HomeMy WebLinkAbout068-150-11068-/S- 60
CARL RASMUSSEN /�O
97 Oakvale Ave, Oroville /
Contr: Oroville Pump & ELEC.
Permit #897-79E(ele ser ch & misc wiring
SF
10MM9 &8-/s zo
Permit #3327-80B,P,E(add util.room,
panry, storage,pm. &_dining room/SF)
068-150-110 03-3467
PEDERSON, DONALD JR
97 OAKVALE AVE, OROVILLE
Cont: TRUITT GRONF
NSF
ll ho Joq
068-150-110 03-3548
PEDERSON, DONALD JR
97 OAKVALE AVE, OROVILLE
Cont: OWNER
[DEMO
vols -1 �U-110
PEDERSON JR, DON
97 OAKVALE AVE, OROVILLE
Cont: LEEN, IRV
ADD/SF
KRAUSE, 0. A.------- 4274B
44'60E -(s) 4183E
- l
#97 Oakvale
oville -
(addition)
}
r
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FCII
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: '(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP051543
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Issued Date: 09/06/2005 APN: 068-150-110-000
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
I
the Business and Professions Code, and my license is in full force and
effect.
Site Address: 97 OAKVALE AVE ORO
License Class : License Number:
Map Index:
Date: Contractor:
Description: ADD SF (659)GAR(1352)COV(1075)
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: PEDERSON DONALD W JR
permit to construct, alter, improve, demolish, or repair any structure, prior
97 OAKVALE AVE
to its issuance, also requires the applicant for such permit to file a
OROVILLE, CA
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
95966-9401
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 o a civil penalty of not more than five hundred dollars ($500).):
Q I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
Applicant: PEDERSON DONALD W JR
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
97 OAKVALE AVE
owner of property who builds or improves thereon, and who does
OROVILLE, CA
such work himself or herself or through his or her own employees,
95966-9401
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
Contractor:
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ I am Exempt under Article 3 of th Busines Q Professions Code
- O�
Date: Owner.
License #:
WORKERS' COMPENSATION Dd&eARATION
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
Architect:
Labor Code, for the performance of the work for which this permit
Engineer: AUSMUS ENGINEERING
is issued.
❑ I have and will maintain workers' compensation insurance, as
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:
Total Square Ft: 3086 S.F.
Carrier:
Valuation: $92,483.00
Policy #:
Census Code:
LM' 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
`' J
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.
lr D.
Date: -(D. —�
(�
�n / �
Applicant:
Ll
pnl
I V
Ure
WARNING: to secure work r ' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY *
This permit is he etiy issued-un`de th K pp able pr visions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolutions t o work indicated ove to which es have been paid. _
performance of the work for which this permit is issued (Sec 3097 Civ.)
_(/ ,0
Name:
/
By: Date: /
PERMIT EXPIRES ON:
Address:
Date
O; 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 any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
Print Name: Signature:
c��
r 6- L
Date: [
Owner C3Contractor ❑ Agent for Owner ElAgent for Contractor
vott )x-3'7,-� 8TECOUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE`. (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION t� q
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY** 3 qt'' y�(
OWNER
Last Narne/91
J�
First Name
Address A Ii—
-
City
State
Zip?
Phone $b03�`Q
O
Fax
E-mail L
A0k e C
CONTRACTOR
Name L W/ att/
Address � �1/C�Q2 A—D
City 060 VI"'� _
Stag
ZipQ, &G
Phone 370 ;Z _f:7Fax
Zip
E-mail
Lic. #777 63
Classy
ARCHITECT ENGINEER
Name AL c—D &A -p-,
carz lc, A -Klaus
Address
Po ax"GV's clj
City v1U4 6HI60
State �
Zip
Phone
Fax
E-mail
State License Number ; �a
APPLICANT NAME
Name �) d-, W
Address 27
/State
City &PV"(/ tee
0�-
Zipg5106
Phone, 5 3 3 S.7,g.�
Fax
E-mail
APPLICANT SIGNATURE
X
For office use only:
Zoning —f2—
Flood Zone
City
SRA Yes
No
Occ.
Tye Const.
ubdivision Name
Map Book
Page
Lot #
r
Date Approved:
1BMITTAL REQUIREMENTS
FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
BP0'S/ S y
BIN # ^ I
LOCATION
AP#
Property Address
City
Cross Street
WORKER'S COMPENSATION
Policy Number �� J
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
S crIz5 cd-w'noXA41r--
Address
44 #ejW SY_ 490 �At& c4 -
Page 1 of 2
Description or Scope of Work:
A-DDI170-;�% O-----
Sq. Footage %4rKbS 9)Y— SkEf LA
LJ Structure Built without Per
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
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.
Received by:
C
Receipt:' �
0
Date: %_A
Amount: Y `" ", Bldg
2a 1 SRA
Sheriff
SMIP
>L ra / Other
� Total
REV 2-24-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor_
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7. '
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530)538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
L, fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2
utte County Department of Development Services
DNNE CHRISTOPHER, DIRECTOR
M
7 County Center Drive
Oroville, CA 95965
(530) 538.7601 Telephone
(530) 538.7785 Facsimile
LO)
TO:
'
FROM:
LO
N
SUBJECT:
O.
Im
DATE:
WILLDAN
Scott Rutherford
(530) 538-7160
srutherford c6buttecounty.net
Plans Transmittal For Review Per Contract
6/15/2005
Applicant: Pederson, Jr. , Don Permit No: 05-1543
Project Type: ASF/Mstr Bdrm/Gar/Bath/Fo er 068-150-110
100% 70%
Plan Check Fees ' $ 494.91 $ 346.44
$ 494.91 $ 346.44
WILLDAN Fee $ 346.44
Copies Attached: Qty
Chk
Application
Site Plan Review,
FEMA Elevation Certificate
Building Plans
Truss Calculations
Energy Calculations
Structural Calculations
Residential Plan Review Guide
Residential Construction Requirements
Other
Other
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: L't>L so� ASSESSOR PARCEL NUMBERyL
Proposed Building 0
ing Use: �li/TI Uv" ��6e Permit Technician: �G / Date:
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.
\ IN 1. Site plans, 3 or 4 sets, signed by the preparer of the plans.
104 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans.
\� r #*J 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
U rJ� 4. Engineered truss details and layouts in duplicate. No faxes!
O 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. Letter of intent for non-residential buildings
\ ❑ 12. Hazardous Material Form
iy✓ 13. Acknowledgement of building permit application without required clearances.
❑ 14. Other_
ain' items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable
r¢�` 1 Fire Sprinklers............................................................................................
D 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by
❑ 18. Soils Report and/or Engineered Foundation required ...........................................
q 19. Erosion Control Plan Required........................................................................
�$,/ 20. Fees as shown on the attached Schedule of Fees Due Sheet ..............................
❑ 21. City of Chico Plumbing permit........................................................................
\ ❑ 22. Site plan and business license approval from the City figgs ..............................
=N 23. California Department of Forestry plan approval paid. Sent by:�_ -2.3-G 5
Planning approval for (A) Use: _j�._(B)Parking: (C) Parcel Check:.......
\ ❑ 25. Contact Land Development about _ Improvements, _ Drainage ........................
'C r4 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 ..........................................
P n/ 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner). * * ....... * , , ,
wner)..............
❑ 31. Letter of Signature authorization....................................................................
❑ 32. Recorded copy of Agricultural Acknowledgment Statement .................................
D 33. Existing violations and/or expired permits.........................................................
❑ 34. Deed Restriction..........................................................................................
D 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO .........................
❑ 36. Other:
D 37. Other:
When issued Telephone 1> -AJ S''3 3 -5--/ S � and hold for pickup.
I have been infojLmedof the above items and requirements for obtaining a building permit.
X
6//
Applicant:40-014,
Date:
1. Index permtt.application for the a items numbered:
Plan Chel
Le ter
2. Additional items r
Contractor, design owng/, was advised of the above data by 2r
ph6ne, D mail, ❑ counter, by
Date:
Contractor, designer, er, was advised of the above data by D
phone, ❑ mail, ❑ counter, by
Date:
Contractor, designer, owner, was advised of the above data by ❑
phone, O mail, ❑ counter, by
Date:
Plans reviewed by: Date:
Plans approved by: I I,
Date:
Structural reviewed b : Date:
Structural approved by: W
Date:
Note transfer by: Date:
Yellow: Building Division
X
o1�
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
'Don 1aeeIK5-&I-I !:�Rc?evak
Owner Location
Plan Approved for: Sewage Disposgr2!�` W ter Supply:
Clearance for dwelling. Other n
Hold final for:
Final clearance O.K. for:
NOTE:
E.H. USE ONLY
Piot Plan Attached
Floor Plan Attached
Sent to B.D. I
Private Well.
c
/ .%/0.
Environmental Health SpecialistLi
ate
8/96
11811101
DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE -(530)538-7541, FAX (530)538-2140
SCHEDULE OF RECEIPT OF FEES
Website: www.buttecounty.net/dds
OWNER V s 6! v
PROP OSEDILDING USE / l DDI 770-v/ 4(A2tf -
1. BUILDING PERMIT FEES
--- Balance Due ..................... $
--- FEMA Flood elevation review ... $
e2.
tional plan. checking Fee.... $
� /J ,,.-,
OOL DISTRICT FEES d� t
(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.)..... X $0.03 = $
Sq. Ftg./�
&*4. RECREATION DISTRICT FEES!G% l C D
(paid at Recreation District Office) (form available after Plan Check)
RESIDENTIAL DEVELOPMENT IMPACT FEES
COUNTY WIDE (per dwelling) $
CHICO URBAN AREA (per dwelling) $
EL MEDIO FIRE DISTRICT (per dwelling) $
N CHICO SPECIFIC PLAN (per. dwelling) Zoning
. SRA FIRE INSPECTION AND PLAN CHECK FEE
$204.98 (paid at Building Division)
A.P. # oy ISO r10r-)
DATE 0'
RECEIPT # DATE REC.
7. WATER TENDER FEES BATTALION #
$2 0 (paid at Building Division)
a )
SMIPz4 �1,8.
9. OTHER O (aT I
10. OTHER
11. OTHER
At time of permit application, I was advised
may be changed during the plan checkiwrl
APPLICANT
<3-9�0s7P
V
fees are required to be paid prior to issuance of the permit. These fees
DATE `e,/ /0
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. 3/05)
14;C/C�W0 WC9k5
Department
.0 o u n t
J. Michael Crump, Director
of Public
o f B u t
Works
LAND DEVELOPMENT DIVISION
Storm Water Management'Program
7 County Center Drive
Oroville, CA 95965
(530) 538-7266
(FAX) 538-7171
National Pollutant Discharge Elimination System (NPDES) Phase II
Construction Storm Water Permit and Storm Water Pollution. Prevention
Plan (SWPPP) Acknowledgement rLESS THAN 1 ACREI
Project Description: 1 `221776)`\l
Project Location and/or Parcel Number: ® Al c�
7 UAL USE
By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB
1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit
from the State of California Regional Water Quality Control Board. Phased projects that contain
multiple site build -outs of less than one acre but when combined with subsequent phases total more
than one acre of disturbed soil will require a Construction Storm Water Permit from the State of
California Regional Water Quality Control Board.
I am aware that submitting false and/or inaccurate information or failure to apply for a Construction
Storm Water Permit from the State of California Regional Water Quality Control Board for a project
that disturbs one acre or more of land may result in revocation of grading and/or other permits or other ,
sanctions provided by law. V
Signed:
Title:
Date:
Less than l Acre NPDES & SWPPP Compliance Certification
Butte County Storm Water Management Program
Revised 5/24/04
p,?P¢TMzNT Co
�VT1T�
1 ° l C
v.e®C WOg
AU��
Department
C o u n t
J. Michael Crump, Director
Public
f B u t t
Works
LAND DEVELOPMENT DIVISION
Storm Water Management Program
7 County Center Drive
Oroville, CA 95965
(530) 538-7266
(FAX) 538-7171
National Pollutant Discharge Elimination System (NPDES) Prase Ii
Construction Storm Water Permit and Storm Water Pollution, Prevention
Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE1
Project Description:
Project Location and/or Parcel Number:
By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB
1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit
from the State of California Regional Water Quality Control Board. Phased projects that contain
multiple site build -outs of less than one acre but when combined with subsequent phases total more
than one acre of disturbed soil will require a Construction Storm Water Permit from the State of
California Regional Water Quality Control Board.
