 Q GANydI/ ��' RtE� P. SCALA /V(o c�fi off'/ S ,9i � aIya E.N. u5E ty Mot /fan Attacher Floor Nan Attache!_ Sant to I.D. ! TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance RIA C7\p- ` - D6 wner Eldcation AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well Clearance for dwelling. Other J/ �� Y2 Hold final for: Final clearance O.K. for: NOTE: nmental Health Specialist 8/96 Date M py 1 ,peCo� t° /oj� 06,