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068-130-120
' r 068-13-0-120 00-19 -�. 69 / 0 TOM & SHAN�f� _ UT, OROVILLE N NEW SINGLE FAMILY B07-0567 068-130-120 MISCELLANEOUS Ag Exempt AG BLDG: HAY STORAGE, LIVESTOI 100 WALNUT AVE CARD, TOM & SHANA ` B07-1751 068-130-120 SECOND DWELLIN( SFD-Custom/Model N G 1300), GAR(1344), C4, WALNUT AVE Q 11 CARD, TOM & SHAfTd � BUTTE COUNTY . DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 100 WALNUT AVE Owner: Permit No: B07-0567 APN: 068-130-120 CARD, TOM & SHANA Issued Date: 03/27/2007 By GLB Permit type: MISCELLANEOUS P O BOX 5104 Subtype: Ag Exempt OROVILLE, CA 95966 Expiration Date: 03/26/2008 ' Description: AG BLDG: HAY STORAGE, LIVES' (530) 589-2007 Occupancy: Zoning: ARI Contractor Applicant: Square Footage: CARD, TOM & SHANA Building Garage Remdl/Addn P O BOX 5104 _ 1,296 OROVILLE, CA 95966 Other Porch/Patio Total (530) 589-2007 1,296 FEE INFORMATION DBEH Building Review Fee $75.70 DBOMSCF Ag Exemption Permit $109.98 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 03/27/2007 Contractor's Signature Date I WORKERS' COMPENSATION DECLARATION I I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; X Carrier: Policy Number: Exp. Date: (This section need not be competed if the permit is or once 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 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, 1 shall forthwith comply with those provisions. 03/27/2007 blgnature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ, code) Lender's Address City State Zip Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that 1 am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractors License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). ❑ I AM EXEMPT under Section B. 8 P.C. for this reason: t i 03/27/2007 Owner's Signature Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enlqp4he above mentioned property pection purposes. I hereby certify that I am the property o r or am authorized to act o arty owners behalf. - 03/27/2007 Owner 0 Contractor OR. 'E]Agent for Owner Agent for Contractor FILE COPY 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 AGRICULTURAL BUILDING EXEMPTION STATEMENT Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated or packaged, nor shall it be a place used by the public. Buildings used for purposes other than described above or that are located in a flood hazard zone are not eligible for an agricultural exemption. Authorization of an agricultural exemption permit by the Department of Development Services does not preclude any requirements and/or review by the Butte County Public Works Department, Butte County Fire Department, Butte County Environmental Health, or any state and federal agencies. Initials g/—AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. Initials k.--- AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 110�0 feet from a manufactured home, and 23 feet from a commercial/industrial buildings Initials � AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum 23 feet from a residence and a manufactured home, and 40 feet from a commercial/industrial buildings Site Address: 100 WALNUT AVE Permit No: B07-0567 APN: 068-130-120 Square Footage: 1,296 Permit Type: MISCELLANEOUS Occupancy: Permit Subtype: Ag Exempt Zoning: AR1 00 Description: AG BLDG: HAY STORAGE, LIVESTOCK Required Setbacks: Applicant: CARD, TOM & SHANA Front: 20' Side: 20' Rear: 20' P O BOX 5104 OROVILLECA95966 Type of Construction: (530) 589-2007 Type of Siding: T-111 Owner: CARD, TOM & SHANA Est. Const. Cost: $ 5,000.00 P O BOX 5104 OROVILLE, CA 95966 Roof Covering: Metal (530) 589-2007 Floor Type: Dirt I declare under penalty of perjury that the building will be used as stated above, and the proposed.use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain the necessary permits, inspections and approvals to comply with the requirements in effect at tha.