I am aware that submitting false and/or inaccurate information or failure to apply for a Construction
Storm Water Permit from the State of California Regional Water Quality Control Board for a project
that disturbs one acre or more of land may result in revocation of grading and/or other permits or other
sanctions provided by law. V
Signed:
Title:
Date:
Less than 1 Acre NPDES & SWppp Compliance Certification
Butte County Storm Water Management Program
Revised 5/24/04
a' `M T" °`
7.
?_ -tCI(3
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.
I personally plan to provide the major labor and material for construction of this proposed
property improvement: YES [ ANO [ I
I HAVE [ AVE NOT [ ) signed an application for a building permit for the proposed
work.
3. I have contracted with the following person (firm) to provide the proposed construction:
NAME: _
ADDRESS:
PHONE: _-370 ' 3 770 o'Z /y -T CONTRACTOR'S LICENSE NO:
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise, and provide the major work:
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
SIGNED:
PROPERTY OWNER
DATE:"��
NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California
Health and Safety Code.
This verification must be completed and returned to our office before we are permitted to issue the
permit.
Rev'd 11/42004
Butte County Department of Development Services
ADMINISTRATION t BUILDING' GIS `PLANNING
7 County Center Drive
Oroville, CA 95965
(530) 538.7541 Telephone
(530) 538-2140 Facsimile
`-L =_a2 -,-x_ ,R4. „,..'Sa..y` t..i-Lvf`.c�i"Ic �..-+UP
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the properly
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 your plan to subcontract, you should be
aware of the following information for your benefit and protection:
o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
o If you are an employer, you must register with the state and federal government 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.
o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to workers' compensation insurance.
o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
state law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "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 contacting the Contractors' State License Board in your
community or at 1020 N Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware
of these matters. The building permit will not be issued until the verification is returned.
Mic el C. Vieirl C.B.O.
Majager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
Butte County Department of -Development Services
%)T r�
7 County Center Drive
0 °
`
Oroville, CA 95965
°°=_o
(530) 538-7601 Telephone
c0UIN
(530) 538-7785 Facsimile
�y
BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES
I request and authorize the Building Division to process this building permit application through the plans
examination process WITHOUT first obtaining all necessary, related permits and clearances from other
regulatory entities, including but not limited to, Planning, Environmental Health, Land Development,
County Fire, and Agriculture.
I hereby acknowledge:
a I need to submit applications for septic and/or well to Butte County Environmental Health
immediately.
o I am required to bring the approved Environmental Health site plan and approved sanitation
clearance to the Building Division as soon as clearance is obtained.
I am responsible for notifying Development Services, in writing, to stop processing of the
application and to arrange for disposition of plans.
The Building Division will process the application through the plans examination process, as submitted,
without input from other regulatory entities that could prohibit issuance of the building_ permit or require
submission of amended building plans to the Building Division. Once the plans examination process
begins, there will be no refund of plans examination fees. Any changes requiring submission of amended
plans to the Building Division will incur additional fees.
Within one year from the date of application for a building permit, all other required permits and clearances
from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances
will void the application.
Typically other required permits/clearances include, but are not .limited to, verification the parcel was
legally created, adherence.to.all mitigations and conditions imposed on the parcel at time of creation, as well
as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture
buffer zones, and habitat/species).
Please print:
Applicant Name:
Building site address: '? 7 b19?,v V*.& AV&"E
APN: 0(PF /5-0 -//
Permit No.:
I have read, understood and accept the terms and conditions as expressed herein as indicated by my
submission of the above -referenced building permit application and my signature below:
A I - 1� vw-
���� plz 6
SiGATURE OF AIVCANT DATE
w
Copy to Applicant/EH/File K:Forms/BldgPermitwithoutClearances 020705
z
I LLD/ \I �1 Maryss Street
117 C
V V
Maville, California 95901
Serving Public Agencies 530/749.2373 fax 530/749.2199
www.willdan.com
d�
August 16, 2005
Scott Rutherford
Butte County Building Department
7 County Center Drive
Oroville, CA 95965
(530) 538-7169
(530) 538-2140 FAX
BUTTE COUNTY PLAN REVIEW REPORT
Status: Approved
Jurisdiction Job No: 05-1543
Assessor's Parcel No: 068-150-110
Description: Pederson, ASF/Mstr bd/GarBa
Willdan Project No: 14353-1725
Dear Mr. Rutherford:
Willdan has completed a plan review of submitted plans and documents for the above referenced project
and recommends your approval with the conditions noted on the 2nd page of this letter. The plans and
documents provided for this review that have been found in compliance with the applicable codes are:
➢ Plans: Two (2) copies, Sheets 1 through 8 dated 12/22/04, revision dated 07/19/05 with no
designer listed, and sheets S 1 & S2 dated 06/06/05 by Ausmus Engineering.
➢ Structural Calculations: Two (2) copies dated 06/05/05, by Ausmus Engineering
➢ Energy Calculations: Two (2) copies dated 05/04/05, by Don Freemyers.
➢ Truss Calculations: Two (2) copies dated 05/31/05, by Longfellow Lumber Co. Inc.
➢ Truss Review Letter: Two (2) copies dated 06/06/05, by Eric Ausmus, P.E.
The plans have been stamped with the Willdan approval stamp and dated. According to our previous letters
relating to this project, the superseded plans and documents will be discarded within 10 days unless we
receive other instructions.
On the pages to follow is the identification of the codes and standards applicable to the project, a code
analysis, conditions -of -approval and identification of any deferred submittals.
W I LLDAN
Serving Public Agencies
APPLICABLE CODES
Our review was based on requirements of the 2001 California Building Standards Code found in the
California Code of Regulations, Title 24:
• Part 2, known as the California Building Code (CBC)
• Part 6, known as the California Energy Code, and Energy Commission Standards (CECS)
CODE ANALYSIS
Our plan review revealed the following information regarding the occupancy designation, type of
construction, and other pertinent features. The information in bold text in the table below is not consistent
with that shown on the plans and permit application. Butte County may recalculate the building permit fee
based on this information.
Specific
Use
Type of
Occupancy
Type of
Construction
Stories
1" Floor
S Ft
2"dFloor
S Ft
Total Sq Ft
Dwelling
R-3
V -N
1
659
NA
659
Garage
U-1
V -N
1
1352
NA
1352
Covered Porch
R-3
V -N
1
1075
NA
1075
CONDITIONS OF APPROVAL
1. Approval is contingent upon the review, requirements and approval of other departments
and/or agencies that have jurisdiction over this project.
2. Revisions and/or notes as red -lined on the plans.
3. *Permit application building areas specified in the scope -of -work shall be reconciled with plans
to Butte County's satisfaction.
SPECIAL INSPECTION NEEDS
Epoxy installed anchor bolts.
DEFERRED SUBMITTALS
Our plan review reveals no deferred submittals required.
Vly,
st
Plans Examiner
Cc:
Alice Mefford amefford@buttecounty.net
Eric Ausmus, Email: eda(0ausmusengineerin:l.com, Fax: (530) 343-5320
Don Pederson, Jr, 97 Oakvale Ave, Oroville, CA 95966, Email: donpedersonjr@comcast.net
Page 2 oat Butte County 05-1543
Willdan .14353-1725
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Buildin j
School District C�7 1Lt, A;& Building Department No.
C) �-:)•i5�3
A.P. Number V L9,10' 1, U Jurisdiction: City County
Property Owner
Property Location/Address
1D f4Qx�v
V-9,-
Subdivision Lot No.
Residential Development Q Q Q
No of Living Mobile Home
:4]d'io 'Supplemental to
Units Installation Conversion Permit #
Commercial/Industrial
New Addition
Building Department
f `t
Sq. Footage
(Group. R)
*(No foundation inspection) W
........................................................................................ ---- ...
Deed Restricted Sq. Footage '
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
Sq. Footage
Date
District Identification No.
J LQe L kjL, School District certifies that 11n= 1 e—ka.�
(Applicant)
(Including Exterior
Roofed Areas)
°t "1 6 "t-� k--0-
(Street Address) (Phone Number)
b I'b r . e C.r'_ '1 S °l (o (o
(City) (State) (Zip Code)
has complied with the requirements of Resolution No. O 3 `� `E — (`� by payment of $
representing � S °t square feet.
School District
62926 , _
ULL'MITIGATION $
Paid by Check # Remarks:
Date
Notice: You may protest the Imposition of the fees Identified above by submitting a written protest to the District, In compliance with
Govemment Code Section 66020(a), within 90 days from the date is" 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 Qualtty Act (CEQA).
this project may be subject to additional school feas to fully mitigate Its Impact on the school district's schools.
White (school district), Yellow (building department). Pink (applicant) feeform.xls (3M5W,m
BUTTE COUNTY DEVELOPMENTYEE CERTIFICATION FORM
l FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD)
0 CHICO AREA RECREATION AND PARK DISTRICT (CARD)
0 PARADISE RECREATION AND PARK DISTRICT (PRPD)
❑ DURHAM RECREATION AND PARK DISTRICT (DRPD)
Assessor Parcel Number (s) Q Building Permit Number
Property Owner (s)
Project Location
Subdivision Name
Assessable Sq. Ftge
699
Type of Residential Development (check one)
New Development Single Family -Detached Single Family -Attached
Alteratio ddition(s Non -Residential to Residential Multi -Family Dwelling
------------
Mobile home Mobile home replacement verified by Assessor Department
Demo Permit (date issued ) verified by Building Department
Comments:
d
Building Department R re entative Date
0 FRRPD ❑ CARD 0 PRPD ❑ DRPD certifies that:
Applicant Name
Mailing Address
Phone Number
City
State
Has complied with requirements of the Butte County Board of Supervisors Resolution No.
by Payment of:
Remarks:
Paid by Check No:
Dwelling Units @ $
Square Feet @ $ _
Paid by Cash:
and Park District Representative
v .�rnnl "Int in nn i�_ C! DT 40%- A, ----.--A A A..-. —, I Anr.
per unit for a total of $
per sq foot for a total of $
Receipt No:
R1
Zip
CLAIMANT
ADDRESS
County of Butte
Oroville, California
GENERAL CLAIM
Donald and Tracy Pederson
97 Oakvale Avenue
CITY & STATE: Oroville
r)ATF OF: rl Alnn• 11 /nd/nA
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
Refund Claim - See attached calculation sheet APN: 068-150-110
Permit N6.:03-3467 c
PAID
RETAINED
REFUND
Development Services
$ 2,050.50
$ 712.00
$ 1,338.50
SRA
$ 43.00
$ 43.00
$ -
Sheriff
$ -
$ -
$ -
Other:
$ -
$ -
$ -
TOTAL
$ 2,093.50
$ 755.00
$ 1,338.50
...............................................
.............
...............................................
.............
:.....::
...............................................
'
................................................
................................................
::REAi{DO VNc ::::::BUDGET
...............
...............
:
...............
..............
..............................
..............
..............................
:ACCOTJ .T::�:AM0t)N-T*:
..............
...............
...............
...............
Development Services
440-001
4210500
$ 1,338.50
SRA
0100
4617240
$
Sheriff
280
1011811
$ -
Other
$ -
TOTAL
$ 1,338.50
$ 1,338.50
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 L• ii day of �V� 2004, at 0f'��� &4a":� - , Calif.
i, me unaersignea, nereoy certny tnat, to the nest or my Knovneage, the services or articles specmea aoove nave oeen pertormea or
delivered and that there is a Budget Appropriation or Specific Board Approval (Check same.
Dated this Oikday of 2004, at Oroville ReWa
ent Head or Authorized Deoutv
Dept. SEE Exp.
Code BREAKDOWN Code PAYABLE FROM FUND
DO NOT WRITE RFLOW THIS LINE - AUDITOR'S 11SF ON[ Y
DEPT 8 SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT.
I 'S�-a47-�
6-/0 Y
Butte County Department of Development Services
www.buttecountv.net/dds
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-7785 Facsimile
ADMINISTRATION * BUILDING * GIS * PLANNING
11./5/2004
Donald Pederson
97 Oakvale. Avenue
Oroville, CA 95966
RE: Permit No. 03-3467 APN#068-150-11.0 Owner: sani.e
On 11110/2003, a deposit was made in the amount of $762.38, also, on 1/23/2004, a
deposit was made in the amount of $1,331.1.2, of which $755.00 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 $ t,338.50.
