HomeMy WebLinkAbout068-350-030fHELMSJame s W
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'240 Mt. View Dr
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (630) 638-7636 (OROVILLE) (630) 891-2834 (CHICO)
OFFICE #: (630) 538-7641
PERMIT NO.
P053334
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
Issued Date: 12/30/2005 APN: 068-350-030-000
effect.
License Class: License Number:
Site Address: 240 MOUNTAIN VIEW DR ORO
Date: Contractor:
Map Index:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Description: HVAC CHANGE OUT
p
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: FU ENTES DAVID J & SUZANNE L
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
240 MT VIEW DR
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
OROVILLE, CA
violation o ectton 7031.5 by any applicant for a permit subjects the
95966
applica o a civil penally 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,
Applicant: FUENTES DAVID J & SUZANNE L
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
240 MT VIEW DR
proving that he or she did not build or improve for the purpose of
OROVILLE, CA
sale.).
95966
❑ 1, 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 contractors) licensed
pursuant to the Contractors' Slate License Law.).
O I am Exempt under Article 3 of the Business and Professions Code
Contractor:
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
License #:
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
Architect:
insurance carrier and policy number are:
Engineer:
Carrier:
Policy #:
that in the of the work for which this is
0 S. F.
9/111c"artify performance permit
otal Square Ft:
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
Valuation: $0.00
and agree that if I should become subject to the workers'
Census Code:
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
This permit is hereby issued under sh a plicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resol ions"to d work indicated bove or which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
/p2 -2-,TQ-
Name:
By: Date: �oCC
PERMIT EXPIRES ON: Z2 - l_-2)2 i�
Address:
I
(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.
Cl Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
O 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 or th duly rued nt of the owner. I agree to comply with
all county and stale laws relating to building construction. I acknowledge it is unlawful to alter the substof a offi al f cu f Butte County. I hereby
own.
authorize reRre tatrves ofBuutte County to enter upon the above mentioned property for inspection pres.
Print Name:' Sl Signature: C
Date:
wner ❑ 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 e CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICA TION
**PLEASE PRINT CLEARLY**
OWNER
LastUAwte-Firsr-Plame
Name
t
Addres�o
77r
Cr //
St
��Ii
Pho �40 53Z 0730
Fax
E-mail
APPLICANT NAME
CONTRACTOR
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Book
Fax
E-mail
Planner
Lic. #
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name
Address
City
State
Zip
Phone
Fax
E-mail
For office use only:
Zoning
Flood Zone
SRA
I Yes
No
Occ.
Type Const
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO. ,Jv
`I3 Y
BIN #
LOCATION
Pr edy Address Ci
Cross S et l /,
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
Sq. Footage
❑ 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 by: Amount (S: Gy Bldg
SRA
Receipt #: Sheriff
<3o 9 SMIP
Lj
Other
Date:
�f - 12VI-11) 11s v 13 - C-0 Total
SUBMITTAL REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply
fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANSMUST BE
LEGIBLE AND IN INK.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ .2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER!
OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed
calculations.
❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 4. Letter from Engineer or Architect for truss design review.
❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to
mobile or modular homes.)
❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 7. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 8. Sanitation and site plan approval from the Environmental Health Department.
❑ 9. Metal Buildings: (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.
Mobile, Manufactured, or Modular Homes:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 2 Data sheets and installation instruction manual.
o 3. 2 Marriage line information.
❑ 4. 2 Floor plans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.
❑ 6. Sanitation and site plan approval from the Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑
1.
4 Site Plans, signed by the preparer. NO GRAPH PAPER!
o
2.
4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑
.3.
2 Engineered truss details and layouts (if required) (NO FAXES!).
❑
4.
Letter from Engineer or Architect for truss design review.
❑
5.
2 Energy compliance design and supporting documentation (if required).
❑
6.
2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑
7.
Statement of Intent for Non -heated and A/C (if required).
❑
8.
Metal Buildings: (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.
❑
9.
Letter of intent.
❑
10.
Hazardous Material Form.
❑
11.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
.......�........�........... rr.r.�n�n�_n__i�..�n__a_ .__ o.,.... ..c'� RFS/ F;- 19-04
BUILDING DIVISION
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES
,, ----
7 COUNTY CENTER DRIVE — OROVILLE, CAC*OR*IA 95965 — TELEPHONE: (916) 538-7 1
-AGRICULTURAL BUILDING EXEMPTION PERMIT
P�R IT NO.
;Agricultural building is defined as follows: Agricultural building is a structure designe and constructed to house farm
implements, hay, grain, poultry, livestock, or other horticultural products. This stru re shall not be a place of human
habitation or a place of employment where agricultural products are processed, t ated, or packaged, nor shall it be a
place used by the public.
ASSESSOR PARCEL NO.�
/ /� r
(� J
C)
ZONING
OWNER
>AvIDs.S Z
NNE=S
PHONE NO.
I 2
OWNER'S ADDRESS -
Z 0 V
O I4,
I CA")
ra y 1
LOCIT BUI DI
V
VAAJD
-►P —O
_. PO O 0 X/O
USE OF BUILDING
L�
SIZE OF STRUCTURE
cp q_ ' X
SQ. FT.
TYPE OF CONSTR �Tl
WOOD FRAME
STEEL CONCRETE
OTHER (Specify)
TYPE OF SIDINGROOF�B;V
FLOO�P,E
ESTI M T COST OF CONSTRUCTION
AG Buildings shall comply with the minimum front, side, and rear yard setback requirements of the applicable County
Ordinances as follows:-!zr
—
, -
5 5
FRONT
4"'� SIDES
ltvu'L'� REAR '-V�
AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields.
AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a
mobilehome, and 23 feet from a commercial building.
AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a
mobilehome, and 40 feet from a commercial building.
AG Buildings must comply with Flood Zone requirements. Finish floor elevation must be at or above elevation
USGS Datum.
I declare under penalty of perjury that the building will be used as stated above and the purposed use confirms with the
AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and
obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before
occupancy.
Date l Signature of Own
Permit Fee $60.00 The above described #AGtBuig is exempt from a building permit.
Receipt No./70-7 70-7 7 3
FL PA71 I P.D RlW ISSUE
Manager Building Division
By Date
White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant
..- ..-.,,.•N.:.nirt,..s'.��5.'►-,i—ir—'- ��-fa.�s�a,.5fe'y`f�,i,1;�1r`1p:�+r'+ah-.'1"j�=.r'v+�'-ra..���^tIFM�rt'ti,�,•• ; rt-�!""�«:.+^i:,;.Yy'-�--.-...,..-.-.-,r�r^rnh.••-s. .....:i►..y..i.rr.r^r.-.-... ...
COUNTY OF BUTTE - DEPARTMENT OF DEVd PMENTSERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541
PERMIT APPLICATION DATSHEET
i OWNER A. No. 6 3 (J
Proposed Building Use Building Inspector Date /
At time :of perm' -application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
- 1 All items have been submitted . ........................................
2.
Plot plans, 3/4 sets, signed by preparer of plans . ..........................
3.
Complete plans, 3/4 sets, signed by preparer of plans.
„t -•, f 4.
Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
"''+•5.
Hazardous Material Form.
6.
Energy Design Compliance and supporting documentation . ..................
7.
Statement of Intent for Non -Heated and A/C Buildings . ......................
8.
Engineered truss details and layout in duplicate (required prior to plan check). ....
9.
Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10.
Fees of $........................................
y • 11.
Impact fees as shown on attached schedule . ..............................
' 12.
California Department of'Forestry.plan approval/fees.
13:
Flood elevation letter (100 year 'flood) by California Engineer . ................. .
4 --,.14.
Sanitation and plot plan approval Health Department . ............
'• 15.
City of Chico plumbing permit . .........................................
i 16.
Plot plan and business license approval from City of Biggs/Gridley. .............
` 17.
Planning approval for (A) Use: (B) Parking:
4-A,,18.
Contact Land Development about (A) Improvements (B) Drainage. .......... .
t9. Driveway permit (construction approval required prior to occupancy). ...
;-+ :ph Pre -Inspection request
20 Pre -inspection for required. . . to Building Inspector (Date)
—121. Contractor's license information. (No., Name Style, Classification) . ............. .
—!22. Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner . ...........
--.24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization . ........................................
—k26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
— 27. Letter of intent on building use . .........................................
— 28. -Mobilehome utility clearance . ..........................................
29:' Documentation of legal access . ..................... :..................
— 30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
r 31. Existing violations/expired permits . ......................................
— 32. Plan check list . .....................................................
33.
34.
When you issue the permit, process as follows: ail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver with inspector.
Other
Parcel Creation
Acreage Applicant l.G ). Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by — phone _ mail Counter by — Date
Contractor, designer, owner, was advised of above required data by — phone — mail Counter by — Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works