�,time and prior to occupancy. Signature of owner: CWAG � Date: 03/22/2007 FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (330) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION ' Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last NameFirst a �L Mailing Address City e Zip g�y� Phone EFap E-mail CONTRACTOR Name Address City State Zip Phone Fax E-mail Lic. # Class _ APPLICANT INFORMATION Citv r State /� Zip Phone � 2OD-� Fax APPLICANT SIGNATURE^ - X PERMIT NO. BIN # PF:OJECT LOCATION AP# 130,-120 Property Addresslev City O WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK, �i �Z . i Sq FT- Living Garage Open Ctv ❑ Structure Built without Permits � i ❑ Proposed Change of Occupancy i (Note previous use) For office use only: I ! Zoning Flood Zone vn; I No ` Occ. Type Const. ARCHITECT/ENGINEER Name Address City State Zip Phone Fax E-mail State License Number _ APPLICANT INFORMATION Citv r State /� Zip Phone � 2OD-� Fax APPLICANT SIGNATURE^ - X PERMIT NO. BIN # PF:OJECT LOCATION AP# 130,-120 Property Addresslev City O WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK, �i �Z . i Sq FT- Living Garage Open Ctv ❑ Structure Built without Permits � i ❑ Proposed Change of Occupancy i (Note previous use) For office use only: I ! Zoning Flood Zone vn; I No ` Occ. Type Const. RESIDENTIAL 068-13-0-120 00-10,0 , PERMIT NO. L. -CARD;-. TOM &.S:4ANA -- - 0— WALNUT, OROVILLE y CONTR: OWNER I NEW SINGLE FAMILY u wtf SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER cam, t• JOB FINALED (Date) jj Signature 1� . OFFICE COPY Address GAS Meter By Date/A,,ga ELECTRIC Meter By Date�� ZO cam, t• JOB FINALED (Date) jj Signature 1� . a V= OK 0 = Not OK�5 - = Not Applicable = Not Ready RESIDENTIAL (Sin le Duplex) Date Un rfloor (Plans) OK except #'s ni -Setbacks-Easements-Flood-Slope tg., ; Soils-Elec. Grnd.-/ P Ftg. De tg., Garage; Soils-Steel-Elec. Grnd.-/ P Ftg. Depth 4. Ftg., P rches & Decks; Soils -Steel-/ P Ftg. Depth tem Main; Steel-Blockouts-Wrapped alls, Garage; Steel-Blockouts-Wrapped OvOlTs—and Special Anchors �fp 7 eel -Wrapped 8. Piers±i placg Ft St V.; -Fi g- st-2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. }' irders-Sills-Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date /J f Card B-1 Date Card B-1 Date SLUMMING (Permit) OK except #'s J,41 ater Htr.; Vent -Access -Combustion Air Baffle lif Water Pipe; Test & Anchor -Nail Protection n 1I_D.W.V -e'st Fittings &Anchor -Nail Protection d'lJy ower, Pan; Test, First Floor -Tub Access 2 b-&-Shewej�,Second Floor -Tub Access jp�Gas Pipe; Sixe & Anchors Date Card B-1 Date Card B-1 Date/a�/ ��( Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s xture & Transformer Clearance -Ins. Protection OP'Ejec. Receptacles Spacing -Lights & Switches at Doors ' ze Boxes & No. of Conductors Stapled R ex Installed Close to Edge of Studs & C.J. 1 ip. Ground made up w/Meth Fasteners -Bond Gas & Water r..2t3/ Appliance Circuits in Kitchen & Conductor Size GFI z(i=- ee 'Wire a A ga or AI-A.C. Wire Size / / ga Cu or At 30. Range Circle/ 711, / ga Cu or AI -Oven Circ. / / ga Cu or At Insulated Neutral ❑ Yes ❑ No 31. Service -Riser Conductors & Ground Main Disconnect ,quip. Clearances Panels-Motors-Mech. Equip. SpIfees Closet Light -Shower Light -Spa Light 1/7 3 moke Detector Date i Card B-1 Date Card B-1 Date Date -0 Card B-1 Date Card B-1 MECHANICAL (Permit) OK except #'s A.C. Ducts Insulation & Support Went Fan, Exhaust above insulation 1- 7. C densate Drain & Overflow, Size & Grade C403urrjace-Vent Access -Comb. Air -Return Air Vent 115 outlet (lb4ti-ic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Sits Proper Materials & Anchors iK-__VaIIs Studs -Nailing Spacing & Braces -Plates -Sound 2. Xaring Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) IlAe'<re Stops, Furred Ceilings -Stairs -Chasers -Tubs 4,4^eaders & Beams -Size & Bearing Date FRAMING (Continued) Itw'Hang s -Post Caps -Anchors -Connectors g. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rfng. R lace Ties or Type A Flue -Fireplace Throat Clearance ttic Access; Size Romex Protech Stop -Ins. Baffles �9�Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 1. Garage Fir Protection Framing jW�Prgerty Lie Firewall & Openings Ext., rs-One 3' -Check Garage 3rd Story, 2 Exits Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection Plywoo on Roof Overhang -Attic Vents -Rafter Outriggers g -Nailing Veneer 17 Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access / lazing Area -Glass Protection-Skvliohts-Plastic Wall Date j IL160 Card B-1 Date P Q) Card B-1 Date ) p Card B-1 j4 Date Card B-1 Date FINAL (Plans) OK except #'s 6 Steps -Door & Sidelight Protection -Landings oke Detector Furnace Vents -clearance -Comb, Air-Connector- IgZarage; Above Floor -Ducts -Meth. Protection G .I. & Bath Fixtures & Tub Access -Spa lec. Trim & Subpanel, Breaker Sizes & Labels & Rails replace or Stove, Clearance -Hearth Elec. Outlets at Wood Panel, Int. & Ext. ),Cit. Fixt. &Appliance; Ground -Air Gap -Cooking Clearance lec. Outlets & Receptacles at Kit. Counter r 4. Garage Fire Door; Swing -Landing -Closure A . Duct in Garage -Damper 7 tr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor -Mach. Protection 7 Plb., Elec. & Mech. Equip. Listed for Location 7 c. Receptacles in Garage (F.F.I.)-Romex Protection sulation-Foam-Looked in Attic uard Rails & Deck Construction -Post Caps 8 . Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth learance Looked under Floor Q Yes Following Instld./Drive 0 Yes p No/Walks i) Yes 0 No/Planters 0 Yes 0 No 83. Stucco row - ash Z` A.C. Unit Disconnect, Electrical -Plumbing ants Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings V,Water Well, Disconnect, Electrical, Plumbing xterior Elec. Trim, G.F.I. Receptacle -Underground Ventilation Throughout House V. Glass Protection 9 Co�ris froro, reyiovs,fbsoectkos i 9 Water & Sewer Connected -C/O to Grade -FID Approval 9 Energy Compliance Certificate -Other Certificates 4. Address Posted Date I / L Card B-1 Date Card B-1 Date 7 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: ✓ = OK , 0 = Not OK - = Not Applicable , ' MOBILE HOMES = Not Ready Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete MISCELLANEOUS Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs.-Connectors Shthg.-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or / /"L"ft./ /'LPG 7. Well Clearance 8 Disconnect 8. Utility Clearance 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s FINAL (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances Elec.; Receptacles and Lighting, Distance-GFI 5. Drain; MH Test -Fall -Flex Connector Elec.; Pool Lighting; 15 Volts-GFI 6. Water; MH Test -Regulator -Connector Elec.; Enclosures; Conduit Entries -Terminals -Listed C 7. Water and Sewer Connected -C/O to Grade -HD Approval Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Gas and Electricity Tagged Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Pan elboards-Ins. to Main in Conduit f 9. Tie Downs -Type -Installation Cert. Health Department Approval { 10. Exits; Insp.-Sketch Plumb.; Cir. Test -Water Supply Test 11. Cert. of Occupancy Light Niche t 12. Permanent Foundation Only; License Decal Date Date Card B-1 Date Card 8-1 Date Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs.-Connectors Shthg.-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Pan elboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card 3-1 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751., 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE zll- 9 OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. Date /9 o Inspector Vss� --9 REV 10/92 { r Date /9 o Inspector Vss� --9 REV 10/92 R` COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 I'r . 7 County Center Drive Oroville, CA • (530) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is %. completed. If you have any questions pertaining to this matter, or need additional explanation, ;F please ntact this office • mediately. Date(��iU Inspector REV 10 92 i~ COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES s; 411 Main Street --Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 is '`` CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. f you have any questions pertaining to this matter, or need additional explanation, please c rct this office immediately. :a ^ 4S Dat%-' GU Inspector.ta REV 10/92 F+' COUNTY OF BUTTE S BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541, T. CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office -immediately. l!l/Ipio41'tJ rower ,.47;'/6/.Z/ 6' Date Inspector REV 10%92 a, 1_': « .IUFIhI`, I•li O PJ I l..L� �_ l..i..L�,UFa. run Johns