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
03-3467.1tr
County of Butte
Oroville, California
GENERAL CLAIM
CLAIMANT: Donald and Tracy Pederson
ADDRESS: 97 Oakvale Avenue
CITY & STATE: Oroville
DATE OF CLAIM: 11/04/04
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES.
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
Refund Claim - See attached calculation sheet APN: 068-150-110
Permit No.: 03-3467
PAID
RETAINED
REFUND
.Development
Services
$ 2,050.50
$ 712.00
$ 1,338.50
SRA
$ 43.00
$ 43.00
$ -
Sheriff
$ -
$ -
$
Other:
$ -
$ -
$ .
TOTAL
$
$4
...............................................
.............
...............................................
.............
...:...:...:...:...: .....c.............................................
................................................
................................................
......A........i.?L!N
..........
.............
: Btj2D,0G9E3.T50
...............
..............:.
..............
...........................
C("O755.00
..............
........ ...$.:A
.......
.......
..lV.I.1,338.50
..........
................
:.
.
N .
...............
Development Services
440-001
4210500
$ 1,338.50
SRA
0100
4617240
$
Sheriff
280
1011811
$ -
Other$
-
TOTAL
$ 1,338.50
$ 1,338.50
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 day of 2004, at Calif.
Signature of Claimant
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 Calif.
Department Head or Authorized Deputy
Dept. SEE Exp.
Code BREAKDOWN Code PAYABLE FROM FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
DEPT & SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT.
0 UTButteButte County Department of Development Services
�. o Building Division
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 County 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 f signature (by the person whose name is on the
receipt) and return to Develo ment ices for a ment Rrocessin .
CLAIMANT'S NAME: -
t
MAILING ADDRESS -
PHONE:
cc
ASSESSOR'S PARCEL NO.:
[Please use one claim form per permit.]
t
BLDG PERMIT NO.:
_, 7
^ Recei t No 1 Rece� Y t No 2 ,
/1 Rece� t No 3
RECEIPT N
RECEIPT DATE:
RECEIPT AMOUNT:
REASON FOR REFUND REQUEST: 6X 2 c
I. ALLIV D Loh 6 -r -le 6-c
9`/ f' fr'o�-vt
S
Check those fees which you wish to have considered for refund:
®Building Permit Fees =Sheriff Fees =SRA Fees (CDF Fire Planning)
=Other (specify): .....:. .
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.
t7`
17!2.
6 :d
Signature Date
K:/Forms/Refund Application 082203
Friday, November 05, zoom Development- Services .
BUILDING DIVISION ver. 1.0
Counter Paula
Person
Payment Date
Permit Number
Receipt Number
Check Number or Cash
Parcel Number
Applicant
Received From
Total Received
Total Fees To Collect
11/10/2003
03-3467
391295
2321
068-150-110
donald & tracy pederson
same
$762.38
l 762.38
Notes:
Fund 10 (Bldg Permits)
$719.38
SRA Fees (Fire)
$43.00
SHR Fees (Sheriff)
$0.00
SMIP
Copies/ Document Sales
$0.00
CUA (Chico Urban Area)
$0.00
TUA (Therm. Urban Area)
$0.00
Water Tender Btln # -01
$0.00
West Chico Fire Station
$0.00
Witness Fees
$0.00
Recorders Fees (N.O.C)
$0.00
Thermalito Drainage
$0.00
Oroville Area Traffic
$0.00
NSF (Non Sufficient Funds)
$0.00
Notice of Violation
$0.00
NCSP Trails System
$U.U0
NCSP Roads/Bridges
$0.00
NCSP Storm Drainage
$0.00
NCSP Fire Station
$0.00
_
NCSP Parks Type $0.00
Value
$0.00
MFriday, November 05, 2004 Development Services
BUILDING DIVISION
Counter Karen
Person
Payment Date
Permit Number
Receipt Number
Check Number or Cash
Parcel Number
Applicant
11/23/2004
03-3467
394467
14700
068-150-110
I Donald Pederson Jr
Received From Isame
Total Received 1; 331:12
Total Fees To Collect $1, 331.12
Notes:
Ver. 1.0
--1
Fund 10 (Bldg Permits)
$1,331.12
$0.00
SRA Fees (Fire)
SHR Fees (Sheriff)
$0.00
SMIP
$0.00
Copies/Document Sales
$0.00
CUA (Chico Urban Area)
$0.00
TUA (Therm. Urban Area)
$0.00
Water Tender Btln #=
$0.00
West Chico Fire Station
$0.00
Witness Fees
Recorders Fees (N.O.C)
$0.00
Thermalito Drainage
$0.00
Oroville Area Traffic
$0.00 '
NSF (Non Sufficient Funds)
$0.00'
Notice of Violation
$0.00
NCSP Trails System
$0.00
NCSP Roads/ Bridges
$0.00
NCSP Storm Drainage
$0.00
NCSP Fire Station
$0.00
NCSP Parks Type
$0.00
Value
$0.00
03-3467 =A1 0 068-150-110
,LAST NAME • FIRST NAME •
CONTRACTOR 'TRUITT GROW CITYLCTY''�
STREET NOSTREET NAME • ' CITY1 •
USE TYPE REMARKS
25 char. max
EE�Bj
VALUATION _�
FEES PAID •
FEES 2_®®
FEES 3
FEES 4 ' _-
PLAN CHECK ACTIVITY
P M
FLOOD
RECEIPT- -:_
RECEIPT
RECEIPT 3'
�RECE/PT 4,
11 /10/2003
1/23/20041
F/NALED= __
Plan Chk-7:N 9 El i l Chkd By -1: OEM Refurn-1: SO; Chk-9: MIM110
91
Plan Chk-2: Chkd By -2:.- Refurn-2: Sfr Chk-2:
Plan Chk-3: Chkd By -3:•_ Approved: Sfr Appr:
COnlnlenfS: '�'I,. 255 char. max
11/10/03 $89.00 SRA #391295.mjs 12/15/03RB To PH 12/31/03RB Mailed plan ck letter to owner fax to engineer. 1/9/04RB To
note transfer 7/26/04 REFUND TO DEBORAH. Permit w/Di
REFUND CALCULATION SHEET
CLAIMANT: Donald and Tracy Pederson
ADDRESS: 97 Oakvale Avenue
CITY & STATE: Oroville
DATE OF CLAIM: 09/13/04 APN: 068-150-110
RECEIPT INFORMATION
NUMBER:
391295
394467
DATE:
11/10/2003
01/23/2004
ISSUED TO:
Tracy Pederson
Donald Pederson
CHECK #:
2321
4700
AMOUNT:
$762.38
$1,331.12 $2,093.50
PERMIT #:
03-3467
03-3467
Yes
No Yes No Yes No
PRIOR REFUNDS:
X
FEES VERIFIED
X
REFUND
BREAKDOWN
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 oe!')"2
ASSESSOR PARCEL NUMBER
068-150-110
ZONING
BUILDING PERMIT
OWNER DONALD PEDERSON JR 533-5183
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
2493 R 134622.00
OWNERS MAILING ADDRESS
97 OAKVALE AVE OROVILLE CA 95966
1294 C 16 822.00
cGMRA�TRUITT GROUP 893-5047
TELEPHONE
1136 U 20 448.00
CONTRACTORS MAILING ADDRESS
CONSTR.D eeb
Fireplace 1 A 1500.00
LENDER'S MAILING ADDRESS
Total Valuation $173.392.00
ARCHITECT OR ENGINEER
LICENSE NO.
Flirt Fee $ 20.00
Permit Fee $ 898.50
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $ 584. Q
BUILDINGADDRESS
97 OAKVALE AVE OROVILLE
Energy Plan Checking Fee $ 23.00
$
PERMIT FEE $1525.5
LOT NO.
SUBONISIONS NAME
PARCEL MAP
PLUMBING PERMIT Fling Fee 20.00
USEOFSTRUCTURE
SF P° Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 7.00 98,00
Solar or heat pump water heater 23.00
Water piping 15-00.15.00
Each gas water heater or vent 15.00 •00
TYPE OF WORK
New -�Il Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work:
NEW FAMILY
Gas piping system 1 - 5 outlets 15.00
-15 -.Da.
Building sewer 15.00
Mobile Home I S I G W 920.00
PERMIT FEE S 178.00
ELECTRICAL PERMIT Filing Fee 20.00
600V OR LESS
Main Service zoOAORLESS 23.00 3.00
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,
W ill do the work, and the structure is not intended or offered for sale.
D/ 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 zooA To ,000A 46.00
NEW CONST. ( OW
.EWNG OCCUP. 3,5¢x: 127.0(
OR ADDNS..MU
NEW CONST. LET
NON•RESID. C @7.50
POWER APPARATUS
8 SINGLE ourLET CIR.
E.00
x. Occup. OUTLET OR FDRURES BAL @ t. 0
Ex. Occup.OUTLETSREFS D OR 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wirina 23.00
PERMIT FEE t 170.0
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
MECHANICAL PERMIT Fling Fee 20.00
Heating 20.00
Cooling 25.00
Hood 6.50
Ventilation
PERMIT FEE S 85.00
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
�f one hundred dollars ($100) or less.)
[1- 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 if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
orthwith comply with provisions.
X _ Date 3%D
Si ure of Applican - Owner ❑Contractor ElAgent
An OSHA permit is req ed for excavations over 5'0" deep and demolition or construction
'
of structures over 3 stories in height.
0 6 4 - -
Mobile Home Installation Fee $
Energy Inspection Fee $ 46.00
occ
R3
CONST. TYPE
VN TOTAL FEE $ 506
HA2.
FEES IMP FLOOD
CDF CEL Po UE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indic e o for whifees have been paid.
B Date11 Z-
L5�
PERMIT EXPIRES ON Z, -Z, I OS
to
ReceiptNo.
WHITE-D.D.S.-B.D. CANAR SESSOR PINK -IN E OR GOL ENROD-APPLIC T
F
TO: Building Department
FROM: Environmental Health
CI
E.H USE ONLY
Plat Plan A"achad
Floor Plan Attached
Sant to B.D./Z,:j_
SUBJECT. Sannadon earance�L40,�- '�
�l
I1V
Owner Location AP#
Plan. Approved for: Sewage Disposal Water Sup ly: P blic Private W11�
,,
Clearance for dwelling. Other f� .1),2
i
Hold final for:
Final clearance O.K. for:
NOTE:
Environmental Health Specialist
8/96
Date
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 9596 hone (530)538-7541 Fax (530)538-2140
PERMIT APPLICA ON DATA SHEET
OWNER: ASSESSQR'?ARCEL NUMBER , `
Proposed Building Use: C unter Technician: Date:
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order 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 faxes!
5. Energy compliance design and supporting documentation in duplicate.
❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be
stamped and wet -signed by the engineer.
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. 2
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate..
❑ 9. Site plan and business license approval from the City of Biggs......
❑ 10. Letter of intent for non-residential buildings ...............................
❑ 11. Detached Accessory Building Form filled out by the owner........
❑ 12. Hazardous Material Form ......................................................
��13. Fire Sprinklers................'...................................................
� f4. Agricultural Buffer clr and site plan apr from the Ag Commissioner
❑ 15. Other
Sent by
Date Received By
F
s needed to issue the permit. (May require additional plan review upon,rec ' ofthefoll w* itehown on the attached Schedule of Fees Due Sheet.......................................t of IntentI`for'N6p,heAted and A/C Buildings .............. n and site plan approval from the Environmental Health Department i��. `A'd'rt �ico Plumbing permit ..............................' ............ Department of Forestry plan approval Ef paid.%0'21. Planning approval for (A) Use: 6K (B)Parking: (C) Parcel Check:
❑ 22. Contact Land Development about ❑ Improvements, ❑ Drainage ...............................
l23. NPDES Form............................................................................................. - p •>
❑ 24. Encroachment Permit for driveway from the Public Works Dept .................................
❑ 25. Pre -Inspection for required ................
❑ 26. Contractor's license information. (Number, Name Style, Classification) ......................
❑ 27. Worker's Compensation Carrier and Policy Number .............................................. 19
❑ 8. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) .....................
/VV29. Letter of Signature authorization.(. � q.) ..................................................... l M
❑ 30. Recorded copy of Agricultural Acltnowledgment Statement ....................................
❑ 31. Manufactured home utility clearance...............................................................
❑ 32. Existing violations and/or expired permits.........................................................
O 33. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ Letter from Legal Owner, ❑ Check to
Other: ' ' � � � � rYN
hen issued Telephone G.:a'�. 1 O:2� and hold for pick
I have been informed of the abov items and requirements for obtaining a building permit. l�
Applicant: e ate:
1. Index permit applicatioL'f. r theit nu Plan Check Letter
2. Additional items required
Contractor esi own wa i e a d ❑ phone, ail, ❑ counter, by _" Date:
Contractor, esigner, owner, was vis abov a by ❑phone, ❑mail, ❑counter, by Date:
Plans reviewed by: Date: Plans approved by: Z7 Date:
Structural reviewed by: Date: j2v_4d103 Structural approved by: ! Date: 4
Note transfer by: Date:
Yellow: Building Division
.7
FVe,j
Y
-/-,o 41",ptXlee-'
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 �� C�]�CJ`( G=% A.P.
D BUILDING USE
BUILDING PERMIT FEES
Balance Due ....................0 $ '
Additional Fees Due ................. $----- — "
Additional Fees Due ................. $
Revised Plan Checking Fee .............$
2. SCHOOL DISTRICT FEES
(paid at District Office) (Available after Plan Check)
3. SHERIFF FEES
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)
DA 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
DATE U ' 10'
U�
RECEIPT #DAT REC.
�q��J
M
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.
MQUACSUM
DATE
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. 6100)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES -BUILD D N 63E
7 County Center Drive a Oroville, California 95965 • Telephone (530) 8-754
ev.12/96) APPLICATION AND PERMIT
1 ZONING BUILDING PERMIT
ASSESSOR PARCELNU B '
SQ. FT. 01Q0. BUILDING VALUATION
W
tOWNERS MAILING REss
�l T HONE
co a 5 N D rndsr ! 13 v D 4 • •�
CONSTRUCTION LENDER
Fireplace
UDzE S MAJUNG ADDRESS Total valuat on
LINO. Firing Fee $ 20.00 '
ARCHRECr OR ENGINEER
Permit Fee $ Q$
� cr oR gIGINEERs MAwNG ADDRESS Plan Checkin Fee40=
$
SUIlDNG ADDRESS 1 o / . v Energy Plan Checking Fee $ "1z—�
V $
PERMIT FEE
$; -'
PARCEL MAP PLUMBING PERMIT Fling Fee 20.00
IOTND suso VN'rJ
Each Trap 7.00
USEOFS UCTURE �' e23.00
Solar or heat um water heater
Water piping 15.00
SF )M Duplex ❑ Mobilehome ❑ Other SK=Fy Each gas water heater or vent 15.00 —
TYPE OF WORK rg; � estem 1 - 5 outlets 15.00
New V Addition ❑ Remodel ❑ UtiBties 13 Installation ❑ Other ❑ Building sewer S G W 15.00/
@20.00
Mobile Home
Describe Work:
PERMIT FEE S
ELECTRICAL PERMIT
1���%�' %� �-- ��' Main Service Eel OR LESS
Main Service ( -11A TO 100" )
..
.PERMIT, FEE PAID
SRA
SHERIFF
OTHER
s
AMOUNT RECEIVED $
DATE RECEIVED1�?_t C,,4 3 9 t
00
46.00
50
57.50 127•e�
Ex. OCCu . OUnV OR MURES SAL @ .SD
Ex. Occup. OVniTS PAID �EA. 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
PERMIT FEE $ '
,MECHANICAL PERMIT Feng Fee 20.00
Cooling J
Hood 6.50
Ventilation
PERMIT FEt S
Mobile Home Installation Fee $
Energy Inspection Fee $
'' C Ns ' TYPE TO L FEE $ d
C ' ss�
�[
This permit is hereby issued unddr the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
By----- ------- -•- Date
From the desk of
DON W. PEDERSON JR.
97 Oakvale Ave.. Oroville, CA 95966
Butte County Public Works
Division of Building Review
7 County Center Drive
Oroville, CA 95966
ATTN: Plan review
Re: Review of construction plans for 97 Oakvale Ave, Oroville, CA 95966
To Whom It May Concern:
We are submitting plans and related documents for review/approval by the County of Butte, for
construction of our home at 97 Oakvale Ave., Oroville, CA. Please accept this letter as a formal request
that the plan check/review and approval process be completed specifically by Butte County personnel
only, as noted on the plans. Should you have any questions, please contact me at the above address,
telephone number below, or at 530-990-3285.
Thank you for your assistance and understanding in this matter.
Respectfully,
Don W. and Tracy L
Pederson
&-'e--te � x
I acknowledge receipt of this lette .
Tel. 530.533.5183 E-mail. Bolo4u@att.net Fax . 781-998-3063
,�-�-r" fir- Il2/.�crb5
We- pvi�740h
ep
0
National Pollutant Discharge Elimination System (NPDES) Phase 11 &
SWPPP Non -Certification for Project # for Butte
County Storm Water Permit Compliance
ng below, I, the project architect/engineer of record, indicate that I am aware that a
constsignion project that disturbs more than I acre of land requires a Construction Storm Water
Permit from State Water Resources Control Board. L additionally, understand that it is the
project owner's/6 er's agent's responsibility to submit a Notice of Intent (N.O.I.), a Storm
Water Pollution Preven ' n Plan (SWPPP) and a fee of $700.00 to the State Water Resources
Control Board to obtain suc ermit. I, further, certify that this project will not disturb more
than 1 acre of land. I have also r 'ewed the BestManagement Practices Handbooks, California
Storm Water Quality Task Force, Sac ento, CA. I certify that appropriate BMPs will be
implemented to effectively minimize the n ative impacts of this project's construction activities
on storm water quality. I acknowledge that it I y obligation to make the project owner and
contractor aware that the selected MQs must be in Iled, monitored, and maintained to ensure
their effectiveness. If, at any time, site conditions an observations by a County official
warrant reevaluation and revisions of the chosen'BMPs, th propriate changes will be made
without unnecessary delay. I am aware that failure to properly ' plement and maintain the
BMPs necessary to prevent the discharge of pollutants from this p 'ect during construction
could result in significant penalties and/or delays.
Signed:
Title:
Date:
By signing below, I, the project owner/owner's agent, certify that I am aware that a construction
project that disturbs more than 1 acre of land requires a Construction Storm Water Permit from
the State Water Resources Control Board and that it is my responsibility to submit a Notice of
Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP) and a check for $700.00
made payable to the State Water Resources Control Board to obtain such a permit, if my project
disturbs more than 1 acre of land. I, further, certify that this project will not disturb more than 1
acre of land. This document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified individuals properly
gathered and evaluated the information submitted. Based on my inquiry of the person or persons
directly responsible for gathering the information, I certify, to the best of my knowledge and
belief, that the information submitted is true, accurate, and complete.
Signed: Q�
Title:
Date: `/— /0—a0^Z
NPDES & SWPPP Non -Compliance Certification Draft
Butte County Stormwater Plan
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
�chool District �i� u'1 1 e I �E�1.,-, �.►��. N
Building Department No. O 3 '3
A.P. Number I D Jurisdiction: City ®County
Property Owner D otia, LA Pgj e r 4 d nJ r.
Property Location/Address 9% 6a K 1,) Qt 1 r- A0 `c- n r D J
Subdivision
Lot No.
Residential Development FT --1
Q
Q
Q
No of Living
Mobile Home
Addition/
'Supplemental to
Units
Installation
Conversion
Permit #
....................................................................................................
*(No foundation inspection)
Commercial/Industrial Q 0
New Addition
gcoQ
a
Sq. Footage ,a2 t% C/ )
(Group R)
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
Sq. Footage
(Including Exterior
Roofed Areas)
I2-- 31-p'3
Date
District Identification No. (e S o t
School District certifies that
(Applicant)
EV
(Street Address) (Phone Number)
r) f J
(City) (State) (Zip Code)
S
has complied with the requirements of Resolution No. 0 t _,o 7—,-c- O by payment of $
T'
representing \ t square feet. JAB 2926 $
FULL Mn1GATION $
School District Represeriiative Date
Paid by Check 8 Remarks:
q
t V3 2.7 .9 -4'6 -c -A
No9c : You may protest the Imposition of the fees klentl8ed above by subn*Ung a written protest to the DlstArx, in compliance with
Govrrtrneru Code Seetlon 66020(a), within 90 days from the daft ties are pail. Failure to submit a timely wrkbn protest vAN prohibit
you from challenging the Imposition of the tees M any court ac"L
K, subsequent to the School District Represerdadvs aipnimg #6 mitt county Schools Impact Fee CeMfic tion Form, the titehool District in
noditd by the appUceble Local Planning Agency that this proleat Isbairg rwlewed under the California Environmental Quality Act (CEQ4
this puof Amoy be subject to additional school fees to fully nu...g I No Impaot on the school dist kft schools.
White (applicant), Yellow (building department), Pink (school district) feefwm.xls (10/03)dmm
' RESIDENTIAL PLAN
° ` - REVIEW GUIDE
o::.- o SINGLE FAMILY, DUPLEXAND
MISCELLAINEOUS ONLY
O,.vrer. D . ?,eAe,,-s D A2 Building Permit Number: D 3 _ 3"1 67
Pians Examiner.
A. P. Number: 6:9 --1 5,6 — 1 1 0
GrERkL:
O
ning requirements - (number of permitted living units).
�Vaas signed by the designer.
per description of work on the application.
sting violations on the property.
ecorded notice of violation.
Building permit valuation.
PLK L A`:
d! o plete parcel size and dimensions.
G(
etbacks, side ard, easements. etc.
�Flood
!dings or structures.
e✓fills and, or drainage. p.�- P
zard. ,� X
6 Special conditions onP , fap:
j�` �i"se SRAM Fire Sprinklers E/ Water Tender ❑ Traffic and Drainage fees ❑
6 E�naQl Aid Route and/or Federal Aid Secondary Route setback requirement
wilding or utilities across lot lines (Lot merger approval by Butte County Land Development)
FL R PLA`:
Plaits andspecificadons drawn to scale with dimensions and of sufficient clarity (UBC section 106.3.3).
10410 of natural light and 5% of ventilation (Uniform Building Code section 1203).
Escape or rescue %vindows shall have a minimum net clear operable area of 5.7 square feet The miaimum>xt
clear openable height dimension shall be 24". The minimum net clear operable width dimension shall be 20'.
When %indo%%s are provided as a means of escape or rescue, they shall have a finished sill height not mote than
44" above the floor (Uniform Building Code section 310.4).
azing in Hazardous locations (Uniform Building Code section 2406).
6! Habitable space shall have a ailing height of not less than 7 feet 6 inches except as otherwise permitted in this
section. Kitchens, halls, bathrooms and toilet compartments may have a ceiling height of not less Wan 7 AW
measured to the lowest eroiection from the ceiling (Uniform Building Code section 310.6.1
P/ ZI habitable rooms except kitchens shall have an area of not less than 70 square feet and not less than 7 foot in
any dimension (Uniform Building Code section 310.6.2 & 310.6.3).
-e'-GFCI in baths. garage, kitchen, wet bar, and exterior receptacles (NEC 210).
V--�Viter heaters %%hich depend on the combustion of fuel shall not be installed in a room used or designed to be
used for sleeping purposes, bathroom. clothes closets or in a closet or other confined space opening into aboth
�°r bedroom ([Uniform Plumbing Code section 509.0).
1�F Fuel burning equipment shall not be installed in a closet, bathroom or a room readily usable as abedmom. or in
/Garaa room. compartment or alcove opening directly into any of these (Uniform Mechanical Coda sto 30d -U
fire%vall separation - required on garage side including supporting walls and posts (UnifbtinHt 8ft
ode section 302.4 exception #3).
7'der no circumstances shall a private garage have any opening into a room used for sleeping proposes iform Building Code section 312.4).
od sto%e location - Alcove - UMC section 205 confined space & 223 unconfined space dt 304.2).
Smok-- detectors (Uniform Building Code section 310.9.1).
Page 1 of 2
Vst
ater closet clearances (Uniform Plumbing Code 408.5).
compartment murumum 1024 sq. i 30" circle (Utriform Plumbing Code 412. ).
11ger g walls shall be supported on masottr)n 8 . or concrete foundations that shall be of sufficient size to support
RU loads (Uniform Building Code secuon 1806.3).
SM MCT TRAL DETAILS:
K Braced wall panels shall start at not more than 8 feet from each end of a braced wall line. Braced Wall Panels
must be in line or offset from each other by not more than 4 feet (UBC section 2320.11.3). Spacing shall not
exceed 34 feet on anter in both the longitudinal and transverse directions (UBC section 2320.4.1.) Braced mall
'li= must be continuous throughout the structure.
2. A California licensed architect or registered engineer must prepare a lateral analysis for the area of the building
that do not comph with the Uniform Building Code. This must include the designees "wet" stamp, signature,
registration number and expiration date on all sheets of plans depicting the designed elements and cover sheets
of calculations.
and/or engineering.
d! Foundation plans complete enough to construct building (Uniform Building Code Table 18 -I -C).
Floor construction details complete enough to construct building.
ons and Wall construction details complete enough to construct building•
Roof construction details complete enough to construct building.
construction details and calculations if necessary.
ge door header size(s).
orch header size(s).
1 icW header size(s).
Stud heights.
ag. jagh-ftjaRsive soil - special foundation design required.
VSZtmg walls requiring design.
wallboard nailing inspection required.
below the lowest floor is fally enclosed. than a minimum of two openings are required with a total
net area of at least one square inch for every square foot of area enclosed with the bottom of the openings no
more than one foot above grade. Alternatively. certification ma)' be pro`'nded by a registered professional
engineer or architect that the design will allow• equalization of hydrostatic flood forces on exterior walls.
Building must be designed and anchored to prevent floatation, collapse or lateral movement. Construction
design requirements must be shown on the building plans �.
14!Bkctric, heating, ventilation, plumbing and air conditioning equipment and other service facilities shall be
designed and/or located so as to prevent water from entering or accumulating with the components during
conditions of flooding.
MISCELLANEOUS ITEMS:
4- tai way -details - landings, rise and tun head clearance, handrails (Uniform Building Code section 1003).
4.-Gus�rdrails (Uniform Building Code section 509).
•eneer (Uniform Building Code section 1403).
plate weep screeds (Uniform Building Code section 2506.5). -
pitcb for roof covering (Uniform Building Code Table 15-B-1& 2, 15 -D -I & 2).
dation - protection.
36" halls and stairways (Uniform Building Code section 1004.3.3.2).
three - story dwellings (Uniform Building Code section 1004.2.3.2).
Un�lenfloor access and ventilation (Uniform Building Code section 2306.3 & 2306.7)-
1�/Attic access and ventilation (Uniform Building Code section 1505). ,
menu.
�desi compliance and supporting documentation.
Fble area requirements. w
]WELDING PERMIT REQLIRENTENTS:
1. 031SPLA.
2. ❑ Flood elevation cenificatc.
3. ❑ Fire SprvulJers required
4. ❑ Special Inspection requiremens.
5. ❑ Use Permit conditions.
6. ❑ Sub -Standard Housing lener.
Pzee -- C) _
From the desk of
DON W. PEDERSON JR.
97 Oakvale Ave.. Oroville, CA 95966
November 16, 2003
County of Butte
Department of Development Services
Building Division
7 County Center Drive
Oroville, CA 95965
RE: Authorization for signature
To Whom It May Concern:
Please accept this letter as authorization for my wife, Tracy L. Pederson, to sign on my behalf, any
paperwork, correspondence, or other legal or official document regarding the property at 97 Oakvale
Ave, Oroville, CA. The Assessors parcel number is 068-150-110. Should you have any questions, please
contact me at the address above or telephone number below.
Respectfully,
Don W. Pederson Jr.
Tracy L. Pederson
Tel. 530.533.5183 E-mail. Bolo4u@att.net- Fax . 781-998-3063
Inter -Departmental Memorandum
To: Mike Vieira, Building Department
From: Ted Crawford, Fire Department
Subject: AP# 68-150-110, Pederson, 03-3467, Oroville
Date: December 1, 2003
The subject parcel at 97 Oakvale Ave, Oroville, does have a South Feather
Water and Power fire hydrant within 800 feet of the property and therefore the
automatic sprinkler requirement does not apply. If there are any questions please
contact me at 538-7994.
CC: Chrono
File
NOTES
RESIDENTIAL
'_0_69_4 0 10 '_0T -3_467__`l
'PERMIT NO. _PEDERSON, DONALD JR
97 OAKVALE AVE, OROVILLE
Cont: TRUITT GRONF
NSF
0
SPECIAL CONDITIONS
CHECKED
BY
ZSRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
JOB FINALED (Date)
Signature
= OK
= Not OK
= Not Ready Applicable MOBILE HOMES
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
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./ P LPG
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
7.
Well Clearance & Disconnect
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
8.
Utility Clearance
4.
Wood Awn.; Posts- Beams- Rftrs-Connectors
Shthg-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
Date
Electric
Card B-1 Date Card B-1
Date
9.
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
11.
1.
Zoning Requirements -Setbacks -Easements
Braced Wall Panels
2.
Footings; Size -Spacing -Marriage Line
Date
3.
Gas; MH Test -Demand -Valve -Connector
Card B-1 Date Card B-1
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
Setbacks -Easements
5. Drain; MH Test -Fall -Flex Connector
Soils; Compaction -Structure Stability
6.
Water; MH Test -Regulator -Connector
4.
7.
Water and Sewer Connected -C/O to Grade -HD Approval
6.
8.
Gas and Electricity Tagged
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
9.
Tie Downs -Type -Installation Cert.
9.
10.
Exits; Insp.-Sketch
Plumb.; Cir. Test -Water Supply Test
11.
Cert. of Occupancy
12.
Enclosure; Fencing -Alarms
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Blocking
4.
Gas; MH Test -Demand -Valve
5.
Electricity; MH Test
6.
Water; MH Test
7.
Water and Sewer Connected
8.
Gas and Electricity Tagged
9.
Exits
10.
License Decals
11.
Verify #'s with Office
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3.
Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4.
Wood Awn.; Posts- Beams- Rftrs-Connectors
Shthg-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
12.
Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6.
Elec.; Enclosures; Conduit Entries -Terminals -Listed
7.
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes -Enclosures- Panel boards -Ins. to Main Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
12.
Enclosure; Fencing -Alarms
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
J=OK
0 = Not OK
- = Not Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
50.
17. Water Htr.; Vent -Access -Combustion Air Baffle
51.
18. Water Pipe; Test & Anchor -Nail Protection
52.
19. D.W.V.; Test Fittings & Anchor -Nail Protection
53.
20. Shower Pan; Test, First Floor -Tub Access
54.
21. Test Tub & Shower, Second Floor -Tub Access
55.
22. Gas Pipe; Sixe & Anchors
56.
23. Fire Sprinkler; Test
57.
Siding -Nailing Veneer
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
61.
24. Fixture & Transformer Clearance -Ins. Protection
25. Elec. Receptacles Spacing -Lights & Switches at Doors
26. Size Boxes & No. of Conductors Stapled
27. Romex Installed Close to Edge of Studs & C.J.
28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29. 2 Appliance Circuits in Kitchen & Conductor Size GFI
30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI
Insulated Neutral ❑ Yes O No
32. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels-Motors-Mech. Equip.
34. Clothes Closet Light -Shower Light -Spa Light
_
35. Smoke Detector
84. Stucco Brown -Finish
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
36. A.C. Ducts Insulation & Support
37. Vent Fan, Exhaust above insulation
38. Condensate Drain & Overflow, Size & Grade
39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
40. Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
41. Sills Proper Materials & Anchors
42. Walls Studs -Nailing Spacing & Braces -Plates -Sound
43. Bearing Walls over Girders & Floor Nailing
44. Draft Stop in Walls (rat proof)
45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46. Headers & Beams -Size & Bearing
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48.
Cling. Joist-Rftr. Ties- Purl in -Roll Brac.-Truss-Shting.-Rtng.
49.
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
50.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52.
Garage Fire Protection Framing -RC Channel
53.
Property Line Firewall & Openings
54.
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57.
Siding -Nailing Veneer
58.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59.
Glazing Area -Glass Protection -Skylights -Plastic
60.
Shear Walls; Nailing -Bolts
61.
Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
64. Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66. Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71. Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74. Elec. Outlets & Receptacles at Kit. Counter
75. Garage Fire Door; Swing -Landing -Closure
76. A.C. Duct in Garage -Damper
77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78. Plb.; Elec. & Mech. Equip. Listed for Location
79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80. Insulation -Foam -Looked in Attic
81. Guard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
_
83. Following Instld./Drive Cl Yes O NoMalks O Yes O No/Planters O Yes D No
84. Stucco Brown -Finish
85. A.C. Unit Disconnect, Electrical -Plumbing
86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87. Water Well, Disconnect, Electrical, Plumbing
88. Exterior Elec. Trim, G.F.I. Receptacle -Underground
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
94. Energy Compliance Certificate -Other Certificates
95. Address Posted
96. Fire Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
• COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION
T;w '
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSORPAgCELNUMBER
X68-150-110
ZONING
BUILDING PERMIT
OWNER DONAID PIDERSON JR 533-5183
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
2493 R 134622.00
OWNERS MAILING ADDRESS
97 OAKVAL.E AVE OWN= CA 95%6
1294 • 1n"86 822.00
CONTRACTOR'S NAME
TRUITT KOO 893-5047
TELEPHONE
/-/,Q.(�/'`
1136 U 20 00
CONTRACTORS MAILING ADDRESS
t1 7 Fit 7T
CONSTRU TI DSA'TEN 1 11
Fireplace 1 A 1500.00
LENDER'S MAIUNG ADDRESS
Total Valuation 1$173,392.00
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $ 898.50
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $ 584.00
BUILDING §§ESS _ __ _AU AVE OROVILLE
9977
Energy Plan Checking Fee $ 23.00
$
PERMIT FEE $1525.50
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 7.00 98.00
Solar or heat pump water heater ` 23.00
Water piping 15.00 15.00
Each gas water heater or vent 15.00 15.00
TYPE OF WORK
�"
b
New Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work:
`iIENE W FAMILY
Gas piping system 1 - 5 outlets 15.00 15,00
Building sewer 15.00 15.00
Mobile Home I S I G I W @20.00
PERMIT FEE S 178.00
ELECTRICAL PERMIT Filing Fee 20.00
600VMain Service 2o..OR LESS 23.00 .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
1 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.
0/1, 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
Mein Service 46.00so
NG CCU000A
DWE200ALLING
NEW CONST. DWELLING OCCUP. 3,5QSFr0_ '1 27 •
OR ADDNS. ( a ACC. BLDS. 1
r,DµgalpT MULTI -OUTLET g7.50
POWER APPARATUS
a SINGLE OUTLET CIR.
20 ° 1.00
ourLEr OR FocruREs
Ex. Occu SAL p .50
Ex. Occup. DFrx TS Aa oE. 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $ 170.00
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.)
Melcertify 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 shallAL
forthwith comply wfth ose provisions.This
{�
X� Date 2/U!
Signature of Applican , -10;Owner ❑ Contractor ❑ Agent
An OSHA permit is regliired for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT Filing Fee 20.00
Heating 0.00
Cooling 5.00
Hood 6.50 6.50
Ventilation 3 4.50 13.50
PERMIT FEE $ •
Mobile Home Installation Fee $
Energy Inspection Fee $ 4b.
occ
Ri
co T. TYPE
VN TOTAL FEE $ 2004.50
HAZ.
D. FEES IMP
FLOOD
CDF
„PARCEL
p0
HD UE
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.
i
B��J i Date 3
e /
PERMIT EXPIRES ON
Dente
ReceiptNo. �` I ' % is 1 �l�Ut�. ' . %_ f ��. /
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
SITE PLAN REVIEW APPLICATION
Date: AP#
Permit Number (if applicable) 6 3 "--SH (o 7 Bin Number A-)
APPLICANT INFORMATION Parcel Size: .51 A e -
Owners Name: PG b e-4Zs.C)jj, T(Z _ DOWN A C�)
Owners Address: �% OA i_Vq LV,, A V D 20101 L.1,6 e.A 9 59�1y
T'2� �T i Gq-nDU-F'
Telephone No.: ��� _51 8 S x6)3 -- SO li 7
Situs Address: �1 i 0T) IS VF) c A V 6
Proposed Use:
Residential
New Single Family Residential
❑ Single Family Addition
❑ Mobile Home
❑ Residential Accessory
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie)
❑ Temporary Travel Trailer
❑ Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
Other
❑ Single Family Remodel
❑ Commercial Remodel
❑ Industrial Remodel
10 Septic ❑ Well
❑ Agricultural Exempt Building ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A
❑. Other:
Brief Explanation (if necessary):
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SERVICES INFORMATION (For Staff Use)
❑ Approved Conditionally Approved ❑ Resolve Problems Prior to Approval
Site Plan Stamped Approved
By Date
Page 1 of 5
a
ALL ITEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In:
❑ Snow Load Area:
❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract
❑ Nitrate Action Plan (See Environmental Health for standards)
❑ Watershed Protection Overlay Zone (See attached standards and requirements)
❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required)
M SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain: (See attached)
• Flood Zone:
• Flood Panel No.: 08 2 Z3 Index Date:
❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements)
❑ Chapman/Mulberry (See attached standards and requirements)
❑ Cohasset Area (See attached standards and requirements)
❑ Grading Zone (See attached handout)
Use Requires:
❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit
❑ Minor Variance ❑ Variance
------------------------------------------------------------------------------------------------------------------------------------
❑ Detached Building Use Form ❑ Encroachment Permit
❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement
Zoning: N — R
Applicable Building Setbacks:
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
®� z✓
Side
Side Street
Rear
Height
Waterway
N/A
N/A
N/A
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
',j
Applicable Development Fees:
Standard Fees Amount Formula
❑ Fire
® School*
❑ Parks/Recreation
❑ Roads
® Sheriff
❑ Drainage
❑ NCSP/CSA 87
❑ Chico Urban Area — Road
❑ Thermalito Drainage Area
❑ Thermalito Urban Area
❑ Other
Subdivision Map Special Fees
❑ Water Tender
❑ Road Improvement
❑ North Oroville Area
❑ Other. (per map)
* Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of
the building permit.
Parcel Created By
Deeds:
M
Date of Creation: Legal Access Provided: ❑ No El Yes
Deed of Reference: Legal Access Required ❑ No ❑ Yes
Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name:
Complies with County Standards for Deed Creation:❑ No ❑ Yes
Comments:
❑ Parcel Deemed to be legal
❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation
❑ Obtaina Certificate of Compliance
❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment
❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23).
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current Environmental Health Department requirements
Page 3 of 5
L2
JLFM
Subdivision Map/Parcel Map:
Map Date of Recording: H —i b— a
Lot: Book:
❑ Use Permit/Minor Use Permit
Permit Number:
)S)
Date of Approval:
f V�
Page:
Parcel Map/Subdivision Map/Use Permit Conditions
Comply with the following Conditions of Approval: II Attached ❑ None
® Meet the Fire Safe Regulations of Butte County and P.R.C. 4290
IS Automatic fire suppression sprinkler systems shall be installed in accordance with the
National Fire Protection Association Standard for installation of sprinkler systems in one
and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized
community water system, with hydrants that meet the Fire Department specifications, serves
the parcel. Ne rov4L r -c l Tem `rte Cr i'er+Q / 211/631
❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission
requirements of the California Clean Air Act of 1988, as amended.
❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan
must be prepared by a registered civil engineer or other qualified professional and be
submitted to and approved by the Department of Public Works.
❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate
Battalion Water Tender Fund may be required.
❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil
construction associated with residential development. Approved dust control measures are
found in the fugitive dust control plan for the site approved by the Butte County Air Quality
Management District, a copy of which can be obtained from the Butte County Department
of Development Services, Building Division."
❑ Engineered foundations are required.
❑ Class A roofs are required.
Property owners responsible for road maintenance, and stop sign maintenance.
F0
Page 4 of 5
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`.-HEEE-T OF
BUTTE COUNTY PROPERTY RECORD
Assessment Fee Number
Book I Page/Block I Parcel
NAME
Base Year
zoo �, r
�J
NAME
0,3 /q/ori .
Size: z
5, o l A -.c_ Land
SITUS
Structural Imps.
ZONING City. ❑ County .❑
Assessment Year
zoo C>
2oC� � 4i Zd6 Z_
UTILITIES -SITE IMPS.
Date
q t0 70v
6rl 3/a < Ile-loZ
Electricity: Yes Telephone ❑
Appraiser
-7-c 3&
-5 6 7_4C 3
Total
Gas: Public E3LF3G. ❑ None'
Use Code
5°
XI -5
Sanitary Swr: Public ❑ Indiv.
Dwelling Units
/
I
Street: Conc. ❑Asph. jVirt ❑ Gravel ❑
Building Class
v
/% �C,C_ C.
Street Lights: Yes ❑ No JZ
Bedrooms
3
3
C & G: Yes ❑ No
Baths
Ud
Sidewalks: Yes ❑ No
Effective Year
SITE TOPOGRAPHY
Area of Residence
Level ❑ Rolling Other ❑
Car Shelter
I Yes JRrNo ❑
Yes ❑ No ❑U Yes No ❑ Yes ❑
No ❑ Yes ❑ No ❑ Yes ❑ No ❑
Slopes: Up Down,PT S -S ❑
Misc. Buildings
At: OAbovb Belo E )rade
Pool
I Yes ❑ No"
Yes 0 No ❑?, Yes ❑ No Yes ❑
No ❑ Yes ❑ Ni�Lrcheckecl ❑ No ❑
View: ❑ Of:
Phy. Char.
Checked ;[�
Checked ❑ 'f Checked � Checked
❑ Checked ❑
WATER
o / 7r -/Z ir�r` Sn1. IT. pliG1+ 5A 69
GPM: Depth:
Comparable 1
A/ /)/Cs, .
6Z —o&ro0 ° 069 rao-o96
Public ❑ Well ❑ Ditch
Comparable 2
ccEPTS�ct
o3G-too—n4c7' o?f-o23-ofl�
Supplier
Comparable 3
o q-470- M_,5 ,; o36 -460 -WS
Aerial Photo Year
Sale Date/Price
���®ov 1
t53,Soo y
Topo Map Year
PRIMARY BASE SECTION
Soil Name Index Acres
Base Year
eov
Zoo zor� 7
Event Date
�2-/03./1Fy
l?/ou I y Qor
Land
105000
�'Z�ov .5o Qec�
Structural Imps.
So o o o
z 60 on -d
Growing Imps.
a.
Fixtures
v
Personal Property
Avq. Soil Ratinq
SECONDARY BASE SECTION
LAND REMARKS:
Base Year
zoo �, r
Land Type: Lot ❑ H/S
ar Acs. ❑ Event Date
0,3 /q/ori .
Size: z
5, o l A -.c_ Land
50U
Description:
Structural Imps.
Growing Imps.
Fixtures
Personal Property
Total
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, Califorgia 95965 • Telephone (530) 538-7541 PER T, N0.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
fs�50-11
ZONING
BUILDING PERMIT
OWNER
TE HONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MA97 ILING ADDRESS
i
IAIE OROVILLE� CA 95966
CONTRACTOR'S NAME
nQNPR
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 S
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee .00
USEOFSTRUCTURE
SF � 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 ❑ Installation ❑ Other EPJ(
Describe Work: DEMO
Gas piping system 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
a00VOR LESS
Main Service 200A OR LESS
23.00
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.PSING
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:
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 ZOOM TO 1000A
46.00
DWELLINGLICENSED
NEW CONST. DWELLING OCCUP.
CCU
OR ADDNS. ( a ACC. BLDS.
SO
3.5¢FT.
NO"ON.pESID. ' ANCHOU CIRCUITS T
@7,50
a OUTLET R. OWELER APPARATUS
Ex. OCCU OUTLET OR FIXTURES
ZO Q 1.00
BAL @ .50
Ex. Occup. ounErs RE..6.) LNS Ea
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE $
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 permitis issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
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 if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
6comply wi thole provisions.
fo hwith
ate 7 _
Wnature of AI ant4- wner ElContractor ❑ Agent
An OSHA permUis4equired for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
$
HAz.
nTOTEALE
D. FEES
CDF
PARCEL
PD
HD
ISSU
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.
y Dae l 3
PERMIT EXPIRES O
efe
Receipt No.
WHITE-D.D.S.-B.D.CANARY-ASS S R PINK -INSPECTOR GOLDENROD -APPLICANT
i
I
Demolition Pe mits
Asbestos Notification Statement
Date
AP#
Pursuant to section 19827.5 of the California Health and Safety Code, all
demolition permit applicants are required to fill out this form.
"19827.5. A demolition permit shall not be issued by any city, county,'
city and county, or state and local agency which is authorized to issue
demolition permits as to any building or structure except upon the receipt
from the permit applicant of a copy of each written asbestos notification
regarding the building that has been required to be submitted to the United
States Environmental Protection Agency or to a designated state agency, or
both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations,
or the successor to that part. The permit may be issued without the applicant
submitting a copy of the written notification if the applicant declares that
the notification is not applicable to the scheduled demolition project. The
permitting agency may require the applicant to make the declaration in writing,
or it may incorporate the applicant's response on the demolition permit appli-
cation."
Attached is a copy of my written asbestos notification to the United States
Environmental Protection Agency for the demolition project located at
Signature of Applicant
OR
I hereby declare that a written asbestos notification to the United States
Environmental Protection Agency is not applicable to this demolition project.
Sidafiture of Applicant
2/19/91
.1f._
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bear*mgyour 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.
10 I personally plan to provide the major labor and materials for construction of the proposed
property improvement: YE�- NO 0
I HAV1Q7t-- HAVE NOT ❑ signed an application for a building permit for the proposed work -
3. I have contracted with the following person (firm) to provide the proposed construction:
NAME:
ADDRESS:
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:
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:
NAMIE ADDRESS PHONE • ' TYPE OF WORK
ROPERTYOWNER: C
SOCIAL SECURITY NTJM[BER:_.
DATE:
NOTE: This Owner -Builder Verification is required by Section 19831 and 19532 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
b v —t,
OB. -1
( OWNER BUILDER INFO][2.MATION
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 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 including state and federal income tax withholding, federal social security taxes,
workers compensation fionwce, 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, 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 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
rely,
J
1 C. Vi ira, CB.O.
er, Building Inspection
NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code
OVER
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION PER No.
7 County Center Drive a Oroville, California 95965 • Telephone (530) 538-�3
(Rev. 12/96) APPLICATION AND PERMIT
ZONNG BUILDING P ERM IT
lSSESSORPARCELNUMBER '
TES" NE SO. FT. OCC. BUILDING VALUATION
OW - 33-51$3
oyyN-qs G ADD ss
CON6TRUcnON LEWER
LENDERS MktUNG ADDRESS
140.
ARCNIECT OR ENGINEER
ARCHrM= OR EN ERs LIAWNG ADDRESS
BuLDOIG ADDRESS /'1, t-,
LOT N0. su8DN61ONs NAME
Total Valua'
Trina Fee
Permit Fee
Plan Checkli
Enerov Plan
Each Trap
USEOFSTRUCTURE Solar or heat
Water piping
SF KDuplex 13Mobilehome 13Other SPECIFY Each gas water
TYPE OF WORK Gas piping
New C3. Addition ❑ Remodel ❑ utrioes ❑ Installation ❑ Other Building sewer
___S Mobile Home
Describe Work.
PERMIT FEE $
ELECTRICAL PERMIT
Main Service mw °oRRSS
Main Service 2DOA To IDDDA
NEW CONST. DYVE]ldtG OCCUP.
OR ADDNS ( 6 ACC. BIDS
I PERMIT, FEE PAID $
SRA
SHERIFF
OTHER
AMOUNT RECEIVED $ -�
DATE RECEIVED 1 103
X13 7 7 �T3a�
Fee $
$
RMIT FEE $
PERMIT
I water heat
ater or vent
1 - 5 outlets
20.00
.w
iling Fee 20.00
7.00
23.00
15.00
15.00
15.00
15.00
@20.00
g Fee 20.00
23.00
46.00
Ex. Occup. Oun.Er OR MIURB BAL @ .SD
Ex. Oeeu v�s sm OR 5.00
Temporary Seivice 23.00
Mobile Home Facilities 20.00
L PERMIT FEE $
MECHANICAL PERMIT Feng Fee 20.00
Cooling
Hood 6.50
PERMIT FEI: S
Mobile Home Installation Fee $
Energy Inspection Fee $
=C CO"ST. TYPE TOTAL FEE $ W
"AZ I D. FEES IMP I FLOOD I COF PARCEL I FD I HD I r.SuE
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---•- -._.--- _.• Date
a9a Iq C-,�
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, alifornia 95965
Telephone: 534-4541
APPLICATION AND PERMIT
autnorize representatives or the county or tsutte to enter upon ine
above-mentioned property for inspection purposes.
X Date i w
Signature of Permitee or Agent
Receipt No.
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
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.
DIRECTOR OF PUBLIC WORKS
By Date
Building permit expires Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor
Mailing Address I "'°
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address �'.j
Plan Checking Fee &/or Penalty
Permit Fee
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
i
Repair drainage or vent piping 1.50
A. P. No. r , „
. ;, Zanin &Planning
Water piping 1.50
Each gas water heater or vent 1.50
s I
W.C.
ni"i,
Fire Dept.
Fire Zone Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
Parcel
Declaration
Parcel Map
60' R/W
I Improvements
Each additional outlet .30
Building sewer 5.00
-�hd'g-PJony-Rea=d
Parcel ApEroval
Plans Approval
Lawn sprinkler system 2.00
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
permit Fee $
is
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR LESS t
100 AMP OR LESS 5.00
Single Family 0 Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD'L 100 AMP 2.50
OVER
Main service OVER 25.00
AMPP OR LESS O
Main service EA. ADD•L 100 AMP 1.00
NEW OR ADDNST ACCLBLDGS.LING CCUP 'k) 20sgft
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
T
NEW CONSTRESID, BRANCH CIRCUIT
NON-RESID. � BRANCH CIRCUITS 2.50ea
NEW CONSTR- (POWER APPARATUS d .
NON -RES D. SINGLE OUTLET CIR.
Ex. OCCUp(OUTLETS OR FIXTURES 50@ 250
.BAL,�1@
Ex. Occup. (FIXED
OUTLETS P(RESID)�EA) 2•00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. zl % Classification
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee
MECHANICAL No. @ FEE
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
1 -have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
r -1I 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 Workmen's Compensation Laws of
California.
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
Land Development Fee
Is
TOTAL PERMIT FEE
$ ""
autnorize representatives or the county or tsutte to enter upon ine
above-mentioned property for inspection purposes.
X Date i w
Signature of Permitee or Agent
Receipt No.
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
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.
DIRECTOR OF PUBLIC WORKS
By Date
Building permit expires Date
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
-. 7 County Center Drive — Orovi lie, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
BUILDING
,
OwnerSO.
c•c
FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor 0V-6 11' �X8r
4
Mailing Address i",Q,
Fireplace
Total Valuation
Telephone No.
c>
Permit Fee
Building Address
P Penalty
$
Permit Fee
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
P. N �j ® Za i g anning
Water piping 1.50
Each gas water heater or vent 1.50
Nes I
Wkt.
FireDept.
FireZone Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
Parcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
Parcel A proval
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
vter_ o 2,ar:,A
ELECTRICAL No.1 @ FEE
Q�>
PERMIT FILING FEE $3.0000V
OR L
Main service 100 AMP ORSLESS 5.00 45, C-C-7)
Single Family if Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD'L 100 AMP 2.50 S(J
Main service OVER e00V25.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 1.00
NEW CONSDWELING
OR ADDNST ( ACCLBLDGSCCUP. 'Y) 22sgft
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business Professions Code under the name
style o �
NEW CONSTR MULTI.OUTLET
NO N.R ESID � BRANCH CIRCUITS) 12.50ea
NEW CONSTR POWER APPARATUS a
NON-RESID. SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTIIRES a @100
Ex. Occup • %FIXED TS (RESAPPLNS. OR ) 2 00
OUTLETS (REST D.) EA
Temporary service 10.00
Mobile Home Facilities 15.00
License No./ Classification el
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$ /L r5—
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
ave placed on file with the County of Butte-a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X11-e-2 Date 2 . �/�7�
Signature o Pe- itee A n)t�(� Z
Receipt No. /O �q
White-D.P.W. — Yellow-Assessor — Pink-Inspector — Goldenrod-Applicant
Land Development Fee
$
TOTAL PERMIT FEE
$
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.
DIREC 0 UBLIC WORKS
r' C
By Date 7-- 7- /
Z,.Z
Hiding permit expires Date
t
PERMIT,NO. 3327-80B',P,E
a
PERMIT.EXPIRES'.✓�/
OWNER Carl Rasmussen
`CONTR. owner
34-19-60
LOCATION (A.P. )
97 Oakvale Ave., Oroville
i
A
t
t
it
Y '
'7
3444,
y�
ll� Temp. Power Pole J
E' Called PG&E C�
Temp. Elec. Seryt
Called PG&•E
Temp. Gas Serv.
Called PSG&E
J�B /FIN' ED 2
i
(Date)
0i
d
(Signature)
COUNTY OF BUTTE — DEPARTMENT OF.PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) i PLUMBING
Setback 6.e Firewall Soil Piping 44 l�
Forms Parapets 1st Floor
Main Bldg. Restroom Finish 2nd Floor
Footings Windows 3rd Floor
Stemwall SidingTo out
Slab Roof Shea thin Water PI in
Piers Roofing Sewer
Garage Fdn. Vents Fixtures
Footings Garage Vents Water Htr.
Stemwa I I Insulation Heaters
Slab Provfor ph sically Appliances
handica ed
Carport Conformance of ex. Gas Piping & Test
Footings structure Temp. Gas
Slab Final — Sanitation
Patio FIREPLACE Final
Footings Footing i E
,,STRI98L
Masonry Walls Throat ] Rough
Reinf. Steel Final N Fixtures
Bond Beam FIRE SAkINKLERS N Motors
Framin.041 g Test I Water Htr.
Stucco Final - Subpanels
Mesh - MECtMICAL Grd. Fault Prot.
Scratch Heatina Service
Brown Cooling Temp. Pole
Finish Ducts Underground
Interior Lath Ventilation Permanent
Door Closer Final Final
MOBILEHOMEUTILITIES ------------------Elec. Service Elec. Pedestal
Water Piping Sewer Gas Piping
Wq13ILEtjOMEINSTALLATION--------------Support Elec. Continuity
Water Piping Drainage Gas Piping
DATE REMARKS OR CORRECTIONS
11
(NOTE: An entry must be made on this form each time you vis t the job site.)
RES IDENT IAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IMC RMANCE WITH CURRENT ENERGY CO SERVATION REGULATIONS
AT4 7 C(7 �A (& ..�.. c.�
(location) \
BU ILD ING PERMIT NO. 35 -2 7 -- 3'0 A `: P . NO. , G it
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS:
(Check each item or write N/A if not applicable)
INSULATION:
Slab Edge
Fdn. Walls
Floors v'
Walls A--
Ceiling/Roof 14 ''
Ducts
Circulating Pipes
APPROVED HEATER
APPROVED WTR.HTR.
GLAZING:
Single Glazed &---
Special
Special (Insulated)
CERT. & LABELED WDS.
& SLIDING DRS.
WEATHERSTRIPPED DRS.
BACK.DAMPERED FANS
INTERMITTENT IGNITION DEVICES
CERT. APPLIANCES
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name (4j Al% 1�
Signature of (p ase print)
Insulation Applicator
State.Contractors
License No.
General Contractor/Owner Name
(please print)
Signature of
General Contractor/Owner Date
State Contractors
License No.
THIS CERT IF ICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
COUNTY, OF'BUTTE - DEPARTMENT0
7 County Center Drive - Oroville, California 959E5 -
F PUBLIC WORKS
Telephone 916/534- 41
APPLICATION AND PERMIT
PERMIT NO. �
t
ASSESS°•y P/�C�L�LI ;,NIGER
(PURR
ZONING'- 4 AZ
BUILDING PERMI
°"')t�3��-/
� M1/5+ SC 5L:,; - /O
OW R:S MAILING ADDRESS ,��j'
7 6,geV, � �v� ,eov�u v � _t
NAME TELEPHONE
SO. T. OCC. BUILDING VALUATION
t00
Mkt:
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER UNKNOWN
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
Permit Fee
�Q, 0 0
$ $,.00
ARCHITECT OR ENGINEER -
LICENSE NO.
Plan Checking Fee
Penalty
$ P_ o0
t
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ •00
BUILDINZ/A7RESS® - / Imo. /�'
//
PLUMBING PERMIT
Filing Fee 3.00
Each Trap
1 2.00 :2,00
Repair drainage or vent piping
2.00
Water piping
2c00
LOT NO.
SUBDIVISION NAMEPARCEL
MAP
Each pas water heater or vent
2.00
Gas piping system' 1 - 5 outlets
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
Lawn sprinkler system
2.00
TYPE OF WORK
New ❑ Addition �/ Remodel El Utilities El Installation ❑ Other ❑
Describe work: &771-' F,(4 61-V44fC- W _
p/���J� �/i/�,
Permit Fee
$ 7,490
Contractor
ELECTRICAL`PERMIT
Filing Fee 3.00
OR L
Main service 100°o AMP ORSLESS
5.00
Main service EA. ADD'L 100 A
2.50
NEW CONST. DWELLING O
OR ADDNS. ( ACC. BLDGS. &
20 Sq ft O v
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check One):
❑ I am licensed under provisions Of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. Business and Professions Code
for this reason
NEw CONSTR ULTI-OUTLET 2,50 ea
' NON.RESID. BRANCH CIRC ITS
NEW CONSTR.POWER APPARATUS .&
NON-RESID, (SINGLE OUTLET CIR.
Ex. Occup( OR FIXTURES B L@1
Aos
FIXED APP LNS, OR
Ex. Occup.(OUTLETS (RESID,) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
Permit Fee $ 91
Contractor
MECHANICAL PERMIT
Filing Fee 3.00
WORKMEN'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood
2.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue7
against saiunntin co sequence of the granting of this permit. cY x
X d C !�/. ` Date �� �7— o u
Signature of Applicant — Owner EL Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Land Development Fee $
TOTAL PERMIT FEE $ 8'g- g®
UP. GROUP
J
w�
TYPE OF CONST.
v
PARCEL
PD
ND
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR PUBLIC
By.
PER EXPIRES Date.
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date7-3
Receipt No. 3
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
Report
No.
j
Page
of
Inspection
Date
0
Permit
No.
ADHESIVE ANCHORAGE OF RODS/ROi.'ll'S
Project Address: CUT p Adv _- Lot:
Development Name:
uali Assurance Agency: Owner/Agent: 2 r
Owner/.gent Signature: Date:
INSPECTION SUMMARY
Plan Approval Date:
Evaluation Report No. & Date:
Hole Depth & Diameter: i'
Cleanliness of Hole:
Anchor Diameter Type & Grade: (,
Quantity of Rods/Bolts Installed:
Anchor Embedment
PRODUCT DESCRIPTION
INSPECTION SUMMARY
I hereby acknowledge that I have reviewed the approved•plans, applicable
evaluation report, and manufacturers' installation instructions. I inspected
the products and observed the product installation. IMe-anchor installation
has been verified to be in accordance with the manufacturer's published
instructions,
OISTMOLMOtd: 1.. JOB FILE 2. OWNER 3.
Product InstallEhionx —omplies with requirements
I hereby acknowledge that I have reviewed the approved•plans, applicable
evaluation report, and manufacturers' installation instructions. I inspected
the products and observed the product installation. IMe-anchor installation
has been verified to be in accordance with the manufacturer's published
instructions,
OISTMOLMOtd: 1.. JOB FILE 2. OWNER 3.
ALA
USMY
ktiilih'F:RL\C
FUJI Civil Engineering and Drafting
PO Box 5115 Chico, CA 95927
(530) 521-2648 eda@ausmusengineering.com
TRANSMITTAL
August 6, 2006
Don Pederson
97 Oakvale Ave
Oroville, CA 95966
RE: Residential Engineering Inspection and review of asbuilts
Dear Mr. Pederson
Please provide a copy of this transmittal and attached documents to your inspector to
verify:
1. Epoxied rods were installed according to manufacturer instructions to develop a
strength required by the shearwall holdown (see attached report and supporting
calcs.) Note: PHD holdowns shall be installed on the sill plate, not raised as
noticed during inspection.
2. The as -built drawings provided by Matthew Benjamin (AB -1) are in conformance
with the design intent and shall support and be appended to the original drawings
by Alfred Edgar — approved by the building department.
If you have any questions or concerns, please feel free to contact me.
Eric D. Ausmus, P.E.
Ausmus Engineering
Page 1 of 1
J:\Work\Ausmus Engineering\2005_ Projects\Pederson\Transmittal.doc
�USHUs a����� �ac�aa�r�Qoa�
Civil En ig, neerin@ and Drafting
PO Box 5115 Chico, CA 95927
(530) 521-2648 eda@ausmusengineering.com ,
TRUSS CONCURRENCE LETTER
August 3, 2006
Ausmus Engineering has reviewed the appended Truss Calculations provided and
approved by:
Longfellow Lumber Co., Inc.
Chico, CA (530) 893-0112
Dated:
February 1, 2006
The truss calculations were used in conjunction with the structural design for single story
residence named:
Pederson Residence
Eric D. Ausmus, P.E.
Ausmus Engineering
Page 1 of 1
J:\Work\Ausmus Engineering\2005_ Projects\Pederson\Truss2.doc
PLAN REVISION/RETURN
Owner's None:
BP#: 05- l 5 'C2
Date:
Contact Person & Phone Number:
pURPOSE OF RE -SUBMITTAL OR REVISION
❑ Permit Application Data Sheet Item
q-
*Engineering �-O —
"�, `
aL
/-4 YU &"
�� 4Q
I�*Plan Revision
❑ *Requested by Building Inspector's Correction Notice - Inspector's Name: _
❑ Requested by Plan's Examiner - Plan Examiner's Name:
❑ Other:
*If revising a plan which has already been issued, submit two (2)
drawings reflecting the revision
for plan review along with your approved plans. If engineeringanc{involved a sip revision,
isets of
starn
engineer must put his requirements on these drawing
engineered drawings. Revised drawings must clearly show changes proposed and locations
involved.
WHEN APPROVED, PROCESS AS FOLLOWS:
❑ Mail to Owner/Contractor at this address:
�( Call �J - - u� �d
!S hold for pick-up.
P�
❑ Deliver with next inspection.
Minimum revised plan check fee to be collected at time of arc needed:
submission of revision, plans
examiner will determine if additional plan checking f
ees
.v
FEW
Minimum $54.99 Receipt #:
Fee not required for revisions requested by plans examiner prior to issuance of permit.
Receipt #:
0 Additional Fee Amount: x�,,sed 2/04
7
iw �0-
C, oo,
IT,
C2
_00 J TT
OV--
? } t I } # i ''
PROVAL
PLANNING DIVISION- BUILDING PLAN Ar P
Use:_ Date:
'j i••Landscanim:
•The 2001 CBC, CMC, CPC, CEC,
Other: dl A
+ and 2001 California Energy
Signature:— kl$. ;. ',4 Efficiency Standards as amended by
Butte County apply to this project
S4,!(, e
&bl nu YIN
L
v
Fasteners for pressure-preservative treated and
fire-retardant treated wood shall be hot-
dipped zinc coated galvanized, stainless steel,
I
silicon bronze or copper per CBC 2304.3. The
builder is responsible for compliance with the
proprietary hardware manufacturer's specific
requirements for corrosion-resistance.
•
THIS PROJECT SHALL COMM
WITH ALL CALIFORNIA
DEPARTMENT Of FORESTRY (Cl
REQUIREMENTS
NOTE:
See the attached
Residential Construction
Re uirements.
Pages
*j%tL.DA+J
. .112
LONGFELLow LUMBER CO. INC.
Customer:
Address:
AP#:
C•20E (Rev. 5105)
Quality Design • Floor, Wall & Roof Systems
89 Loren Avenue • Chico, CA 95928-7434
Phone (530) 893-0112 • (800) 678-0112
Fax (530) 893-0140
E -Mail: trusses@longfellowlumber,com
DON PEDERSON
97 OAKVALE
OROVILLE
Relo 1= kk .11)
&5r-- 16-q-3
13UTTE COUNTY
8UILDING DIVIS100
APPROVED
Job No: PEDERSON
ENGINEER
Mitek Industries, Inc.
Redong (Ray) Yu
7777 Greenback Lane, Suite 109
Citrus Heights, CA 95610
(916) 676-1900
APPROVED INSPECTION AGENCY
Timber Products Inspection, Inc.
P.O. Box 20455
Portland, OR 97220
(503) 254-0204
-2-0-0 9.3.0 2-0-0
8-3-0 2-0-0
= 1:428
24a0 8-3.0 4x! II
NO TOP CHORD NOTCHING IS ALLOWED
�TMm tea- nF THE HEEL JOINTS. 3,ra 3 3A
5.7-10 1
s7-10
s2-12 s7-10
LOADING (psf)
SPACING
240-0
TCLL
1C.0
Plates Increase
125
125
TCDL
10.0
Lumber Increase
NO
SCLL
0.0
Rep Stress Ina
Code USC971ANS195
SCDL
7.0
LUMGER
TOP CHORD 2 X4 DF No.1 B1r G
SOT CHORD 2 X 4 DF No.1 iatrG
WEBS 2 X4 DF Std G
OTHERS 2 X4 DF Std G
REACTIONS (WsIze)Max 2=a�p case 4)
Max Uprdl2=-250aad case 5). 4=25(1110411 case 5)
FORCES (Ib) - Maximum �npresa'anlMalarrlum Tension
TOP CHORD 1-2=0157.2-3=1173!8, 3-1=117318.4-"--7
SOT CHORD 2 7=OMM. 5-71958, 4-6=-OM98
120
WEBS 3-G=155, 3.7-151205
ERS.
�a
`-,•=0.30BerKTL)
in
(lac) Well
V4 PLATES GRIP
MT20 2201195
L) -0.03
rr7 x999
r►7 >999
240
180
-0.0G
1'L) 0.02
4 n1a
Na Weight 137 lb
GRACING
TOP CHORD
Sheathd or
5-11-7 oc puffins.
applied or 10-0-0 ae Yndnp.
��"
GOT CHORD
Rigid coling
drectly
NOTES level. using 10.0 psf top shard dead
1) Untsalanced roof 1'rve lands have been can �� eneraled 75 mph winds at 25 It above gr.lrlld I wrldition 1 endosd buldiry, of
2) This truss has heart designed for the wind to wind. If
rr S ASCE 7-93 per USC97/ANS195 H end ver&Ws or c2rdevers exist 1hcY are exposed
Nail and 7.0 cast MOorrl chord dead Nd, 100 mi from hunicane oceanGne, art an occuparwy N .
dirnerwAllns 45 h 1111124 R with expose 1.33 , and sed the plate grip increase is 1.33
Arches elist ft" are, exposed 1• wind. The lumber DOL Increase is y wired (normal 1• the face), see MiTek'Standard GaMe
3) Truss designed for wind loads in the plane of the truss only. For studs expo
End Detail
4) Gayle studs spaced at 1-" --chord li- land noneoncurren<wph any Igds.
5) This truss has been designed foraed for 10.0 psf b~ du"
green lumber members. r back (S).
7) In the LOAD CASE(S) section
6) A plate rating reduction of 20% has been aper
. loads applied 1• the Dace of the truss are noted as front (F)
LOAD CASE(S) Standard
1) Regular. Lumber Inetease=1.25. Plate Increase-' 25
Untform Lads (pif)
Vert 2-4-14, 1 -2 -104(F= -52).45=104(F-52)
Trapezoidal Loads (calf)
G4(F=112). 3=1G4(F=112}to 4=105(F=53
Vert: 2=105(F-53}u-3=-1
aeere�ar•r FA f-r•74731ERrlrt V=
aAn1e1r1rc . 7er{1tI leerin 7�1ie� arrd � �1rTnS open s r ms's 1« an indNW ku wm*dealt _M*N�n hr
AIJIUvew for ace any vAh hhie! conrreclers. Thir reslrr �� a=�yily d M+iJn! d Cqm� ��ra ry al aye
hA� ; ee,',h�, f !nn
ni ..aa kcw" W.'.0 Mm'er«y Yreck � For met pid nce r�^O^g eo,
creel«. kits.. pe -w-nl brocilg al the overol dnw1b'mme the terp«elr^N
! 1 puetiy C�11eAa.0iM end SCln %mAAaa —V—
tew.6fien. ehraw canket sterale• defray erecrren aril O M• �s vn SW 17.
Selely Inrennaien e—imrle tram fres ryele IM11ula Sia dOnalrla Dirve. hAaiearL
C
LLC
0-1
fl,
Q�pFESS1pN�
pONG yGl �yC2
m
Uj C4 9
1 *KP. !30106
7177 GreenYadclane w
Suite 10!
CIM Heil hie. CA. ON10 R
Meek'
16.6-0 laiu
-2-0-0 4.315 430 72-21 2-60
241-0 4-315
311-1 311-1 4.319 Seale = 139.9
4X4 =
8.3-0
6-3.0
LOADING(psf)
SPACING
2-0-0
TCLL
16.0
Mates Increase
125
TCDL
10.0
Lumber Increase
1.25
{CLL
0.0
RepIncr
odde
YES
iCDL
7.0
Code BC971ANS195
LUMBER
TOR CHORD 2 X 4 DF No.1 &ft G
BOT CHORD 2 X 4 DF No.1 iBtir G
WEBS 2 X 4 DF StdG
REACTIONS (Iblsiie) 2=646m,". 6=66ro 3.5
Max HerzUpIV 2--240 a� case 5), 6� 24p� case 5)
Max Upli2=24(lead
�a
CSI
DEFL in
(lac) Well
Lid PLATES GRIP
MT20 2201195
TC 0.15
Vert(LL) -0.09
2-0 >999
240
BC 0.45
Vert(TL) -0.16
2-5 >999
150
WB 0.14
Horz(n) 0.01
6 Na
1112 Weight 76 Ib
(SimIdiried)
{RACING
TOR CHORD
Sheathed or
60-0 oc FurSns.
BOT CHORD
Rigid ceiling
dlredly applied or 10-0-0 ec bracing.
FORCES Qb) - Maximum CamFressW M2) imum Tension 5 G= Gt9M 67 129
TOP CHORD 1-2=0129,2-3=`a"0-3-4=-469'31' 4-5=469131.
BOT CHORD 2-8=01630.6 5 01530 174123
WEBS 3-9-1742 4-1=-
3.441345, . �_
NOTESconsidered far using 10.0 ta' chard dead
1) Unbalanced roof live leads have been rated by 75 mPh winds at 25 R above ground I--
2) This truss has been designed for the wind Mads! an a category 1. condition I enclosed Wilding. of
Wed and 7.0 rs( b~ Chord dead lead. 100 car from hurticane oceonline, on encu' r1cY sed to wind. If
dimensions 45 R by 24 R with exposure B ASCE 7-93'u USC971ANS195 If end vertials or anNevers exist they are e O
porches elist they are exposed b wind. The bBnber DOL increase a cone rRM with annd Vie plate y other livrip e leads.se is
3) This truss has been designed for a 10.0 Rsf bottom chord gve load nencOncu
4) A Nate rating reduction of 207E has been applied for the green lumber members.
LOAD CASE(S) Standard
EjrEjtZVcZ alb T115 AIM a � LIGE J<74FJ �u USE'
wAB1rBr0 - ♦ertfY aerie P....1.
....1 s'WOMEN, BLV_ is fid. §V a ,.n +barrels * w� .n+'s br.n'r,i t b m deiW— k srwn+
�.,DeW APOSC0110Y at . N a,pwomr en r.rnPrtes «rr 1'e Pe"N rear: o M++ns e e wwl gui mince r� rye
e„r,anent tr.r a+g of n1e averN stuctue the resperaatAWMI Qur.,r Cih--.s. tl .e. sea, ba+hs «•••e
reclar. Ad4fifianal kal storoK• Ier^1e^/• 4rec6an er+I ^m census w53711.
IaYica6wt wraay ryarW. de pMte wMguim 563 D pnolrio Drive. �4arl+an.
Salely lnlerrt..iiee .*.dobe
QRpFESSIpN'
pONG YGC�2c2
X19
l *� EXPA9130106 / it 1
7777 G--� M=
Suie 10! `
Cimra Heijhls. CA. 15619 _
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