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068-320-048
RASH, JACL- wsur 3657 D CONT:: SKILLED D 13L t' NSF(MSTR 01-35A) f 065-320-048 05-2431 . BASH, lACE 3657 HILDALEA CONT: OWNER CONV SF TO STG 4.-:f NOTES PERMIT NO. RESIDENTIAL: 068-320-048 � 05-2431 �. RASH, JACE 3657 HILDALE AVE, OROVILLE I CONT: OWNER CONV SF TO STG il SPECIAL CONDITIONS SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY _ USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER , CHECKED BY JOB FINALED (Date) J=OK 0 =Not OK = Not AppricReady Ele . =Not Heady MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s Card B-1 . Date 1. Zoning Requirements -Setbacks -Easements Date 2. Sols; Special MH Support Sketch B-1 3. Sewer, Location -Test -Fall -C/O -Concrete PERMANENT END SYSTEM (ONLY) 4. Water, Location -Test -Easement Needed (Sketch) S. Electricity, Location-Clearances-Gmd-/ . /Amp -Concrete 6. Gas; Location -Test -Wrap;-:/ - : P L'fL / P Nat or'/.* P L 'AJ . P LPG 2. Footings; S¢e-Spacing -Marriage Line ` ..- 7. Well Clearance i£ Disconnect 8. utility Clearance- Date learance .. Date Card B-1 Date Card B-1 Date Card B-1 = Date - : Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2- Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test=Crossovers-Breakers-Clearances S. Drain; MH Test-Fall-Flek Connector ' 6. Water, MH Test-Regulator-Connectd 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert 10. Exits; Insp.-Sketch 11. Cert of Occupancy MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s Date Card B-1 . Date Card B-1 Date Cana 6-1 DateCard B-1 Date PERMANENT END SYSTEM (ONLY) S.- Alum. Awn.; Columns-Cohnections-Splice-Decal-Enclosures 1. Zoning Requirements-Settracks-Easements 7. Electric 2. Footings; S¢e-Spacing -Marriage Line ` ..- . 3. BlocidrSg.... .. - 10. Roof; Shthg-Roofing - 4.`Gas; MHTest=Demand-Valle ',_. 11. Ext; Steps -Doors -Landings. " 5. Electricity; MH Tess 6. Water, MH Test Card B-1 Date Cana B-1 Date 7.. Water. and Sewer"Ccinnected . Date POOLS (Plans) OK except #'s 8. Gas and Electricity Tagged' 1. Setbacks -Easements 9. Exits 3. Pool Structum; Steel -Connections -Thickness . Dead. Men -Lining. `10.: License Decals 4. Elec.; Receptacles and Lighting, Distance-GFI 11. Verify #'s with Office,_ 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater Date Card B-1 Date Card B-1. Date Cana B-1 .Date Card B-1 11.,..Ughf Niche ------------ 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 S.- Alum. Awn.; Columns-Cohnections-Splice-Decal-Enclosures 6: Cavorts; 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 Cana B-1 Date Card B-1 Date Cana B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structum; Steel -Connections -Thickness . Dead. Men -Lining. 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Sec.; Pool Lighting; 15 Volts -GF! 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-Panelboards-Ins. to Main Conduit 9." Health Department Approval 10.- Plumt�.; Cir. Test -Water Supply. Test 11.,..Ughf Niche ------------ 12. Enclosure; Fencing -Alarms Date... Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 On Not OK Not Appriable itot Ready RESIDENTIAL (Single & Duplex) ite UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Sols-Elec. Gmd. / /" Ftg. Depth 3. Ftg., Garage; Sols -Steel -Flet. Gmd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ P Ftg. Depth S. 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 late Card B-1 Date Card 8-1 )ate Card B-1 Date Card B-1 )ate PLUMBING (Permit) OK -except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection Date 19. D.W.V.; Test Fittings & Anchor -Nail Protection Date 20. Shower Pan; Test, First Floor -Tub Access Date 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sime & Anchors 23. Fire Sprinkler, Test 38. Condensate Drain & Overflow, Size & Grade Date Card B-1 Date Card B-1 Date Card B-1 Date Card BA Date ELECTRICAL (Permit) OK except #'s Date 24. Fixture & Transformer Clearance -Ins. Protection Date 25. Sec. 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 GR 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or AI 31. Range Circle/ /ga Cu or Al -Oven Circ. / /ga Cu or AI Insulated Neutral O Yes O No 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 & Bearino Date FRAMING (Continued) , 47. Hangers -Post Caps -Anchors -Connectors 48. Ging. Joist-Rftc Ties-Purtin-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 Fre Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. ExL Doors -One T -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fre Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed-Fd.Vents-Underfk 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 Fioor-Ducts-Meth. Protection 67. Bedroom Exiting 68. G.FI. & Bath Fixtures & Tub Access -Spa 69. Sec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. IOL Fizt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Sec. 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 -Meth. Protection 78. Plb.; Sec. & Mech. Equip'. Listed For Location 79. Elec. Receptacles in Garage (FF.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 tnstldJDrive O Yes O No/Walks O Yes O NaManters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Pibg-Apprrance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical. Plumbing 88. Exterior Sec. 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: 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels -Motors -Meeh. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except Its 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform it 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 & Bearino Date FRAMING (Continued) , 47. Hangers -Post Caps -Anchors -Connectors 48. Ging. Joist-Rftc Ties-Purtin-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 Fre Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. ExL Doors -One T -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fre Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed-Fd.Vents-Underfk 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 Fioor-Ducts-Meth. Protection 67. Bedroom Exiting 68. G.FI. & Bath Fixtures & Tub Access -Spa 69. Sec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. IOL Fizt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Sec. 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 -Meth. Protection 78. Plb.; Sec. & Mech. Equip'. Listed For Location 79. Elec. Receptacles in Garage (FF.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 tnstldJDrive O Yes O No/Walks O Yes O NaManters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Pibg-Apprrance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical. Plumbing 88. Exterior Sec. 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: NOTES `Y. RESIDENTIAL PERMIT NO. X068-320-048 05-2430 1 iRASH, JACE '3657 HILLDALE ., OROVILLE CONT: SKILLED BLDRS } NSF(MSTR 01-35A) . SPECIAL CONDITIONS CHECKED BY SRA 1 FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. - SPECIAL INSPECTION ITEMS VERIFY ' s w i USE PERMIT CONDITIONS ,4 SUB-STANDARD"HOUSING LETTER OFFICE COPY Addres 3 5� } .J GAS��; Meter By � Da ELECTRIC Meter By—Datel�"�3 c �- JOB FINALED (Date) e 4 - OK o =Not OK NotRadcahle = Not Ready . = MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except Vs 1. Zoning Requirements -Setbacks -Easements 2. Sols; Specidl MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Water Location -Test -Easement Needed (Sketch) .5. Electricity; Location-Clearances-Gmd-/ . /Amp -Concrete 6. Gas; Location -Test -Wrap;=/ • : P L'fL / P Nat or/ . P L'ftl . /"LPG . 7. Well.Clearance & Disconnect 8. Utility Clearance, .. 10. Roof; Shthg-Roofing t. Date Card B-1 Date Card B-1 Date Card B-1 -Date .: Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except 3's 1. Zoning Requiremerits-Setbacks-Easements 2- Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity, MH Test=Crossovers-Breakers-Clearances 5. Drain; MH Test -Fall -Flet Connector ' 6. Water, MH Test-Regulator-Connectot 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp: Sketch 11. Cert of Occupancy Date Cana B-1 Date Card B-1 Date Card B-1 ...Date'..: Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirerhents-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 Electrfaty Tagged ' _• . ... ": ` ° 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 9'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 t. 11. Ext; Steps -Doors -Landings . 12. Braced Wall Panels_ Date Card B-1 Date Cana B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except Vs 1. Setbacks -Easements 2. ..Soils; Compaction -Structure Stability 3. Pool Structure; SteeVConnections-Thickness . Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance -GA 5. Sec.; Pool Lighting; 15 Volts -GF! 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elea; Grounding; Equip. w/5' G1ri Mating Equip; Pool Lghtg. Boxes=Enclosures-Panelboards-ins. to Main Conduit 9: Health Department Appnival 10... Plumb.; Cir. Test -Water,' Supply. Test. 11.._Ughf Niche 12. Enclosure; Fencing -Alarms -Cana Date B-1 Date Card B-1 Date Card 0-1 Date Card 13-1 0 OK Not OK ' Notdy hle Ftndy Net HeaRESIDENTIAL (Single & Duplex) to UNDJWFLOOR (Plans) OK except ff's 2.- Ft ain; Sols -Flet. Gmd. / . r Ftg. Depth 3eTtq,,Girage; Sols -Steel -Flet. Gmd.-/ /" Ftg. Depth 4eltg�-Porches & Decks; Soils -Steel-/ /' Ftq. Depth OL Hold Downs and Special Anchors / 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' late Card B-1 Date Card B-1 late Cana B-1 Date Card B-1 late PIVdBING (Penni 'except Ws ter Htr.x9qB4Access Zombustion Air Baffle ter Pipe; Test & Anchor-'Nail'Protection W D.W.V ; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. est Tub i£ Shower, Second Floor -Tub Access Gas Pipe; Sixe & Anchors 23. Fin: Sprinkler, Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card BA Date ELE RICAL (Permit) OK except 9's ixture & Transformer Clearance -Ins. Protection . Receptacles Spacing -lights & Switches at Doors i e Boxes & No. of Conductors Stapled _ omex Installed Close to Edge of Studs & C.J. k.quip. Ground made up w/Meth Fasteners -Bond Gas & Water 2 Appliance Circuits in Kitchen & Conductor Size GFl _ 30. 1Subfeed Wire Size/ /ga Cu or AI -AC. Wire Size/ /ga Cu or AI W. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes 0 No 32. ce-Riser Conductors & Ground Main Disconnect Equip. Clearances Panels -Motors -Meth. Equip. 34, Plothes.Closet Light -Shower Ught-Spa Light Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ME ICAL (Permit) OK except S's Ducts Insulation & Support Vit Fan, Exhaust above insulation ndensate Drain & Overflow, Size & Grade ' umace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet i . 0 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 (PerTnit) OK except Y'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) c 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearina Date FR G (Continued) Hangers -Post Caps -Anchors -Connectors i g. Joist-Rftr Ties-Purlin-Roll B hting= Rtng. )replace Ties or Type A Flue -Fireplace Throat Clearance SKAttic Access; Size & Romex Protection -Draft Stop -Ins. Baffles � drm. Windows or Exiting Doors -Sill HL & Dimensions x,52. Garage Fire Protection Framing -RC Channel 5p3,�perty Line Firewall & Openings Doors -One T -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. S joing-Nairing Veneer §/Stucco Mesh -Drip Screed -Fd. Verits-Underilr. Access 59. Glazing Area -Glass Protection-Skyh9hts-Plastic 61. Brace Interior/Exterior Wall Panels Insulation-Walls-Celings Infittration-Wall - tndows Date ,2 i Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date _ _ FINW(Plans) OK except Vs Ext. Steps -Door & Sidelight.Protection-Landings moke Detector W Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection Bedroom Exiting G_F I. & Bath Fixtures & Tub Access -Spa 581-Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rads 7,f!Fireplace or Stove, Clearance -Hearth 72. Elec..Outlets at Wood Panel, Int & Ext 7.3. -'Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74!Elec. Outlets & Receptacles at Kit Counter 7 . Garage Fire Door, Swing -Landing -Closure 76. A.C. Dud in Garage -Damper' - Wtr Htr; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor -Meth. Protection 78!VIb.; Bec. & Mech. Equip: Listed For Location 7 . Elec. Receptacles in Garage (FF.1.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. guard Rails & Deck Construction -Post Caps . Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 13 Yes 83. Follower tnstld Yes D No/Waft D Yes O No/Plarrters 0 Yes O No ),,,�( 84. Iucco Finish A.C. Unit Disconnect, Electrical -Plumbing Vents Above Root, Pibg-Appriance-Fireplace-Clearance to Openings. 87. Water Well, Disconnect, Electrical, Plumbing W8 erior I7ec. Trim, G.F.I. Receptacle -Underground tlation Throughout House ST Glass Protection 91. Corredi from Previous Inspections 3116), 0 s, • 92. G s est -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval rgy Compliance Certificate -Other Certificates Address Posted 95. Fire Sprinkler Date Card B-1 Date Card B-1 Dat . Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: insulation Certificate >t �T101KIMIM' BUILDING LOCATION: Description of Installation ROOF Material Thickness (inches) CEILING Batt or Blanket Type Thickness ('inches) -77 Loose Fill Type e --- . ' e 10 S Contractor's minimum installed weight/ft lb i� Brand Name Thermal Resistance (R -Value) Brand Name Thermal Resistance (R -Value) '" 3 Brand Name Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance (R -Value) EXTERIOR -WALL Material's , `p S S!/ Brand Name - Thickness (inches) Thermal Resistance (R -Value) RAISED FLOOR _ Material -e f',1 �R 5 S Brand Name Thickness (inches) 6 Thermal Resistance (R -Value) / SLAB FLOOR Material Thickness (inches) Width (inches) FOUNDATION WALL Brand Name Thermal Resistance (R -Value) Material Brand Name Thickness (inches) '-.-rmal Resistance (R -Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of -the California Administrative Code. Ja CR- -11) General C_onpractor (Builder) j License Number ignamre and Title Sub -Contractor (Insulation Installer) Signature and Title Date License Number Date THIS CERTIFICATE MUST .BE PROVIDED TO THE BUILDING DEPARTZEM PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. JANUARY -1993 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION A: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BPO52430 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 10/05/2005 APN: 068-320-048-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 3657 HILDALE AVE ORO Map Index: Date: Contractor: Description: NSF(2198)GAR(624)COV(24)OPEN(200) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the MASTER 01-35A Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a Owner: RASH, JACE signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 6317 POWER HOUSE HILL ROD she is exempt therefrom and the basis for the alleged exemption. Any OROVILLE, CA 95965 violation of Section 7031.5 by any applicant for a permit subjects the (530)693-1937 applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: RASH, JACE PP owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 6317 POWER HOUSE HILL ROD sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of OROVILLE, CA 95965 proving that he or she did not build or improve for the purpose of (530)693-1937 sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: SKILLED BUILDERS pursuant to the Contractors' State License Law.). ❑ [am xe Dtu5derArticl .3oftheBusinessarl Profes or,,kCode 6317 POWER HOUSE HILL RD 95965 Date: Owne (530)693-1957 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Architect: ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 3046 S.F. Policy #: Valuation: $160,230.00 ❑ I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 1 n (� O Date: Applicant: WARNING: Failure to secure workers' compensation coverage is t unlawful, and shall subject an employer to criminal penalties and one 10—S-05 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 hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.)B — s Name: y: Date: t l� If.VIi(CatJllJ�ll1/.� J�c I — IS— lJ o Address: PERMIT EXPIRES ON: l J Date ❑ 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 do m nt of Butte County. I hereby authorize repres gtatives of Butte County to en upon�tthh7e a o e mentioned property for inspection es. Print Name: J Signal Date: Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" .11 OWNER INFORMATION Last Name '/ SL i 1 / I First N me Address I /� * City ,i,�-_ yo � , State_ (, Zip 9 S- j Phone ,� _ /gam Fax E-mail E-mail .11 APPLICANT INFORMATION CONTRACTOR Name i 1 / I Address Zip Address Fax City Zip State Zip Phone E-mail Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANTSIGNATURE X F office use only: Zoning Flood Zone SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BP BIN # //� PROJECT LOCATION V OCATION _ �/ AP# 0 (o ?5 — S z S Property Address City ,` �t f ( p2csvi l Cross SXeetf— r AW 1ORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Page 1 of 2 Description or Scope of Work: Sq FT- ' in ra e 0 go CAVIL ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received cy.wAmount: Bldg F� SRA Receipt #: 42�� / S- Sheriff SMIP Date: -1 4 hrLoOther �• Total REV 8-12-05 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 manual, (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. Building Permit Application Without Required Clearances Foam ❑ 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. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 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 check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSOUILDING F0RMS\131dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVIS16N 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax,(530)538-2140 63 a4 3 o PERMIT APPLICATION DATA SHEET �j -tip OWNER: � � ASSESSOR PARCEL NUMB R '�V �� `CU Proposed Building Use: SF / Y�5»--"y� �-� Permit Technician: Date: ? Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. ,,,,16 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form ❑ 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 16. Fire Sprinklers............................................................................................ tl 17. - Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... 019. Erosion Control Plan Required... ..................................................................... V �ees 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 of Biggs .............................. 4fnD California Department of Forestry plan approval ❑ paid. Sent by: Planning approval for (A) Use: �B)Parking: (C) Parcel Check:..:.... QST ❑ 25. Contact Land Development about _ Improvements, _ Drainage ........................ :=T 26. NPDES Form.............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ecorded copy of Agricultural Acknowledgment Statement ................................. ❑ 32. 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone ' 9,3 7 and hold for pickup. If I have been informed of the abo�s and requirements for obtaining a building permit. Applicant: �f/*'�- �� Date: 1. Index pept application for the above items numbered: Plan Check Letter 2. Addition5l items required C�feN, designer as advised of the above data by ❑ one, ❑ mail, mo�ounter, by - Date: 'as C ntra'0', designer n was advised of the above data by phone, ❑ mail, Vcounter, by Date: ractor, designer, o ner was advised of the abov data _❑ phone, ❑ mail, ❑ co me , by Date: Date: f Plans approved by: Date: Plans reviewed W - Structural reviewed by: Date: Y Structural approved by! Date:vgj�� Note transfer by: Date: Yellow: Building Division E.H. USE ONLY �- 'Piot Pian Attached Raw Plan Attached Santa G.D. / TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance IT, f� a- n -? J�c I &)�, --ILG-)- \.O � , —�,/ A4 Owner Location AP# Plan Approved for: Sewage Disposal—,_ Water Su ply: P bli Private Well T Clearance for dwelling. Other Hold final for: Final cl NOTE: Environ 8/96 tal Health Specialist Date COUNTY OF BUTTE 615 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 PRO ROSED BUILDING USE 1. BUILDING PERMIT FEES -- Balance Due ..................... $ --- FEMA Flood elevation review ... $ --- Additional plan checking Fee.... $ 2V 2. SCHOOL DISTRICT FEES( ag, (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. VV 4. RECREATION DISTRICT FEES ' (paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per dwelling) Zoning 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) U 8. SMTP I to. -d-, 9. DRAINAGE FEE 10. OTHER 11. OTHER A.P. # W-3RO" Qql� DATE RECEIPT q DATE REC. At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed durin he plan checkin oc APPLICANT �� DATE Pursuant to Govemtpdt 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 tfie 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. 7/05) ,'III!jib o V. Ac0 CipL Department r , ,, n t ' Michael Crump, Director of Public Works LAND DEVELOPMENT DIVISION Storm Water Management Pm%rzn 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FA)() 538-7171 National Pollutant Discharge elimination System . (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement (LESS THAN! 1 ACRE Project Description: Project Location rT and/or Parcel Number: the project ownerlowner's agent, certify that this project WILL NOT DISTURB By signing below, I, p ] 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit Pori 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. 4 Signed: Title: Date: BUTTE COUNTY (DEVELOPMENT FEE CERTIFICATION FORM P(FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) 0 CHICO AREA RECREATION AND PARK DISTRICT (CARD) ❑ PARADISE RECREATION AND PARK DISTRICT (PRPD) ❑ DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) Building Permit NumbeiCSd43 0 Property Owner (s) Project Location /Address Subdivision Name Assessable Sq. Ftge 0 E Type of Residential Development (check one) New Development Single Family -Detached Single Family -Attached Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling Mobile home Mobile home replacement verified by Assessor Department Demo Permit (date issued ), 1 /7/1 , -Z— verified by Building Department Comments: Building ❑ FRRPD ❑ CARD ❑ PRPD ❑ DRPD certifies that: Applicant Name IPhone Number Mailing Address 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: Recreation and Park District Representative v-% r %9—Tm nD.ir_ ClnD 1101--A, - -..... A—A F .m . is 1 Arir. per unit for a total of $ per sq foot for a total of $ Receipt No: Zip School District nrov, A.P Property Owner Property Locatic BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) Building Department No. County Subdivision Lot No. Residential Development Q Q Q € Sq. Footage No of Living Mobile Home Addition/ 'Supplemental to (Group. R) Units Installation Conversion Permit # *(No foundation inspection) Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial 0 Sq. Footage New Addition (Including Exterior Roofed Areas) los- j6ildi-ng Department Repre to ive Date District Identification No. 13 -10 School District certifies that (Applicant) 3l. 5-1 �-� 1 4o--tp-- Eye - (Street Address) (Phone Number) aL b s� (City) (State) (Zip Code) has complied with the requirements of Resolution No. b 3 --04 by payment of $ :z::) ,S`E representing t G -1 t- square feet. B 2926 $ ULL MITIGATION $ School District Representative Date Paid by Check # Remarks: L �"1 (-Cd Notice: You may protest the Imposition of the fees Identified above by submitting a written protest to the District, In compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the Imposition of the fees In any court action. M, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District Is notified by the applicable Local Planning Agency that this project Is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate Its Impact on the school district's schools. White (school district), Yellow (building department), Pink (applicant) feeformids (=S)drbm AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2005-0060549 Recorded I REC FEE 10.00 Official Records I .- County of I COPIES 2.50 Butte I CMACE J. GRUBBS 1 County Clerk-Recarderl I I BII 0110NM 05 -Oct -2@05 1 Page 1 of 2 IIII III III I IIII I III I II{ II IIII II III t AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building PC, 14it. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: SEE ATTACHED LEGAL DESCRIPTION Date _ PROP RTY OWNERS: r /---'IACE K. RASH SUSAN KI'STE AS State of California ) County of BUTTE ) On , ,OCTOBER 3, 2005 before me, personally appeared JACE K. RASH AND SUSAN KISTER RASH personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. I WITNESS my hand and official seal. Signature A.P. # MARY A. THOMPSON c� Commission #1351470 U Notary Public -California Butte County My Comm. Exp. APR. 15, 2006 No ALL THAT PORTION OF LOT 229, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "OFFICIAL MAP OF OROVILLE-WYANDOTTE FRUIT LANDS UNIT NO. 6", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MARCH 8, 1929, IN BOOK 10 OF MAPS, AT PAGE(S) 3A, 4A AND 5A, LYING SOUTHWESTERLY OF A LINE DESCRIBED AS FOLLOWS: BEGINNING AT A POINT ON THE NORTHWESTERLY LINE OF HILDALE AVENUE DISTANT SOUTHWESTERLY 580.3 FEET, MEASURED ALONG THE NORTHWESTERLY LINE OF HILDALE AVENUE AND ARBOL AVENUE, AS SHOWN ON SAID MAP, FROM THE INTERSECTION OF THE NORTH LINE OF SAID LOT 229 WITH THE NORTHWESTERLY LINE OF SAID ARBOL AVENUE, SAID POINT HEREIN BEING DESIGNATED AS POINT "A"; THENCE NORTHWESTERLY IN A DIRECT LINE TO A POINT IN THE NORTH LINE OF SAID LOT 229, HEREIN BEING DESIGNATED AS POINT "B", DISTANT NORTH 89 DEG. 52' 30" WEST 563.5 FEET, FROM THE INTERSECTION OF THE NORTH LINE OF SAID LOT 229 WITH THE NORTHWESTERLY LINE OF SAID ARBOL AVENUE. EXCEPTING THEREFROM THAT PORTION OF SAID LOT 229 LYING NORTHWESTERLY OF A LINE DESCRIBED AS FOLLOWS: COMMENCING AT THE INTERSECTION OF THE SOUTHWESTERLY LINE OF SAID LOT 229 AND THE NORTHWESTERLY LINE OF HILDALE AVENUE, AS SHOWN ON SAID OROVILLE- WYANDOTTE FRUIT LANDS UNIT NO. 6 MAP; THENCE NORTHEASTERLY ON A CURVE TO THE LEFT ALONG SAID NORTHWESTERLY LINE OF HILDALE AVENUE, A DISTANCE OF 125 FEET; THENCE LEAVING SAID NORTHWESTERLY LINE OF HILDALE AVENUE NORTH 26 DEG. 00' WEST AND PARALLEL WITH THE SOUTHWESTERLY LINE OF SAID LOT, A DISTANCE OF 300 FEET; THENCE SOUTHWESTERLY AT A RIGHT ANGLE SOUTH 64 DEG. 00' WEST, A DISTANCE OF 125 FEET, MORE OR LESS, TO A POINT ON THE SOUTHWESTERLY LINE OF SAID LOT 229 AND THE TRUE POINT OF BEGINNING FOR THE HEREIN DESCRIBED LINE; THENCE LEAVING SAID SOUTHWESTERLY LINE OF SAID LOT, NORTH 64 DEG. 00' EAST TO A POINT ON THE DIRECT LINE FROM POINT "A" TO POINT "B" PREVIOUSLY ABOVE DESIGNATED, AND THE END OF THE HEREIN DESCRIBED LINE. 1 ALSO EXCEPTING THEREFROM A PARCEL OF LAND LOCATED IN THE SOUTHWESTERLY CORNER OF SAID LOT 229, MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE INTERSECTION OF THE SOUTHWESTERLY LINE OF SAID LOT 229 AND THE NORTHWESTERLY LINE OF HILDALE AVENUE AS SHOWN ON SAID OROVILLE- WYANDOTTE FRUIT LANDS UNIT NO. 6 MAP; THENCE NORTHEASTERLY ON A CURVE TO THE LEFT ALONG SAID NORTHWESTERLY LINE OF HILDALE AVENUE, A DISTANCE OF 125 FEET; THENCE LEAVING SAID NORTHWESTERLY LINE OF HILDALE AVENUE NORTH 26 DEG. 00' WEST AND PARALLEL WITH THE SOUTHWESTERLY LINE OF SAID LOT, A DISTANCE OF 300 FEET; THENCE SOUTHWESTERLY AT A RIGHT ANGLE SOUTH 64 DEG. 00' WEST, A DISTANCE OF 125 FEET, MORE OR LESS TO A POINT ON THE SOUTHWESTERLY LINE OF SAID LOT 229; THENCE SOUTH 26 DEG. 00' EAST, ALONG SAID SOUTHWESTERLY LINE OF SAID LOT 229, A DISTANCE OF 300 FEET, MORE OR LESS, TO THE POINT OF BEGINNING. PARCEL HEREIN IS PURSUANT TO A MERGER APPROVED BY THE COUNTY OF BUTTE, RECORDED MAY 19, 2004, UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 2004-29770. SITE -PLAN REVIEW APPLICATION Date: �d AP# T Permit Number (if applicable) APPLICANT INFORMATION Owners Address: [, 3 / 7 119, Parcel Size: Telephone No.: Situs Address: 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 ❑ Septic ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) 95 -96 -5 - Telephone 5 -96 -5 - Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Site Plan Stamped Approved' By DateR O,� Page 1 of 5 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) �c / Expansive Soils (Test for expansive soils and if verified proper foundation design required)'A V SRA - (CDF to determine specific requirements) 100 -Year Flood Plain: (See attached) • Flood Zone: • Flood Panel No.:J``C. Index Date: q ❑ Sacramento River Reclamation District (Approval must be obtained from the Californiait 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 ❑ Minor Variance El Administrative Permit ❑ Variance ------------------------------------------------------------------------------- ❑ Detached Building Use Form ❑ Encroachment -Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: 12- Applicable Building Setbacks: Front Zoning Code Streets & Highways Fire Prevention Subdivision Map Side Side Street Rear 5— 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 Applicable Development Fees: Standard Fees Amount Formula ❑ Fire. ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ 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 to Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ 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 J. ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑Provide Deed of Creation ❑ Obtain a 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 ❑ Subdivision Map/Parcel Man: Map Date of Recording: Lot: Book: Page: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development.. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of.Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for roa C Page 4 of 5 u Summary of Specific Requirements: This information provided in this summary is based on the application information and on the best available data at the time of review. C:U2rryslBuilding Permit Site Plan Reviewl.doc Page 5 of 5 to -� %� RESlDEf1IT�AL E�IILl�ING RECORD PARCEL ...;.•I -: . 1: Approiser Dote 0 F SHEETS 74-116 7-3 -0 --Unit Unit Area --Un'tt =Vni, Cost cost Cost Unitst Cost ost Co'ct nit ost nit Unit Cost cost Cost C;ost Cost DESCRIPTION OF BUILDING C L AS§ P SMA PE coNsrRucrioN STRUCTURAL EXTERIOR ROOF LIG14TING IR CONDITION FLOORS ROOM AND FINISH DETAIL FLOOR FINISH INTERIOR FINISH 7, Ar 17M e Flat 14 Pilch Wiring Healing li— Stucco on Heal CooMROOMS - . 1 2 ;eonz 9 TRIM Ceiliqs Material Grade -5-ub— - 'o'" . s . i ndard d Ar r - Conduit Forced a ALL :t- Coble vily All 6r.",y Nip B X 6ra — — — — "-Well - -1 ARCHITECTURE siondord Jheothi,,q — Un Fixtures Above-51ondard C01Cref&BIOCA he '>!' few, cAeOP Ent Hall Stories 'rpec,o/ Cut Up --- Living 4 Medium floor LWt Living USE -FOUNDATION shingles Dormers — -n= Many Special Zone 11.7il Dining — — — Single Adobe Shakes _ — Central- Concrete _fo Floor.joiz -X iaaT. Fr46 Gutters PLUMBING Bed Duplex Reinforced w, 2":"X Bk Phis le F,, FGood Bed Aporlment Brick Wood Si(b Floor Shake O#Burnet rJol— - I — WINDOWS NDOWS rile Fixtures Court D.N.lCare Tile rrim Motel In5uloled C,� �ti—ee),tajh Composition Auiamalic tt. splash.- zi, its Insulated Nolls. re n 16as Iflect I DroinBd. Material. BATH DETAIL -�y CONSTRUCTION - RECORD NORMAL % GOOD 50 Its j EFFEG. A PPR- - FINISH FIXTUR SHOWER Perini!Amount Arch. Func. Can- Stara SPOce Wzft- Fl. No. --S YEAR YEAR Age fflemo#79- ,,1, 0/0 Cond. Alan form set hsh;p —Floo, —, Wo//s Wc Lo. Type Grade S." r 5A fhw'.sh 4r- For Dole Lite Attr. 4on,Y. -C11-30 hsia—-4--1- 7 2 77 d 94v-- — A& )- -;nw SPECIAL FEATURES Book cases Buill 417 Beals Venetian Blinds SAullers TOTAL --NORMAL -/,, GOOD Tl—t--R-. C. —LN, D. AH 53 A 2 j -j f I rL-i4 - Cost —V '2— A COMPUTATION Approiser Dote 11 74-116 7-3 -0 --Unit Unit Area --Un'tt =Vni, Cost cost Cost Unitst Cost ost Co'ct nit ost nit Unit Cost cost Cost C;ost Cost Ot F TOTAL --NORMAL -/,, GOOD Tl—t--R-. C. —LN, D. AH 53 A 2 j -j f I rL-i4 - Cost SHEET OF BUTTE COUNTY PROPERTY RECORD NAME Q i"q. V- �r S Iz- NAME Assessment Fee Number Book Page/Block Parcel ZD f�!r SITUS3(o$ 7 I % L o/t AuE ZONING City ❑ County ❑ Assessment Year .2005 12005 20 20 20 20 UTILITIES -SITE IMPS, Date 7-S -o5 - 5 -05 Electricity: Yes ® Telephone ❑ Appraiser ,?'C. 3L 2'�- 34 Gas: Public © LPG ❑ None ❑ Use Code 2S Q S Sanitary Swr: Public ❑ Indiv. Dwelling Units t Street: Conc. ❑ As h. W2irt ❑ Gravel ❑ Building Class 9-1 , 4 Street Lights: Yes ❑ No Bedrooms 1 C & G: Yes ❑ No Baths l Sidewalks: Yes ❑ No ER Effective Year %.-15 7 SITE TOPOGRAPHY Area of Residence -13' 2 - Level Rolling ❑ Other ❑ Car ShelterYes ❑ No Yes ED No EI Yes ❑ No ❑ Yes[::] No CD Yes El No ED Yes ❑ No ❑ Slopes: Up ❑ Down E)S-S ❑ Grade: At Above [:]Below ❑ Misc. Buildings Pool Yes ❑ No C� Yes ❑ No Yes [:]No ❑ Yes ❑ No ❑ Yes E] No [3 Yes E3 No ❑ View: ED Phy. Char. Checked ❑ Checked Ef Checked ❑ Checked ❑ Checked ❑ Checked ❑ WATER MARKET DATA GPM: Depth: Comparable 1 L1,n Public Well ❑ Ditch ❑ Comparable 2 A LLL r - Supplier sr-wvp Comparable 3 Aerial Photo Year Sale Date/Price 12-15, ova Y, Topo Map Year PRIMARY BASE SECTION Soil Name Index Acres Base Year 2 -vas, Avg. Soil Rating SECONDARY BASE SECTION LAND REMARKS: I Base Year Size: Descri 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. BP052431 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class :,13 License Number: 2 �6 Date: '5ConIracIor: �mCe 5lA¢i 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 permit to construct, alter; improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, 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 the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Policy #: certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Name: Address: Issued Date: 09/09/2005 APN: 068-320-048-000 Site Address: 3657 HILDALE AVE ORO Map Index: Description: CONV SF TO STG(522) Owner: RASH, JACE 6317 POWER HOUSE HILL ROD OROVILLE, CA 95965 (530)693-1937 Applicant: RASH, JACE 6317 POWER HOUSE HILL ROD OROVILLE, CA 95965 (530)693-1937 Contractor: License #: Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: This to do PERMIT EXPIRES -4f- q3s57s' 4/61,76 - under the applicable provisions of the Butte Count Cod and/or Vave for which fees have been paid. �q Date: vJ Q Q A -, 't ❑ 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 1 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 Coounty�����y-t----o����enter upon the above mentioned property for inspection purpose . Print Name: ��Q �\ Signature: Date: g ❑ Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Nam ( First amen Add s City Slatr City Phone Q� /_ ���� C Fax E-mail APPLICANT INFORMATION CONTRACTOR Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICA T SIGNATURE X F office use only: Zoning Property ddress /�V I Dr` Flood Zone Cross Stree SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BP:- I BIN N PROJECT LOCATION (/q AN 079_320 n(/ q Property ddress /�V I Dr` City Cross Stree WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. SMIP LENDING AGENCY Name Address Description or Scope of Work: c� 6 !�c 1/6 _G)6•cq'y Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be 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. K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 8-12-05 Received by: Amount: Bldg SRA Receipt #: Sheriff SMIP Date: Other / O� v Total K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 8-12-05 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 AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bidgs: (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. Building Permit Application Without Required Clearances Form ❑ 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. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 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 check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 l.. �A 4. AK 2005-0060549 ` 1 AND WHEN RECORDED MAIL TO: Recorded 1 REC FEE 10.00 Official Records 1 . BUTTE COUNTY BUILDING DIVISION Coun4y of I COPIES 2.50 7 COUNTY CENTER DRIVE But I OROVILLE, CA 95965 Cffim J. GRUBBS I County Clerk -Recorders I I BW 011:&& 05 -Oct -2005 I Page 1 of 2 IIII III III' IIII (III' III II IIII II III AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: SEE ATTACHED LEGAL DESCRIPTION r Date PROP RTY OWNERS: ACE K. RASH SUSAN KISTE ASH State of California ) County of BUTTE ) On OCTOBER 3, 2005 before me, MARY A. THOMPSON.NOTARY personally appeared JACE K. RASH AND SUSAN KISTER RASH personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. I WITNESS my_hand and official seal. Signature. A.P. # MARY A. THOMPSON Commission #1351470 n v Notary Public -California � imo���M ALL THAT PORTION OF LOT 229, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "OFFICIAL MAP OF OROVILLE-WYANDOTTE FRUIT LANDS UNIT NO. 6", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MARCH 8, 1929, IN BOOK 10 OF MAPS, AT PAGE(S) 3A, 4A AND 5A, LYING SOUTHWESTERLY OF A LINE DESCRIBED AS FOLLOWS: BEGINNING AT A POINT ON THE NORTHWESTERLY LINE OF HILDALE AVENUE DISTANT SOUTHWESTERLY 580.3 FEET, MEASURED ALONG THE NORTHWESTERLY LINE OF HILDALE AVENUE AND ARBOL AVENUE, AS SHOWN ON SAID MAP, FROM THE INTERSECTION OF THE NORTH LINE OF SAID LOT 229 WITH THE NORTHWESTERLY LINE OF SAID ARBOL AVENUE, SAID POINT HEREIN BEING DESIGNATED AS POINT "A"; THENCE NORTHWESTERLY IN A DIRECT LINE TO A POINT IN THE NORTH LINE OF SAID LOT 229, HEREIN BEING DESIGNATED AS POINT "B", DISTANT NORTH 89 DEG. 52' 30" WEST 563.5 FEET, FROM THE INTERSECTION OF THE NORTH LINE OF SAID LOT 229 WITH THE NORTHWESTERLY LINE OF SAID ARBOL AVENUE. EXCEPTING THEREFROM THAT PORTION OF SAID LOT 229 LYING NORTHWESTERLY OF A LINE DESCRIBED AS FOLLOWS: COMMENCING AT THE INTERSECTION OF THE SOUTHWESTERLY LINE OF SAID LOT 229 AND THE NORTHWESTERLY LINE OF HILDALE AVENUE, AS SHOWN ON SAID OROVILLE- WYANDOTTE FRUIT LANDS UNIT NO. 6 MAP; THENCE NORTHEASTERLY ON A CURVE TO THE LEFT ALONG SAID NORTHWESTERLY LINE OF HILDALE AVENUE, A DISTANCE OF 125 FEET; THENCE LEAVING SAID NORTHWESTERLY LINE OF HILDALE AVENUE NORTH 26 DEG. 00' WEST AND PARALLEL WITH THE SOUTHWESTERLY LINE OF SAID LOT, A DISTANCE OF 300 FEET; THENCE SOUTHWESTERLY AT A RIGHT ANGLE SOUTH 64 DEG. 00' WEST, A DISTANCE OF 125 FEET, MORE OR LESS, TO A POINT ON THE SOUTHWESTERLY LINE OF SAID LOT 229 AND THE TRUE POINT OF BEGINNING FOR THE HEREIN DESCRIBED LINE; THENCE LEAVING SAID SOUTHWESTERLY LINE OF SAID LOT, NORTH 64 DEG. 00' EAST TO A POINT ON THE DIRECT LINE FROM POINT "A" TO POINT "B" PREVIOUSLY ABOVE DESIGNATED, AND THE END OF THE HEREIN DESCRIBED LINE. ` ALSO EXCEPTING THEREFROM A PARCEL OF LAND LOCATED IN THE SOUTHWESTERLY CORNER OF SAID LOT 229, MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE INTERSECTION OF THE SOUTHWESTERLY LINE OF SAID LOT 229 AND THE NORTHWESTERLY LINE OF HILDALE AVENUE AS SHOWN ON SAID OROVILLE- WYANDOTTE FRUIT LANDS UNIT NO. 6 MAP; THENCE NORTHEASTERLY ON A CURVE TO THE LEFT ALONG SAID NORTHWESTERLY LINE OF HILDALE AVENUE, A DISTANCE OF 125 FEET; THENCE LEAVING SAID NORTHWESTERLY LINE OF HILDALE AVENUE NORTH 26 DEG. 00' WEST AND PARALLEL WITH THE SOUTHWESTERLY LINE OF SAID LOT, A DISTANCE OF 300 FEET; THENCE SOUTHWESTERLY AT A RIGHT ANGLE SOUTH 64 DEG. 00' WEST, A DISTANCE OF 125 FEET, MORE OR LESS TO A POINT ON THE SOUTHWESTERLY LINE OF SAID LOT 229; THENCE SOUTH 26 DEG. 00' EAST, ALONG SAID SOUTHWESTERLY LINE OF SAID LOT 229, A DISTANCE OF 300 FEET, MORE OR LESS, TO THE POINT OF BEGINNING. PARCEL HEREIN IS PURSUANT TO A MERGER APPROVED BY THE COUNTY OF BUTTE, RECORDED MAY 19, 2004, UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 2004-29770.