Manville a September 2, 1999 e0'2 34 y0554 P.01/01 Johns MinVllli Corporatlan Residenlial inoulations Division 717 171h 51rest (807011 p.Q. Box $108 Denver. CO 80217.6108 70 978 2000 ` 303 97e 3618 fix To. Johns Manville Customers and Specifiers Subject: L003C-Fill Insulation 4n Sloped Ceilings ]ohne Manville liber glassblowing wool ed on our testin� ese tm�1►t{ons are expected to be stablaucu can be ilvitalled over das on�� of up to 6 In U pitch. Baa the insulation Is carefully installed to the bag label density. The following aonside[atioas should also ba taken into aoeount. Blookipg or baffles may be needed to prevent the insulation from oovering any eve Vons at the baso of the slope. Required ventilation spaces must be maintained between the roof deck and. imuiation, and around rccoWd lights or other heat producing devices. Some lave -slope roofs may ncA provide enough room at ,thc ridge for correct hutalladom Please let us know if you need any additional.infotimtiwL Sincerely, 441)w put�K� Reed H. Larson Manager, Market and Technical Services 1 ENERGY INSTALLATION CERTIFICATE C Building Own�tl `-er C -,+ Building Permit # 00 Building Location /0,-0 Cjj;'/"/0j_ Iyk B - /3 O - /Zol DESCRIPTION OF INSULATION ROOF Material Brand Name Thickness(inches) I Thermal Resistance (R Value) EXTERIOR WALL Material Thickness(inches) CEILING Batt or Blanket Type Thickness(inches) Loose Fill Type Minimum Thickness (Inches) Area covered(ft.2) FLOOR, ELEVATED Material Thickness(inches) FLOOR, SLAB Material Thickness(inches) Width (inches) Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) Brand Name . Number of Bags Wt. per bag lb. Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) FOUNDATION WALL Material Brand Name Thickness(inches) Thermal Resistance(R Value) I hereby certify that the above insula tion was installed in the above building, -is consistent with. approved building department--plans--and attachments and- con- forms with requirements of Chapter 2-53 of State of California Energy Requiremen FIRM N&ME / OWNER STATE CONTRACTOR'S LICENSE NO. SIGNATURE OF INSTALLATION APPLICATOR DATE / I hereby certify the required features, devices, and equipment, az:i shown on the approved Building Department plans and attachments have been installed and.conform to the appli- ance standards and Chapter 2-53 of the State of California Energy requirements. BUILDING CONTRACTOR/OWNER (Please Print) STATE CONTRACTOR'S LICENSE NO. (FIRM NAME) SIGNATURE OF BUILDING CONTRACTOR/OWNER HVAC FIRM NAME/OWNER (Please Print) DATE STATE CONTRACTOR'S LICENSE NO. SIGNATURE OF HVAC CONTRACTOR/OWNER DATE THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE -POSTED WITHIN THE BUILDING. SEPTZ4BER 1988 7 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE" C6.ti"'( fro 156 OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. LOERKE INSULATION CO., INC. INSULATION CERTIFICATE 100 Walnut Oroville Number and StreetCity County Subdivision Lot Number DESCRIPTION OF INSTALLATION 1. ROOF Material Thickness (inches) 2. CEILING Batt or Blanket TypeFiberglass Batts Brand Name Thermal Resistance (R -Value) Brand Name Johns Manville Thickness (inches) Thermal Resistance (R -Value) Loose Fill Type - - Fiberglass- - -- — Brand -Name— Johns Manville-- - - , --- - Contractor/s min. installed weight/ft sq. .659 �b. Minimum Thickness 16.25" inches. Manufacturer's installed weight per square foot to achieve Thermal Resistance (R Value) R38 3. EXTERIOR WALL Material Fiberolass Batts Thickness (inches) 3.5" 4. RAISED FLOOR Material Fiberglass Batts Thickness (inches) 6.5" 5. SLAB FLOOR / PERIMETER Material Thickness Perimeter Insulation Depth (inches) 6. FOUNDATION WALL Material Thickness (inches)-- DECLARATION inchesDECLARATION Brand Name Johns Manville Thermal Resistance (R -Value) R13 Brand Name Johns Manville Thermal Resistance (R -Value) R19 Brand Name Thermal Resistance (R -Value) Brand Name Thermal Resistance (R -Value I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Energy Efficiency Standards for residential buildings (Title 24,Part 6, California Code of Regulations) as indicated on the certificate of compliance, where applicable. C.L.#499150 - . Item #s g ature, Date Item #s Signature, Date Item #s Signature, Date LOERKE INSULATION CO., INC. Installin-- Subcontractor (Co. Name) Or General Contractor (Co. Name) Or Owner Installing Subcontractor_ (Co. Name Or General Contractor (Co. Name) Or Owner Installing Subcontractor (Co. Name) Or General Contractor (Co.Name) Or Owner 4S6Mi5'w"A ,rR :i'-Zwv6.=�iC .: F.*.'�.ZL'� ..+ � _ J'9.^�,..";1c-,�T,. ,+•NP+rZ'- Z.+t...�i'... � - � r]V,CRDACHMENT PERMIT COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE, OROVIL,LE, CALIFORNIA 95965 FAX: (530) 538-2140 APPLICATION IME, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the county roads and highways, all in accordance with County ordinances and general laws. (All information except signature must be typed or legibly printed.) NAME: SIGNATURE: MAILING ADDRESS:— 'PHONE:- DDRESS:PHONE• DATE: O� LOCATION OF WORK TO BE DONE: is i. • - A /- TYPE OF WORK TO BE DONE 1. Curb: ❑ Gutter: ❑ Sidewalk: ❑ (PLEASE CHECK) 2. Driveway (List Type): 3. sqF 4. Other: 0 i PERMIT GRANTED In compliance with your above request, and subject to all terms, conditions (including those printed on the back of this form) and special conditions written below, permission is hereby granted. SPECIAL CONDITIONS:�� f ,ti ❑ All work shall conform to accompanying Detail ❑ Date Issued: f/ a 7— 00 Surety: Yes ❑ No 3 -- Expiration — - Expiration Date: 12 " % ` 00 Plans ❑ Special Conditions ❑. Mike Crump Director of Public Works /- By �jj;c 4� NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE Phone: (530) 538-7081 PERMIT # 2D/0S3,E DISTRICT �-� IME, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the county roads and highways, all in accordance with County ordinances and general laws. (All information except signature must be typed or legibly printed.) NAME: SIGNATURE: MAILING ADDRESS:— 'PHONE:- DDRESS:PHONE• DATE: O� LOCATION OF WORK TO BE DONE: is i. • - A /- TYPE OF WORK TO BE DONE 1. Curb: ❑ Gutter: ❑ Sidewalk: ❑ (PLEASE CHECK) 2. Driveway (List Type): 3. sqF 4. Other: 0 i PERMIT GRANTED In compliance with your above request, and subject to all terms, conditions (including those printed on the back of this form) and special conditions written below, permission is hereby granted. SPECIAL CONDITIONS:�� f ,ti ❑ All work shall conform to accompanying Detail ❑ Date Issued: f/ a 7— 00 Surety: Yes ❑ No 3 -- Expiration — - Expiration Date: 12 " % ` 00 Plans ❑ Special Conditions ❑. Mike Crump Director of Public Works /- By �jj;c 4� 3 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVI ON 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-75 1 PERM" N (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR P VJELC:pN�MTJ-0-J_ZV / 1 ZONING BUILDING PERMIT OWNER 7011 & Si- 6,NA CURD T %'��i° J��� SQ. FT. OCC. BUILDING VALUATION �-b �% U 264 OWNERS MAI DRES ` :2?. 30�: 5104 orovi? 1e, cc �5�66 U 10 368 CONTRACTOR'S NAME G11QL.,? TELEPHONE I 1 Cc 8 3�0 CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ D2 ARCHITECT OR ENGINEER LICENSE NO. -Filing Fee $ 20.00 Permit Fee $ 10,00.50 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan CheckingFee $ .. {' BUILDING ADDRESS Energy Plan Checking Fee $ 23.00 100 17u_11u--, orov-i-e $ PERMIT FEE $ 1-1132.80 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 81 7.00 56.00 Solar or heat pump water heater 23.00 Water piping 15.00 15.00 Each as water heater or vent 15.00 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: iib SINGLE Fi�IILY �JI'd ij7�r C Lu G�^u �:Gr Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 15. 00 Mobile Home S G W @20.00 PERMIT FEE $ 136. GO ELECTRICAL PERMIT Fling Fee 20.00 Main Service 6 A ON, LESS 1 23.00 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.POWER License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. 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 To 46.00So WEE200A CCU000A NEW CONST. DWELLING OCCUP. 3.51tF°: 7� . 72 OR ADDNS. ( BBLDS. v NEW CONST. MULACC. NON RESID. @7.50 APPARATUCIR.S ti SINGLE OUTLET Ex. Occup. ourLEr OR FaruREs 20 @ 1•00 SAL. p .50 Ex. Occup. OFIXUTE S Aa ) E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ 119. %? 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.) ❑ 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 f rthwith comply with those provisions. p X _ _ Date -00 Signature of'Applicant Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Coolingi5 Hood 6.50 6. 5 :, Ventilation 2 4.50 9.00 PERMIT FEIE $ Mobile Home Installation Fee $ Energy Inspection Fee $ 4b. OU oc r. TOTAL F E $1, 5 0.00 HAZ. D. FEES IMP D C P CEL HD SU This permit is hereby issued under the.applicable provisions of the Butte County Code and/or Resolutions to do work indicated indicated above for whi I fees have been paid. By Dat PERMIT EXPIRES ON d ate Receipt No. 0 01) WHITE-D.D.S.-B.D. CANA -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT (Rev. 1,2/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County'Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESOORPCENUM�BE xv/,V) ZONING / BUILDINGPERMIT OWNEROWNER (� TELEPHONE SO. FT. OCC. BUILDING VALUATION owNERs "AILING AooREss � CONTRACTOR'S NAME J�O 5 TELEPHONE / CONTRACTOR'S MAUNG ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuatlon S $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.90 Permit Fee $�- ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ , 3 SUILDINGADDRESS t/O wzltfal 0 D /EnergY Plan Checking Fee S ,OV a PERMIT FEE S 4, EO LOT No. BUBDIV6gNS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other sPECFY Each Trap7.00 3 ,O6 Solar or heat um water heater 23.00 Water piping 15.00 /jr— Each gas water heater or vent 15.00 NErvv Addition ❑ Describe Work: TYPE OFWORK Remodel ❑ Utllities ❑ Installation ❑ Other ❑ Gas piping system 1 - 5 outlets 15.00 / — Building sewer 15.00 Mobile Home ISI Gj W1 Q20.00 PERMIT FEE $ /3 ELECTRICAL PERMIT Fling Fee 20.00 800V OR Main Service p.OR LESS 23.00 ReceiptNo. WHITE•O.D.S.•B.D. D 6� (///-/ / / d b '3 I q ¢ 6 ( 3 CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROO•APPLICANT Main Service 200A TO 1000A 46.00 OR ONSr. ( DWEwNG OCCUP. OR ADDNs. a Acc. BIDs. 3.5QSO. �H FT. / NEW CONS MULTI.OUTLET NON-RESID. @7.50 P0WE3i APPARATUS 8 SINGLE OUTLET C.. OUTLET OR FDCTURES L ® 1.00 B20 .50 EX. OCCU _ Ex. Occup. OFUT E7S PM.I EA 5•00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE S 9� MECHANICAL PERMIT Fling Fee 20.00 Heating CoolingJ Hood 6.50 Ventilation 46 a 9,oD PERMIT FEt S Mobile Home Installation Fee $ Energy Inspection Fee j�o °C NST. TYPE� TOTAL FEE $ of, NAZ. 0. TEV,,ued D COF P � HD 165UE This permit is herebunder the ap a le 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 eta 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 P(W_dl 1. BUILDING PERMIT FEES -- Balance Due ............... -- Additional Fees Due ... . ....... . -- Additional Fees Due ........... =- Revoed Plan Checking Fee ....... SCHOOL DISTRICT FEES / (paid at District Office) R 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 (per unit) . x : _ $ #Units Amt. Commercial (sq.ft.) x _$ Sq.Ft. Amt. 5. RECREATION DISTRICT FEES (paid at District Office) 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. #_��D DATE 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 during the plan checking process. APPLICANT DATE %(o— 00 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 Div. 2nd Copy - Applicant 3rd Copy - Owner (Rev. 2/97) TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance t E.H. USE ONLY Plot Plan Attached Floor Plan Attach d Sant to B.D. y ©68 -t `30 -- k zo Owner Location AP# Plan Approved for: Sewage Disposal iC Water Supply: Public x Private Well Clearance for3Rdnnwelling. Other Hold final for: Final clearance O.K. for: NOTE: Environmental Health Speci6rist 8/96 Date � � T � ,.Y..;p'2.. -. •,��i l - , . r �;- i "'��.'i°T''P'�3`�r;"" �'�^'�•:�,Y��i> �'� �1.- d 3�`-i �� v, ..w - /COUBUTTE -DEPARTMENT OF DEVELOPMENT SERVICES - BULD G DIVIS161V COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 8-7541 PERMIT APPLICA TION DA TA SHEET OWNER: �' ��� llw/`d ASSESSOR PARCEL NUMBER: Proposed Building Use: ��� ,S� Building Ins ctor:�:="' Date: :r At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: Date Received By ❑ 1. All items have been submitted.-------f=1-=----`r '--------- — — Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ 1 n . Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- 114. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ . Energy Design Compliance and supporting documentation. ---------------------------------------------------- El 7 �Sttatement of Inte t for Non -Heated and A/C Buildings. --------------------------------------------------------- ❑ 8. Hazardous Materi orm.--------- -------------------------------------------------------------------------------- ❑9. anufactured•Hom�d t allation instructions including Tie Down Specifications .------------------ 1 ees of $ ------------------------------------------------------------------------------------- 1 pact fees as shown on the attached `schedule ---------------------------- ------------------------------------ 2. California Department of Forestry plan approval/fees111wlxy__ Flood elevation certificate. ---------------------------------------------------------------------------------------- ` 14. Sanitation and plot plan approval Health Department. ------------------------------------------- ❑ 15. City of Chico plumbing permit - - ---------------------------------------------------------------------------------- i s ------------------------------------- . ❑ 16. Plot plan and bsjnes5cense ap royal from tl�e City of Biggs. --------- 7 arming apPigqv (A)�Use�, (B) Parking: -------------------------- 1 Lea C ntact Land Development about Im rovements, ❑ Drainage ' > P P g gal Parcel. ----------------------- 19. Encroachment Permit for driveway (construction approval prior to occu ancy). ---------------------------- ❑20. Pre -inspection for required Request to Building Inspector on (Date) ❑21. Contractor's license information. (Number, Name Style, Classification).------------------------------------ W23KWorkers' Compensation carrier and policy number. ----------------------------------------------------------- . Owner -Builder Verification (Given to owner ❑, Mailed to owner EI) - -------------------------------------- ❑ 2 . Letter of signature authorization. -------------------------------------------------------------------------------- 5. Recorded copy of Agricultural Acknowledgment Statement. ------------------ -------------------------------- ❑ 26. Letter of intent on building use. -------------------- ------------------------------------------------------- =----------- ❑27. Manufactured Home utility clearance. --------------------------------------------------------------------------- ❑ 28. Existing violations and/or expired peTm -------------------------------------------------------------------- ❑29. ❑433 A, ❑Grant Deed, ❑ MRTrifle; Check to H.C.D $ --------------- 030. Other: 5f • `� When you issue the permit, prd-ess as follows ❑ Mail to owner, ❑Mail to contractor. El Telephone and hold for pickup at -office. ElDeliver w'th inspector. Applicant: ,r Date: �F 6' 1/ Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: _ ;. $'- Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: f By: 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Divisio counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building D'v/s n counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Buil ' i 'sion counter, by Da Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: 'N Date: 6E�:: •, 00- BUTTE.COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District ��,�' /-e/74z. *1 L Building Department No. A.P. Number ,�(�.a-�a✓� Jurisdiction: City County Property Owner Property Location/Address Subdivision Lot No. .......................................................................................:.......................... Residential Development Sq. Footage No of Living Mobile Home Addition/ 'Supplemental to (Group R) Units Installation Conversion Permit # '(No foundation inspection): .................................................................................................... . ..... CommerciaUlndustrial .— Aaaa.__ Sq. Footage (Including Exterior Roofed Areas) J Date Irioor rians rewewea Dy Scnool uistnct rersonnep District Identification No. School District certifies that (Applicant) l n w /j f (Street Address) (City) has complied with the requirements of Resolution No. representing 6 IL square feet. School District Representative Paid by Check # % Remarks: (Phone Number) /} (State) (Zip Code) p % 0 -0 S by payment of $ o: O 1.2. 6 AB 2926 $ FULL MITIGATION $ Date Notice: You may protest the imposition of the fees identified above by submitting a written protest to the. District, in compliance with Government Code Section 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. 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I!AePUN axWDN611 0gdas amu ❑ APPROVED CONDITIONALLY APPROVED _ ❑ RESOLVE PROBLEMS PRIOR To APPROVAL PERMIT CLEARANCE •• Permit #: C) D _) 9 1-=;' ` 1 G� ^ S7 — Date: Genera/Infon77abW7 AP#: 7 - Owners Name: ��^ �}�i A!V 1--, cI---):z-- �� Parcel Acreage: f Owners Address: RD �� � �� 1� � � � (��/) � ,� Cil 9 S9 fo - Building Site Address: Yv d� (—(J� O J��'v BM efX Informabron Permit Type: ❑ Agriculture Building ❑ Commercial ❑ Industrial ❑ Mobile Home SFD ❑ Residential Accessory ❑ 2nd Dwelling ❑ Multi -Family >2 units per parcel ❑ Septic ❑ Well ❑ Other Zone District: AR - ' Date of Zoning Ordinance: General Plan: A rz Development Agreement: Use Permit: Variance: Parcel Is In: Land Conservation Agreement Iff No ❑ Yes, check use Minimum Acreage: Nitrate Action Plan -MNo ❑ Yes Violation Area -%No ❑ Yes Specific Plan -No ❑ Yes ❑ Chico ❑ D2N ❑ Cohasset Enterprise Zone No ❑ Yes, check use Floodplain -gNo ❑ Yes P Zone: Panel Number: �U°�� ❑ Watershed Protection Zone No Yes Proposed Use Complies With General PlanZoning Proposed Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Accessary Building Use Commercial/Industrial/Multi-Family Uses: Parking: ❑ Parking Requirements are OK as Shown Landscaping: ❑ Landscaping Requirements are OK as Shown Road and Drairage Improvements Required: ❑ No ❑ Yes Aoolicable Setbacks: ❑ Other Other Zcninq Ccde Street & Highways, Fre Prevention Subdivision Ma Front �O Side �/ 7S© Side street �� Rear D 3 Height 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 budding permitw�l . be issued until this verification is received. x 1. I personally plan to provide the major labor and materials for construction of the / proposed propertyimprovement: YES[ j NO�j�j. �Z. I HAVE[Xj HAVE NOT[ ]signed an_ application' for a :bu�7dina permit for the proposed work 3. 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: t . ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following+eisons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: SOCL-kL SECURITY NUMBER: >�pATE: Z—// -z-520 NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. May 1995 2.26 Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as.the builder of . . property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of iecord on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: 0 If you employ or otherwise engage any ' persons other than your immediate family, and the work -(including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and yoware subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions... 0 There may be financial riskifor you if you do not carry out these obligations,'and these risks are:especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your r obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial C Accidents. If the structure is intended for sale, property owners who are not licensed contractors are.allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their ocvn 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. Sincerely, Michael C. Vieira, C.B.O. Manager, Building Inspection NOTE: This 0, ner-Builder Information is required by Section 19830 of the California Health and Safety Code. Mav 1995 2.27 5 9 1 E LA N -............- - -- -- --•-•---• - ...--•-•- --- - - - - . - ... ------ •••------------ ;... .. . . . . _ • . _. .. ._--•---• •--------••--•-.......... _- 23.00 FW"GAPFRMW Dates 7,oi 2b -3 - - - t IN 4 L - - _ 75 gr 9 Assessor's Parcel Number ®® Fol m 0..O ® Scale: 9 °' = �� Owner'Name :a/"v Address/ Phone No. _I LD® tj A-oc- o llC CA 520., 4If Z007 Si e Location u Copied: Name Phone -5136 —S�� ®� � �'� ��4 • �(af(.. ' �_ FOR OFFICE WE ONLY honing: General Plan ®esig: Size, Ams PR®061®E FOR ALL - ADJACENT. PARCELS SIZE (AC): ZONING: GEN PLAN: USES: