Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
069-080-035
069-080-035 PERMIT#95-2755 THOMPSON, Cheryl 90 Greenbrier Dr., Oroville Cont; Executive Homes MH on Perm Fnd I' 069-080-035 PERMIT#95-2756 THOMPSOP,, Cheryl 90 Greenbrier Dr. , Orovill� Cont; Executive Homes J ' r New Pri Det Garage C) & 9 - C)%o -- 3s- C] RESIDENTIAL 069-080-035 PERMIT#95-2756 THOMPSON,,Cheryl 90 Greenbrier Dr., Oroville F Cont; Executive Homes New Pri Det Garage JOB FINALED (Date) /7 — Signature V=OK O = Not OK , '=Nott ReadApply MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s Requirements -Setbacks -Easements 1. Zoning Requirements - Setbacks - Easements Footings; SoilsSize-Depdv-Spacing-ConnectorsSteel 2. Soils; Special MH Support Sketch 8. Decks; Girders and/or Joists-Decking-BracingStairs-Rails 3. Sewer; Location -Test -Fall -C/0 -Concrete 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg: Bracing 4. Water, Location -Test -Easement Needed (Sketch) 5. Alum. Awn.; Columns-Connections-Splice.Decal-Enclosures 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Carports; Windows -Doors 6. Gas; Location -Test -Wrap; / /"L'ft. / /Nat. or/ /"L ft./ /LPG • 7. Well Clearance & Disconnect rr .; Sils-AnchorsStuds-Rttrs-Trusses 8. Utility Clearance !pg; Nailing -Veneer -Stucco -Mesh . oof; Shthg-Roofing Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Card B Date Card B-1 1. Zoning Requirements -Setbacks Easements Cana B Date Card B-1 2. Footings; Size -Spacing -Marriage Line POOLS (Plans) OK except #'s 3. Gas; MH Test-DemandVake-Connector 1. Setbacks -Easements 4. Electricity; MH Test -Crossovers -Breakers -Clearances 2. Soils; Compaction -Structure Stability 5. Drain; MH Test -Fall -Flex Connector 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 6. Water; MH Test -Regulator -Connector 4. Elec.; Receptacles and Lighting, Distance -GR 7. Water and Sewer Connected -C/O to Grade -HD Approval 5. Elec.; Pool Lighting; 15 Volts-GFI 8. Gas and Electricity Tagged 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 9. Tie Downs -Type -Installation Cert. 7. Elec.; Bonding; Metal wX-Circulating Equip. -Heater 10. Exits; Insp.-Sketch 8. Elec.; Grounding; Equip. w/5 Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 11. Cert of Occupancy 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MISCELLANEOUS Date DEC OVERS, CARPORTS, GARAGES(Plans) OK except #'s Requirements -Setbacks -Easements Footings; SoilsSize-Depdv-Spacing-ConnectorsSteel 8. Decks; Girders and/or Joists-Decking-BracingStairs-Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg: Bracing 5. Alum. Awn.; Columns-Connections-Splice.Decal-Enclosures 6. Carports; Windows -Doors is rr .; Sils-AnchorsStuds-Rttrs-Trusses !pg; Nailing -Veneer -Stucco -Mesh . oof; Shthg-Roofing t.; Steps -Doors -Landings Date Card B Date Card B-1 Date Cana B 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 -GR 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal wX-Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5 Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK O=Not OK - = Not Applicable = Not Ready 1: .RESIDENTIAL (Single & Duplex) F Date UNDERFLOOR (Plaris) OK except ft's 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main;'Soils-Elec. Grhd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Bfockouts-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 -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 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 a's 16. Water Htr.: Vent -Access -Combustion Air -Baffle ----------------------------------------------- ------------- 17. Water Pipe. Test & Anchor -Nail Protection --------------------------------- 18. -------------------------- 18. D.W.V.: Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test. First Floor -Tub Access ---------------------------------------------- 20. Test Tub & Shower. Second Floor -Tub Access ----------------------- ----------------------- ------------------------ 21. Gas Pipe: Size & Anchors ---------------------- ------ -------------------------------------------------------------------------- Date Card B-1 Date Card B-1 --------------------- ---- ------------- .. - ------ ---_ . -- - - Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except n's 22. Fixture & Transformer Clearance -Ins. Protection ------------------------------------------------- 23. -------------------------------------------- 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled - -------- ------------------------------------ - --- ------_... .. _ _..... 25. Romex Installed Close to Edge of Studs & C.J. ------------- -------...--------------------------------- .._._... _ ...... 26. Equip. Ground made up wrMech. Fastners-Bond Gas & Water ----------- --------------------------------- 27. --------------------------- 27. 2 Appliance Circuits in Kitchen & Conductor Size,GFI ----------------------------------- - -- ----- --- --- -- 28. Subfeed Wire Size ga. Cu or AI-A.C. Wire Size ga. Cu or At - - -- - ------------------_ ...... .. 29. Range Circ. ga. Cu or AI -Oven Circ. r r ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No --------------------------- - ------------------------------------_..... .. 30. Service -Riser Conductors & Ground -Main Disconnect ------------------------------------------------------------ ...... ....... ....... 31 Equip. Clearances Panels-Motors-Mech. Equip. -------------------------------------------------------- ---- 32. Clothes Closet Light -Shower Light -Spa Light ------------ - ---------------------------- 33. Smoke Detector -------------------------------- ...............-------- _-- --- ....... ....... .. Date Card B-1 Date Card B-1 - --- ------ . .._..._._..._....... ..... .. - --_..... ... ... ... ... Date Card B-1 Date Card B-1 Date MECHANICAL.(Permit) OK except rr's 34. A.C. Ducts Insulation & Support --------------- - --- ---....... .... 35. Vent Fan: Exhaust above insulation ------------------------. . ... ........... 36. Condensate Drain & Overflow: Size & Grade .......I ........ ....... ... ........... .. .. . 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet - - - .............. ... .. _ ... .. 38 Attic Access & Platform if Furnance in Attic ----------- .. ... ....... . . .. .-....... .. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B -I Date FRAMING (Plans) OK except P 39. Sils. Proper Material & Anchors 40. Walls Studs -Nailing. Spacing & Bracing -Plates -Sound ...... ....... ... ... ........ 41. Bearing Walls over Girders & Floor Nailing ....... ........... . .... .... ... .-. . 42. Draft Stop in Walls (rat proof) ...... - ....... ... ... ........ ... ... 43. Fire Stops: Furred Ceilings -Stairs -Chases -Tub -----------..... ............... .. _..._. 44. Headers & Beam -Size & Bearing Date FRAMING (Conti6ued) 45. Hangers -Post Caps -Anchors -Connectors --- _ 46. Cing. Joist-Rftr. ties -Pu rlin-roof Brac-Truss-Shthng.-Rfng. ----------------- ------ 47.. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing ---------------------------------- - 51. Property Line Firewall & Openings ----------------------------------- - - __ 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits -------------53.-Stairs;-Width-Headroom-Rise-Run-Landing-Fire Protection ---------------- - 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers ------------------- 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls: Nailin Bolts _ 59. Insulation -Walls -Ceilings _ 60 Infiltration -Walls -Windows ------------------ ------------------------------------- Date Card B-1 Date Card B-1 - - ------------------------------------- Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except a's 61. Ext. Steps -Door & Sidelight Protection -Landings -------------------- - - -- 62. Smoke Detector -------------------------------------- 63. -Furnace ---------------------------------63..Furnace: Vents -Clearance -Comb. Air -Connector - In Garage: Above Floor -Ducts -Meth. Protection ------------------------------ 64. Bedroom Exiting .... - - - - - -------------------------------- 65. G.F.I & Bath Fixtures &'Tub Access -Spa ---- .. - ----- -..---------------____ -- 66. Elec. Trim & Subpanel: Breaker Sizes & Labels --------------------------- 67. Stags & Rails -..------------- ------- 68. Fireplace or Stove: Clearances -Hearth ----------------------------------- - 69. Elec. Outlets at Wood Panel: Int. & Ext. ------------------ ---------------------- 70. Kit.Fixt. & Appliance: Grnd.-Air Gap -Cooking Clearance ........ ..-------------- 71.. - - ------------------------------------ -- 71. Elec. Outlets & Receptacles at Kit. Counter . .... ... ............------------------------- ---------- 72. Garage Fire Door: Swing -Landing -Closer 73. A.C. Duct in Garage -Damper . _ .. - - - - ----------------------- ------------------- 74. Wtr. Htr.: Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage: Above Floor -Meth. Protection .....------------------------------------------- 75. ------------------q - --------- ---- 75. Plb.. Elec. & Mech. Equip. Listed for Location _.....------------------------ - 76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection - -- ------------- ------ ------------- 7,. Insulation -Foam-Looked in Attic ❑Yes --------------------------------------------- 78. Guard Rails & Deck Construction -Post Caps .._..---------------------------------------------- -- 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes -------------------- 80. Following instld. Drive ❑ Yes ❑ No: Walks ❑ Yes 11No: Planters ❑ Yes ❑ No -------------------------------------------------------------- 81. Stucco: Brown -Finish .. .. ............._.._...----------------------- ------- ------- 82. A C. Unit: Disconnect. Electrical, Plumbing ... ... ... ...... ....--------------------------- -------- -- ----- 83. Vents Above Roof: Plbg.-Appliance-Fireplace.-Clearance to Openings - .- . - . ... .... ......---. ---------------------------- D-- 84 Water Well: Disconnect. Electrical. Plumbing ..------------------------- --------- --- - 85 Exterior Elec. Trim: G.F.I. Receptacle -Underground 66 Ventilation Throughout House - - - ----------------- 87 Glass Protection 88. Corrections !rorn Previous Inspections 89 Gas Test- Meters Tagged: Gas -Electric -------------------------------------- 90. Water Sewer Connected-CrO to Grade -HD Approval - _. _ .....---------- ------------------ 91. Energy Compliance Certificate -Other Certificates -- -- -- ------------------- -- Date Card B-1 Date Card B -t ----- ----------------------------------------- Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments. at Final ..d':r1.i.�,Fa"Y'�h'�^..•..-=1�`•�..:..+�.M�.y.'�v'"�'"'-'-^r.cl...."r:i.ir"`^'"Tr'".r'�4�i^"��+'�n...+'.^-"r�.'`^��',.'`�-„-'.-...c'.'i COUNTY OF BUTTE BUILDING DIV191ON ' DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE ER MIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. Date ��J7 �� a Inspector /� REV 10/92 / COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, Cali�nia 95965 - Telephone (916) 538-7541 95 ^ Pf�R IT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 059-080-035 RTI± ZONING BUILDING PERMIT OWNER CHERYL TI.IO�IPSON TON!1451 SO. FT. OCC. BUILDING VALAZLOK �p� 20 1.1 /,560.00 OWNERS MAILING ADDRESS 1394 KERI LN CHICO, 95926 CONTRACTOR'S NAME EXECUTIVE HOMES TELEPHONE 891-6992 CONTRACTORS MAILING ADDRESS 042 ESPLANADE CHICO, 95925 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ 99.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 64.35 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 90 GREE,dHRILnR DR PERMITFEE $ 183.35 OROVILLE PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 IAT NO. SUBDN510N'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other PRIVATE DET. GARAGE SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New IN Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: 20, X 21' Mobile Home I S I G W 1 920.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filing Fee 20:00 Main ServiceOOOV OR LESS ( zooA oR LEss ) 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION 1 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(gL40!5!25LIC. NOCq OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR S OR ADDNS. ( & ACC. BLDS. ) 3.50Ar.' 14.70 NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( 8 POWER APPARATUS SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES) 20 Q 1.00 BAL SO Ex. Occup. OUTLETS(P'D.OEA ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 34.70 Contractor 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. I 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' ompensation insurance carrier and policy number are: Carrier ()lam t) y -A MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number '7 y,) P�0(1,12d (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X __u Qn Date Signature of Applic - O Owner ❑ Contractor Agent An OSHA permit is required for excavations over 5'0" d ep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ 218.05 I HAL. D. FEES P FLOOD CDF D ISS This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON applicable provisions Resolutions to do been paid. Date 1 It Z / (Dat work 7 (; / ReceiptNo.j86267 — 104.35�� 17 � �a� � / l� ` 7 Z% WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT i - } '�" J -]4,l1' Ir'.'}'''�T'.'Mh Y��:,jll.•�'^lry'y•a.�y �' COUNTYOF BUTTE - DEPARTMENTOF DEV,ELOPI.MENTS CES -BUILDING DIVISION t X .1 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER e - Proposed Building Use G't ✓' Gt 2: � I /IV A. P. N . Building Inspector Date / IN At time of permit application, I ,was advised the following data must be submitted prior to permit processing and/or issuance: .DATE RECEIVED BY L 1, --- �i All items have been submitted. .... t .........:......................,- Plot plans, 3/4 se j signed by preparer of plans. ...................:... Complete plans sets, signed by preparer of plans � It 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............ . e 5. Hazardous Material Form . ............................................. 6. Energy Design Compliance and supporting documentation . .................. Statement of Intent for Non -Heated and A/C Buildings . ..................... . Engineered truss details and layout in duplicate (required prior to plan check). d Mobilehome data a anufacturer's installation instructions, 2 sets. . t t Fees of $ .......................................... —21 11. Impact fees as shown on attached schedule. ............ . 12. California Department of Forestry plan approval/fees. ....................... . 01 4 Flood elevation letter (100 year flood) by California Engineer. . !`................ Sanitation and plot plan approval Health Department . ............ . City of Chico plumbing permit . .......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ......... 18. Contact Land Development.about (A) Improvements (B) Drainage. ........... - 19. Driveway permit (construction approval required prior to occupancy). .. N . 20. Pre -Inspection requs Pre -inspection for required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification). ............ ! ..- .22. 22. Certificate of Workmans Compensation Insuradce. ................. '......... 23. Owner -Builder Verification (Given to owner , Mail to owner )......... \.. . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. ._..-. - 25. Letter of signature authorization . ........................................ 26. 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. .... ....... . 31. Existing violations/expired permits................................a``a'�... . 32. Plan check list . ....................................... ........... ' 34. When ou issue the p t, p oc ss as follows: Mail to owner. Mail to contractor. Telephone / and hold for pickup at a ryn ti office. Deliver with inspector. Other Parcel Creation Acreage Applicant `� Date I� 1 Copy of Haz-Mat form sent Health Dept. Fire q�pt. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. �_ Other Date By The following data must be submitted prior to pe isua%ice:,(Circle new item not checked above). 1. Index permit for above items No.1, 2. Additional items required: 1` 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 C, ► 6 13 0,4S Date//-�o�iC Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works :RESIDENTIAL 069-080-035 PERMIT#95-2755 THOMPSON, Cheryl �y 90 Greenbrier Dr., Oroville " Cont; Executive Homes MH on Perm Fnd c j THE HCD FORM 433A FOR THIS MH BE RECORDED UNTIL ONE OF THE FOLLOWIN Qp - HAVE BEEN TURNED IN TO THE BLDG DIV: (1) LICENSE PLATE (S) (2) LICENSE DECAL 3 S, TATQENT OP PAPTq -7 a,4 e&k .#,f U4, /d 0# e.ow5 — _ � f OFFICE'COPY - r Address GAS > Meter By Date :W 11 ELECTRIC Meter By Date JOB FINALED (Date) f — Stgnature V=OK 0 = Not OKNot Ap q�� '=Not Readybl& 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/0 -Concrete i 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ Amp -Concrete 6. Gas; LocationrTest-Wrap; / Mt. / /Nat or/ /'9_'ft./ /LPG 7. Well Clearance & Disconnect 8. Utility Clearance F Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILX40ME INSTALLATION(Plans) OK except #'s equirements- Setbacks Easements :i s; Sive-Spacing-Marriage Line uI a NFH Testl3emandAfahe-Connector P; . Iggocity; MH TestCrossovem-Breakers-Clearances MH Test -Fall -Flex Connector , meter, MH Test-RegulatorConnector . Waterartdf Sewer Connected -C/0 to Grade -HD Approval as and Electricity Tagged 9 - pe=lnstallation Cert 'ts; Insp.-Sketch s- 11. Cert of Occupancy Date Date Card B- Date Card B-1 Ca Date Card B-1 90 0A4!L"5 175 /g1635K1z- MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; SoilsSine-DepthSpacing-ConnectorsSteel 3. Decks; Girders and/or Joists-Dedting-BracingStaim-Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns-ConnedionsSpl�ce-Decal-Endosures 6. Carports; Windows -Doors 7. Electric 8. Fang.;Sill-Anchors-StudsRftrs-Trusses 9. Siding; Nailing-VeneerStucco-Mesh q 10. Root, Shthg-Roofing 11. Ext; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'a 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -lining 4. Elec.; Receptacles and Lighting, distance-GFI S. Elec.; Pool Lighting; 15 Volts-GFl 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/6Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/3 Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards4ns. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Cana B-1 Date Card B-1 Date Card B-1 r q. 4 O O = Not OK = Not Applicable Not Ready RESIDENTIAL (. ' = Date UNDERFLOOR (Plans) OK except If's k 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 -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel- Bloc kouts-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 -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 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 #' 16. - Water Htr.: Vent -Access -Combustion Air -Baffle ------------------------------------------------- - --- - - - - - -- -- 17. Water Pipe: Test & Anchor -Nail Protection ------------- ------- 18. D.W.V : Test -Fittings & Anchor -Nail Protection 19. Shower Pan: Test, First Floor -Tub Access ------------------------------------------------- ------- -- 20. Test Tub & Shower, Second Floor -Tub Access ------------------ ------------------------------------ I ---------- 21. Gas Pipe: Size 8 -Anchors ----------------------------------------------------------------------- - Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except O's 22. Fixture & Transformer Clearance -Ins. -Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors --- ---- ---- ---- - - ------------- - --------- --- --- --- --- -- 24. Size Boxes & No. of Conductors -Stapled ------ ------------ ------------------ - --- - -------- - -- - - -- 25. Romex Installed Close to Edge of Studs & C J ------- ------------------------------- ------- ------ .. 26 Equip Ground made up wrMech. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size GFI -------------------------------- •-- . .. ... .. 28. Subteed Wire Sizer ga. Cu or AI -A.0 Wire Size ga Cu or At -------- `---------- --- ----------- - - -- - 29. Range Circ r , ga. Cu or AI -Oven Circ. r - ga Cu or At Insulated Neutral ❑ Yes No 30. Service -Riser Conductors & Ground -Main Disconnect ---------- - .......... ....... ....... ... ... ... .. 31. Equip ClearancesPanels-Motors-Mech Equip 32 Clothes Closet Light -Shower Light -Spa Light ------- . -- ....... ........... . 33 Smoke Detector --------------- --- -- ------- ......... . Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except R'S 34. A C. Ducts Insulation & Support 35. Vent Fan: Exhaust above insulation 36 Condensate Drain & Overflow. Size & Grade ------ -- 37 Furnance-Vent. Access -Comb. Air -Return Air Vent -115 outlet ... .. ... . . . . 38 Attic Access & Platform if Furnance in Attic ------ ------- --- .. Date Card B-1 Date Card 6-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except n s 39 Sils. Proper Material & Anchors 40 Walls Studs -Nailing. Spacing & Bracing -Plates -Sound 41 Bearing Walls over Girders & Floor Naming 42 Draft Stop in Walls (rat proof) 43 Fire Stops. Furred Ceilings -Stairs -Chases -Tub 44 Headers & Beam -Size & Bearing single & Duplex) ilwe FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. CIng. Joist-Rftr. ties -Pu rlin-roof Brac-Truss-Shthng.-Ring. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Scop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions ---------------------- - 50. Garage Fire Protection Framing ------- --------------------- 51. Property Line Firewall & Openings _ 52 Ext. Doors -One 3=Check Garage -3rd Story, 2 Exits --- ------------------------------------- 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers ----------------------------------- 55. Siding -Nailing Veneer ----------------- 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls: Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows -- -------------- ------------------------------ Date Card B-1 Date Card B-1 ------------------ --------------------- Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except a's 61. Ext. -Steps -Door &_Sidelight Protection -Landings 62. Smoke Detector -------------- ------------------------------ - 63. Furnace: Vents -Clearance -Comb. Air -Connector - In Garage: Above Floor -Ducts -Meth. Protection -- --- ------------------------------- 64. Bedroom Exiting-------------------------- __ 65 G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec Trim & Subpanel Breaker Sizes & Labels --- ---- -------------------- ---------- 67. Stags & Rails _ 68 Fireplace or Stove Clearances -Hearth ....-..------------------------------- - 69 Elec. Outlets at Wood Panel: Int. & Ext. 70. Kit Fixt & Appliance Grnd.-Air Gap -Cooking Clearance .. ------------------------------------ -- 71 Elec. Outlets & Receptacles at Kit. Counter . . ... .... ---- -- . . --- ------------ --------- 72 Garage Fire Door: Swing -Landing -Closer _.. ... ... ------------- ---- ---- --- 73 A.0 Duct in Garage -Damper . . .._..._...----------------------------- ----- 74. Wtr Htr . Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage: Above Floor -Meth. Protection . . ----- -----------i - ------------------- --- 75. Plb . Elec. & Mech Equip. Listed for Location ------------------------------- - 76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection ..- ------ ----- --------------------------------- 7; Insulation -Foam -Looked in Attic 0 Yes - _ ---- --------------------------- --------- -------- 78. Guard Rails & Deck Construction -Post Caps - - ----------- -- -------------------- -- 79 Fdn Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor O Yes ... ..... --------------- 80 Following insild 'Drive 0 Yes 0 No: Walks 0 Yes 0 No: Planters 0 Yes 13 No ... - .. . .... I - - - - - - --------------- - -- - - - ---- ------------------------ ----------- 81 Stucco. Brown -Finish - - - - - - -- - - ---- ----------------------------- d2 A C Unit. Disconnect. Electrical. Plumbing 83 vents Above Roof. Plbg -Appliance-Fireplace.-Clearance to Openings 84 Water Well. DisconnecL Electrical, Plumbing 85 Exterior Elec Trim. G F I. Receptacle -Underground 86 Ventilation Throughout House 87 Glass Protection _ 88 Corrections from Previous Inspections 89 Gas Test -Meters Tagged. Gas -Electric 90 Water & Sewer Cunnected-C'O to Grade -HD Approval 91 Energy Compliance Certificate -Other Certificates . .-- --- ----------- ------------ Date ---------Date Card B-1 DateCard 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 —� 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 069-08-35 RT1 ZONING BUILDING PERMIT OWNER CHERYL THO14PSON -i4L21451 SO. FT. OCC. BUILDING VALUATION 1586 R 85,644/00 OWNERS "UNG ADDRESS 1394 P.ERI LN CHICO CONTRACTOR'S NAME MI EXECUTIVE HOES TELEPHONE 891-6992 CONTRACTORS MAILING ADDRESS 042 ESPLANADE CHICO Fireplace CONSTRUCTION LENDER UNMOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee 576 5019Plan $ ARCHITECT OR ENGINEER LICENSE NO. Checking Fee $ 2300 Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 90 GREENBRIER DR PERMITFEE $ ' OROVILLE (KELLY RIDGE) PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LAT No. SUBDIVISION'S NAME ypAP P I J' Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome CX Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: MOBILE HONE 014 PErJJANANT FOUNDATION Mobile Home IS I GI W1 920.00 PERMITFEE $ 5. Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service EOOv OR LESS ( 2..A OR LESS ) 23.00 Main Service ( 200A To 1000A ) 46.00 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 II force and effect. R • ` � License Class f Lic. No. r�� OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ADDNS. ( a ACC. BUDS. ) s0. 3.50 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FD(TURES) BAL 0 L:50 Ex. Occup. (FIXAPPLN .ORA) OUTLET 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE S 43.00 Contractor 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 i rance c crier and policy number are: Carrier MECHANICAL Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number —I w (The above sections need not be completed if t e permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. 1of X _ D e _��_ Signature o pplicant Owner ❑ Contrac or Agent An OSHA permit is requir or 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 TOT EE $ 1+39 ,25 HAZ. D. FEES FLOOD XX D HD SU VM !!77 This permit is hereby issued under the the Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Date ` 7 (DA) ReceiptNo. 186267 — 83.00// 196 YJ 8 6✓ ,, j- _,5 WHITE•D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Ili 'rm-•..,t � p r :. � " '-'r+'•;.�'� 'G' ,�.-� .. '� r.1' F - r1�` 1,' _ . gyp, « A. -. 1. .... ,� ..r"ut•s� -tw+T� . . _ COUNTYOF BUTTE - DEPARTMENT OF DEVffLOPM!ENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, GA IFbKt� IA 95965 -TELEPHONE (916) 538-7541 — �. � PERMIT APPLICATF®N "DATA SHEET 0 OWNER �vL 6 r v /0,0,0 -Soffit ) A. P. No. 7 Proposed Building Use rI ti Building Inspector Date - At time of permit application, I was advised the following data must tie submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted. ....i ........... !........................ 2. Plot plans, 3/4 sets, signed by preparer of plans.0'......................... . 3. Complete plans, 3/4 sets, signed byfipreparer of plans . ...................... 4. Engineered plans and talcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form. ........ ................................... . 6. Energy JDesign Compliance and supporting documentation . .................. r 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 ufacturePs installation instructions, 2 sets. . pFees of $ g" �o , of . ................. ................... . 1 Impact fees as shown on attached schedule. .t jj ! I -�I y5 2.3 /— California Department of Forestry plan approvaes.�q, ... ��a� ..JFlood elevation letter 100 ear flo d b if r ............:::: . ( Y q �gineer 2 a K11I Sanitation ar�l�4wal �� He�iih' epa e City of Chico plumbing permit. ...... ............................... . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. . 17. Planning approval for (A) Use: (B) Parking: . ........, Contact Land Development about (A) Improvements (B) Drainage. . Driveway permit (construction approval required prior to occupancy). .. e. .. ... J�2CG Pr"apectionreque Pre -inspection for required. .. to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . ............. 22. Certificate of Workmans Compensation Insurance. .......................... 0Owner -Builder Verification (Given to owner Mail to owner �:::: �. :. . 4. Recorded copy of Agricultural Acknowledgement Statement. Letter of signature authorization . ....................................... . 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ....,. 2' . 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. ............... 31. Existing violations/expired permits . ...................................... Planc ,' ist. _ .. t ............. . ... ...............:... 7A�' C AIV When you issue the er it, pro e s as follows: Maill�to owner. ) I Mail to contractor. Telephone (o nd hold for pickup at -r'O t/' / office. Deliver with inspector. Other Parcel Creation - 1 Acreage , Applicant Date ` 1 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 top rmit i suance: (C 1. Index permit for above items No. T 2. Additional items required: ontractor, esigner, owner, was advised of above required data by �c phone _ mail Counter by G Date It -14e - Contractor, ( -/4e -Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by G, eS Date 1 Plans approved by Date --Z. Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works OWNER ..P. COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE CA 95965 TELEPHONE (916) 538-7541 .h P s Lj / / 170 /V7 d S© /7 A.P. a_5-5— PROPOSED BUILDING USE DATE ll f Z25- REC. # DATE REC 1. SCHOOL DISTRICT FEES /'p /C- vy ) (paid at District Office) ..2. SHERIFF FEES (paid at Buildmi Div ion) 1� Residential. 1 x..$� unit amt. Commercial (sq.ft.). x =$ 3. URBAN AREA FEES (paid at Building Division) Residential (per unit). x =$ #units amt. Commercial (sq.ft.).. x =$_ sq.ft. amt. 4. RECREATION DISTRICT FEES (paid at District Office) 5. THERMALITO DRAINAGE DISTRICT FEES $400.00 (paid at Building Division) S INSPECTION AND PLAN CHECK 9.00 paid at Building Division) 7. WATER TENDER FEES (BATTALION # ) $200.00 (paid at Building Division) 8. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 9. OTHER It, At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. APPLICANT DATE RgCORDING REO.UESTED BY: AND WHEN RECORDED MAIL TO- NAME GNAME BUILDING DIVISION STREET - 7 COUNTY CENTER DRIVE ADDRESS OROVILLE CA 95965 CITY, - STATE and ZIP 56-00,30471 Rec Fee .00 1 Total .00 :-Recorded. I official Records Records I ' County of I Butte I Candace J. Grubbs 1. Recorder I 10:34am 24—Jan-96 I COMS XX SPACE ABOVE THIS UNE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM - Recording of this document at the :request of the- local. cgency indicated is in accordance with California Health .and Safety Code '- Section ,18551. This document is. evidence that -such local . agency.-.. has -issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording: When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to -all persons thereafter clearing with. the real property. CHERYL A.-THOMPSON_ BUTTECOUNTYBUILDING DIVISION REAL PROPERTY OWNER/LESSOR 1394 KERI LANE MAILING ADDRESS CHICO, BUTTE, CA 95926 CITY COUNTY STATE ZIP 90 GREENBRIER DRIVE - INSTALLATION MAILING ADDRESS. IF DIFFERENT OROVILLE, BUTTE CA 95966 CITY COUNTY STATE ZIP SAME UNIT OWNER (If also property o:+ner, write "SAME'l MAILING ADDRESS CITY COUNTY STATE ZIP UNIT DESCRIPTION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE, BUTTE, CA 95965 CITY COUNTY STATE ZIP 95-2755 (916) 538-7541 BUILDING PERMIT NO. �' TELEPHONE NUMBER �/I , 6, ?�1�, . �7'`--V : 1/23/96 SIGNATURE OF LOCAL AGENCY.GOFFICLA DATE EXECUTIVE HOMES DEALER NAME (If nor a denier saie, write "NONE'") 92081 DEALER LICENSE NO. FLEETWOOD 1995 STONE CREEK MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER CAFLS17A/B18163SK12 61'X26' RAD 862881/862882 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER A P 4069-08-0-035 LOT 12, AS SHOWN ON THAT CERTAIN MAP ENTITLED "RESUBDIVISION OF KELLY RIDGE ESTATES UNIT NO. 2A," WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MAY 7, 1974, IN BOOK 43 OF MAPS, AT PAGE(S) 38 AND 39. �4ENT Of p0 Q?4 GJi HCD FORM 433(A) Rev. 8/91 �,(/jr,„r, np•� �' WHITE—County Recorder CANARY PL IK—Applicant GOLOENR00—Budtling Dept. BUILDING PERMIT NUMBER: 95-2755 Address or location of unit: 90 GREENBRIER DRIVE, OROVILLE CA 95966 Legal Description of Real Property: A . P. #068-08-0-035 LOT 12, AS SHOWN ON THAT CERTAIN MAP ENTITLED "RESUBDIVISION OF KELLY RIDGE ESTATES.UNIT NO. 2A," WHICH MAP WAS RECORDED IN THE OFFICE OF -THE _ RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MAY 7, 1974,_ IN BOOK -43 OF MAPS, AT PAGE(S) 38 AND 39. [X]Mobilehome/Manufactured Home [ ]Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: CHERYL A. THOMPSON Owner's address: 1394 KERI LANE, CHICO CA 95926 INSIGNIA OF HUD NUMBER: RAD 862881/862882 SERIAL NUMBER OR V.I.N. CAFLSI7A/B18163SK12 MANUFACTURER'S NAME: FLEETWOOD YEAR ; 1995 OFFICIAL APPROVING INSTALLATION: DATE: 1/23/96 PHONE: (916) 538-7541 H.C.D. 513C, 1112.1/•96' 10:18 93`916 893 0715 BTEC C'HICtO J nftW094 at trio RoqugAl or auc V411ty Trtro i Esmwt"psny 0 ` – 8830 Oldor No. Escrow N0. 1/20T;/Vrt-7 �OOr► No. 94-01 8834: RIC 6 flee .00 _ WHEN RECOADEO tiwL TO. r noc 35.75 t� RecorCled I Check 41.73 CHERYL. A. THOMPSON Official ftecorda I 3901 PERIE LANE -County ofbut%- SAN JOSE. CA 95132 Candace) J. Grubbs I Recorder - I 41100alh 2 -nay -94 I' r1VTC JR 1 MAIL TAX STATEMENTS TO, DOCUMCNTARY TRANSFER TAX USZ - � t.Grlpvlae a M eanabasoon'a wuo d pepenr eenwyoO. CK SAME A.S ABOVE Colflpwsl M 111 aeellAanlden er rwa ru Sana m inoutnDAten _ .Iyllaehl NITo of IW. - - . - _. - 7hw ll[1CRIJU .t� ►i. In[ ortwfla - .. 6lpnalun d boclalanl at Aywil Gabnhlneip W F4m Rama _ -GRANT DEED FOR A VAJUAeIE CCN$109RATION, rGoelpt el Wmch Is hGretq ulnowiwpao. DUANE R. ARNEKLEV and NANCY L ARNgKLEV, hllabind and wits hefolly 011AN't(S) to CHERYL A. THOMPSON, en unmarrled woman the real p'0,7oRtf u1 tht I,ININGORPORATEO AREA C,ovnq of BUTTE Sto1 O of t:G,ilortNs, dtw.oes Y LOT 12, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "RESUBDIVISION Of KELLY RIDGE LSTATES UMI)l IIv. *A"I WHICH MAP WAb 1 kiCURpEp IN THE OFMCt OF THE RECORDER OF THE COUNTY OF BUTTE, VATS OF CALIFORNIA. ON MAY T. 1974, IN BOOK 43 OF MAPS, AT PAGE(S) 38 AND 39. r4E _ Datod -Apul 10, 1994 �.''.,{ (` �C�✓' L;Wilt h, t%'MNtRIEV'•'-' — — STAT[ W ���., �tC.a,..�,, I � � •� ' F7xAC�TwtRCL� Un Lei (i ar•fYNir / aIw � t� ' "v p016Oni.1 kite% to fist Ia prev04 is FRO Oh IPG t&Gla OI Mlldaalaly - rAdGrte) to to the porfollts) whW mnlo(fl Wna v0scllbfd to I%* 0111n Nuumom end sabnowiedgW 19 IM lM1 Pdlhwkhot oltocvod IN canto M Wfilernnar W414n10e IIA114 bilN)• Ind true M h0slnbu svAilve:f) On v.*. 1fvMON the petaents) a Ih& OAUly upon /onaI at T~ tb pv*(srrtasd, iIrMAad iM Inallwma-it IYITNlSS 111: M� � ofAelGt ►sll. , Y• Q00". 1VI8ION OF COD3AI1D STANDAitDS :; �.w..•, 'RE018 'R MON ANMITUNOPROGRAM- SrA' lmW OF FAC'T'S Ws uait b a M Nlobiiehome Q oommercial_Cbach [ Floating Homs:. i.� i':. Camper " Decal poem) No.(s ?AD S eZg$ j ?,AD gb2-si 2 Meda New .Sadat No4s) )lWe, the undersfgeted,,homby, state: THIS UNIT IS BEING_ PLACED ON A FOUNDATION SYSTEM It' ACCORDANCE W0.11 SECTION 18551" OP THE 'iiGALTH AND SAFETY COBE, Ilwe further agree to indemnify and save harmless the Director of Musins and Community Development, Statt of California, and subsequent purchasers of said unit, for any lou they may suffer resulting from registration of the above-described unit In California, or from issuance of a California certificate of title covering the some. IAVe certify under penalty of perjury that the foregoing is true and correct. Executed 08 t� c L ) (City) � (State.) ton�...,.. . , ...�.., .� State AA M. 1 FACT M I., WIFR 1.�,'T'I I Please deliver 6he followinv, pages to: 'rex Total Nurber 00 P es including cavi::- atieet Date If you do riot feceiue all naizes , olease call hack. as soon as possible Phone: h 3442 ESPLANADE CHICO,CA 95926 (916) 891-6992 KELLY RIDGE HOME OWNERS ASSOCIATION ARCHITECTURAL COMMITTEE OWNERS NAME CR RL T P50" OWNER ADDRESS D CONTRACTOR ' NAME TELEPHONE N0. —4 ?_may TELEPHONE N0. — Z LOT & UNIT NO. 2— — Z� TYPE'OF WORK BEING.DO,NE. COLORS EXTERIOR WALLS ROOF NEW HOME MOBILE CARPORT - FENCE DRAINAGE PROBLEMS RETAINING WALL ARCHITECTURAL COMMITTEE RECOMMENDATION: kaA t 7 k. S 7 P7 '7) VeC'C BOARD REVIEWED YES G/ -DATE REVIEWED NO DATE APPROVED T DATE F'INALED -7 A yK.R.E.O.A. Director Architectural Control Committee LAND DEVELOPMENT BUILDING / ENVIRONMENTAL HEALTH - PERMIT CLEARANCE Building Permit No. NAMERS osoher4lNUMBER: PRINT LAST NAME FIRST COUNTY ZONING DESIGNATION: T FLOOD ZONE:: X FLOOD MAP: .3175 !3 APPROVED: CONDITIONALLY APPROVED: ' y RESOLVE PROBLEMS PRIOR TO APPROVAL: PARCEL CREATION BY DEEDS OR MAP DEED INFORMATION: DATE OF CREATION: DEED REFERENCE:; LEGAL ACCESS PROVIDED: YES NO COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: COMMENTS/CONDITIONS:' MAP INFORMATION: LEGAL ACCESS REQUIRED: YES NO l?esu 6 kA Z 4 - YES NO DATE OF RECORDING S/% / �� LOT 2- BOOK 43 PAGE 3r% 317 COMPLIANCE WITH OLD SUBDIVI ION LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT PAGE 23): YES do NO. IF YES, MARK APPROPRIATE ITEM(S) BELOW: A. Construct road to B. Meet parcel size required, by zone. C. Meet current E.H.D. requirements. CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BE PAID TO THE BU/LD/NG DIVISION UNLESS OTHERWISE NOTED. 1. Maintain a 50 ft. building setback from centerline of road. _ 2. Maintain a ft.bu,ilding setback from right-of-way/centerline of 3. Maintain a 100 ft. leachfield setback from all existing wells. 4. Maintain a ft. leachfield setback from 5. Pay water tender fees in the amount of $ to Battalion Number of the Butte County Fire Department. 6. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290. _ 7. Connect to a public water supply. 8. Connect to a public sewer system. 9. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National Fire Protection Association Standard for the 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 Fire Department specifications, serves the parcel. 10. Pay T.D.D. (Thermalito Drainage District) fee in the amount of $ 11. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See phone number below) 12. Obtain approval from the Department of Fish and Game for vegetation removal. Contact Fish & Game at 916-355-7010. _ 13. A traffic mitigation fee for each new or additional living unit shall be paid. Pay the amount of $ as stated in the Oroville Area Traffic Mitigation Fee Agreement. Payment to be made to the Prmnkg Dhdskn. _ 14. All new residential buildings shall be constructed to comply with the requirements of the Uniform Building Code for seismic safety: Mobile homes shall be constructed on a permanent foundation system which complies with the Seismic Zone 3 requirements of the Uniform Building Code. _ 15. Deer Mitigation fees are to be paid, if such fees have been adopted by the Butte County Board of Supervisors. X 16. Pay school impact mitigation fees. X 17. A development impact fee for sheriff facilities shall be paid pursuant to the provisions of Chapter 3, Article II of the Butte County Code. _ 18. 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. _ 19. If any cultural resources are encountered during ground disturbing activities, all work shall cease in the area of the find pending examination of the site by a professional archaeologist. This person would then be able to assess the site significance and suggest appropriate mitigation measures. 20. 21. 22. 23 24. 25 Ala IWYN013A30 aw 31ins j0,11Rf100 5661 9 0 A 0 N a3n1333a LD 9/95 - C:\WPSITORMS.K\BLDGPERM.CLR eLgCTRICAL., MECHANICAL, AND PLUMBING CO COMN NOT PLAN CHECI(ED ) SAU- pLLY WITH CURRENT EDITION of: NEC, UMC AND UPC. Ieof GGca -P. Tbie set pin kept on the at make aay Written A www 1 fobT G, s 7yi' i� y2 � c",� CoivcrGTe S Q� kZ it provide els" x 1,� - 0 anchor bolts- _ 0 6' O.G. max. and withip, 12" Of WWk �.....�._� The agadwd Fire Safe requirements must be compifted as specified an approved by C.D.F. /b• C, cc. cue MGM. with of a quaw Prw in the Uniform B Codes and the Na and speci8cattons k -M be 41 tftws and it is unlet to or altersuoafe an sone Vr#hc from the Department of Pub one -ho .?°�'on era of common wall to- i4h self-closing d -core door• & Workmanship Shall Be In :ognized (food Practim and ed for the Specified use Ling, Plumbing & MechanioW ia1 Blectrioal Code. am COUNSy IMG DEPAR'iAENT PpRp�ED r.( 71 rT F, IZ Of 4 x 43 �(D Covy,\p. wj( _2 _y , q CL v 68 Oxy 5I vis BUM COUNiY IBUILMNG DEPARTMENT APPROVED ;�. !' TOP CHORD .}2X4 FIR -LARCH 01 i l BOT CHORD .2X4 ,FIR -LARCH 01 C IfEBS: 2X4 FIR -LARCH Standard CONNECTOR PLATES MUST BE INSTALLED IN ACCORDANCE WITH !' REQUIREMENTS OF I.C. B.O. RESEARCH REPORT 02949. ALL PLATES ARE CENTERED ON JOINT UNLESS OTHERWISE INDICATED. $EE ORNGS. 130 6 160/16OA-F FOR TYP. PLATE LOCATION DETAILS. TOP CHORD SHALL BE LATERALLY BRACED WITH PROPERLY CONNECTED bk PURLINS SPACED ATA MAXIMUM OF 24' O.C. 9'1{ NOTE: 2X4 03 HEN OR BETTER CONTINUOUS LATERAL BOTTOM CHORD BRACING Q 72' MAX. O.C. REQUIRED. ATTACH WITH '. 2-16d NAILS. BRACING IS NOT REQUIRED IF A RIGID CEILING IS ATTACHED DIRECTLY TO BOTTOM CHORD. BRACING MATERIAL TO BE SUPPLIED AND ATTACHED AT BOTH ENDS TO A SUITABLE SUPPORT BY ERECTION CONTRACTOR. TC X -LOC L -R: 0.29 5.41 12.00 17.59 23.71 BC X -LOC L -R: 0.29 8.27 15.73 23.71 - (U) BOTTOM CHORD CHECKED FOR 10 PSF LIVE LOAD. ALL TOP CHORD SPLICES OCCURRING BETWEEN PANEL POINTS ARE TO BE LOCATED AT APPROXIMATELY 1/4 OF PANEL LENGTH FROM PANEL POINT (WITHIN 12-) AND SHOULD NOT OCCUR IN PANELS NEXT TO A PANEL POINT SPLICE. CONNECTOR PLATES DESIGNED FOR GREEN LUMBER PER NDS TABLE 8.18. j i 4X4 1X3 ' 2X6 (A1) ' 4.00 9� 2.5X4 2.5X4 3X4 12-0-0 _0_ All �l-0-0 OVER 2 SUPPORTS— R-838# N- 3.50' PLT TYP.-ALPINE SEON--2f0725 wMySX! KOJIM[ EMTKK GAK 0 KIK CMOwHEEweo MMI01L/& IHC. *tlIMPORTANTWW pHu. Mor e[ weaFOMalslE ro• ARMING in wwCLlwwC EM[enw UO 1MlS DESIGN 0 0 0 0 C= 0 C! o DEVIATION MwON /Ms DESIGN 04 raw SPEC IFICA11o.S. OM AHF SNACINS. SEE "1"1 00 IPI sE[ FON AOOITIosI SPECIAL P[sMMes/ SPAC04 ME o C= C7 FAILve To BUILD THE MRS IN CO/oRsutE WITH 05109 of TMI nD, OF 200A SALV. TED. w C=3C AAAs p A [RCSTALPINE r"ARE EA AS NOTED. APFIT CONRCiONIECL D KMII�KSOI R a AS NOTED. C.0[O SHALL K LA1[MKMI■yAED NIT" MORE AITACMED K10000 sw alMlHa. sorrow GOND O ALPIN CJ L= o T60 LOCATED 1M CMOs 010 POSITION Os.[sS owMeeraNs FEN aNArtics Lae. lse s Iwa-F. leslw suMeAMn lV MI1M «gME0.F q/AOEO N1CI0 cElUon .. SEE TECHNICAL 1/OA/E IrHHt1 FON THIS C= o o coKOA11 VAMIIPiEL.E FROVISIOwS OF NOS E 1.1, w [MeI/EEN's A1ILIES TOM COOOENT DEPICTED seat AL►IH[ F OICHLLL APPLICATION. FUMION A ESFT IO THIS o TRUSS SEAL as THIS o "IRB RELIED flow IM ART OTHER MAT. O[Slw 10 rHE /M115! lRECTIOH COHTIIICTOR. 0 0 0 0 0 'C= IM 00.V. Ab LwAll Mor N—h1 . TMS MATE 1HSTITItt[ HOS • 1eel HartOMAI OESiw 3CC111U110N /oa MOOD COM/AlCr10N 1 1X3 2X6 (A 1) 4.00 1� O 12-0-0 2-0-0 "' = O R-8380 W- 3.50' REV 15.6.5 SCALE -= 0.2500 DESIGN CRIT.- C REF R427--3030: TC LL f /92 • SF ORW C us 1 7 207607 t C TC A BC ) TOT.LO. S A L DUR.FAC 12 SPACIN 4. 3111093. 0 0 CDF FIRE SAFE REQUIREMENTS AP# PERMIT # NAME Under authority of PRC 4290, the following checked items are required by the Butte County Fire Department and are made a part of this permit. These requirements are minimums and will be superseded by Butte County local regulations which equal or exceed these standards. Field inspections will be made by the Butte County Building Department for compliance. [ 1272.00 Maintenance of Defensible Space. To ensure continued maintenance of properties in conformance with these standards and measures and to assure continued avail- ability, access and utilization of the defensible space provided for in these standards, annual maintenance must be provide for by the land owner. Driveway Standards [N 1273.02 Surface. All driveway surfaces and structures (bridges, 1273.07 culverts and other app irte-iant-structures which supple- ment the roadway bed or shoulders) shall provide unob- structed access to conventional drive vehicles, includ- ing sedans and fire apparatus weighing up to 40,000 pounds. ] 1273.03 Grade. Not to exceed 16 percent unless paved. 1273.04 Driveway Radius [.� 1. No roadway shall have a horizontal inside radius of I` curvature of less than 50 feet and additional sur- face width of 4 feet shall be added to curves of 50- 100 feet radius; 2 feet to those from 100-200 feet. 2. The length of ver':i:l curves in roadways exclusive of gutters, ditches and drainage structures designed to hold or divert water shall be not less than 100 feet. 1273.05 Turnarounds. If required, will have a minimum turning j radius of 40 feet from the center of the road. [�} 1273..05 Turnouts.. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 foot taper on each end. 1270.10 Width. All driveways shall provide a minimum 10 foot traffic lane and unobstructed ver 1 cclearance of 15 feet along its entire lengt���C Page 1 ocf :3.-. Z9/4CO/'N 4,p Dep ?Y 4 Fiy� F� J. (� 9-�� - �S� 9.s'—?-�s� ;tom„-rOs�v✓, �tyL. AP # PERMIT # NAME [j(] 1273.10 Turnouts. Driveways exceeding 150 feet in length, but less than 800 feet in length, shall provide a turnout near the midpoint of the driveway. Where a driveway exceeds 800 feet, turnouts shall be provided no more than 400 feet apart. [�Q 1273.10 Turnaround. A turnaround shall be provided at all / building sites on driveways over 300 feet in length and shall be within 50 feet of the building. 1273.11 Gates [�`] 1. Gate entrances shall be at least two feet wider than / the roadway it serves. [y] 2. The gates must be located at least 30 feet from the / roadway and shall open to allow a vehicle to stop without obstructing traffic on that roadway. [ ] 3. Where a one-way road with a single traffic lane provides entrance, a 50 foot turning radius shall be used. Fuel Modification 1276.01 Setback for Structure Defensible Space. All parQels 1 acre and larger shall provide a mini- mum 30 foot setback for buildings and accessory buildings from ul] property lines and/or the center of the road. ] 2. For parcels less than 1 acre, local jurisdiction shall provide for the same practical effect. See Other Requirements below. [�} 1276.02 Disposal of Vegetation and Fuels. Disposal, including chipping, burying, burning or removal to a landfill site approved by the local jurisdiction, of flammable vegetation and fuels caused by site development and construction, roai and driveway construction and fuel modification shall be completed prior to completion of road construction ,r fi_ral inspection of a building permit. aUrrF ��[Dj COU4 y Page 2 of 3 A P � �R�E4 AP # PERMIT # Other Requirements [ l If Building Setback is 15 to 30 Feet: NAME - Class A or B roof - Enclosed eaves [ If Building Setback is Less Than 15 Feet Choose any 3 of the following: Metal or no doors on side toward property line with insuffi- cient setback Class A or B roof with enclosed eaves Interior automatic spri:ikler system per NFPA 13D Glass area not to exceed 'i0% of wall area toward property line with insufficient setback Siding from the following list: Stucco - 3 coat Hardi-Board or Plank Masonry Masonry veneer Metal Other Butte County Fire Department approved materials Date Signature Page 3 of 3 BUTTE COUNTY BUILDING DEPARTMENT APPROVED And when recorded mail to: Building Division #7 County Center Drive Oroville, Ca. 95965 Nov %1195 95-041109 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code requires 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, necessan. farm operations. All that real property situate in the County of Butte, State of California, described as follows: t~ o f \-4 Ck n S h o L t3 n D n +kc":� c e_r-4 \_o O F k e l t `l P, E-5�c�.-4- es U v; �� t\,)0- 2-P " w h i ch M �2Cp ►fC12C o SFVC.e o A-V) e- Pe- c,ordet/ o_�_ 44h.e CoU�y o� C:a l��rorh�a on s '� , ��74 '`� C3oek 43 0- tMa-Ps, 38 and 39 tw-* ouq - o w --o� Date: t d131 1 el PROPERTY OWNERS: CAT. NO. NNO1501 TO 2931 (1290) (Witness Acknowledgment) STATE OF CALIFORNIA COUNTY OF biA' A-� On In 1 �3l111-11 1-1:11personally appeared -k before me yiilliQ rr rn. �Q,yP,�Gr'1► - 1 TICOR TITLE INSURANCE I } SS. 1e undersigned, a Notary Public in and fogy said State, personally known to me to be the person whose name is subscribed to the within instrument, or proved to be such by the oath of a credible witness who Is personally known tome, as being thAsu1scribin g Witness thereto, said subscribing Witness being by me duly sworn, deposes and says: That th�yv rtnessres des iner C)and that said witness was present and saw _ lif l i1 4A.T n�r-3c2j personally known to said witness to be the same person(s) described in and whose name(s) is!are subscribed to the within and annexed instrument as a party thereto, and acknowledged to said affiant that he/she/they executed the same in his,her/their authorized capaclty(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, and that affiant subscribed his/her name to the within Instrument as a Witness. WITNESS my hand and official seal. Signature I tiri , �ruruuunauuuuualuwuolulunnunolnwuluurunll� OFFICIAL SEAL 11010979 D N WENDY M. AUER Y. NOTARY PUlLIC - CALIFORNIAN Q COUNTY OF BUTTE w My 1ltMIWMiH�18fi liko;res Filibruery 13, tt4a= (111111Nlllllll!!NIlNNNININlNfl1111iiIINN111NINiilletiiuli'1 (This area for official notarial seal) personally subscribed to the :apacity(ics), and person(s) acted, PERMIT NO: 49-95 Lake Oroville Area Public Utility District 1960 Elgin Street OROVILLE, CALIFORNIA 95966 533-2000 DISTRICT APPROVAL AND VERIFICATION OF INSPECTION BUILDING SEWERS This verification form must be submitted to the Butte County Department of Public Works Building Department prior to issuance of a building or occupancy permit, whichever is applicable. Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by Lake Oroville Area Public Utility District, must be submitted to Butte County. Date: November 21, 1995 Applicant: Cheryl A. Thompson (Executive Homes) Applicant Address: 1394 Keri Ln. , Oroville, CA 95926 Applicant Phone No.: 342-1451 (891-6992) 90 Greenbrier Dr., Oroville, CA 95966 Property Location (s): Kelly Ridge Estates Unit 2A Lot #12 A. P. No. (s): 069-080-035-0 Fees due: All fees paid. Application for service approved: .KE ORO L"REA LIC UTILITY DISTRICT Inspection(s) made and successful test(s) observed: Location: Date: Lake Oroville Area Public Utility District release to close permit: Date: By: r rL. BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM r (One Forr LPer Building) i School District Oro Building Department No. A.P. Number Q49' 'Qs�Jurisdiction: City County . ) 7T Property Owner Property Location/Address 20 �ie E>1 �1^ i f l ►� 0-r0 V r Subdivison Lot No. Residential DevelopmentSq, Footage S No. of Living MHI Addition (Group R) Units Commercial/Industrial Sq. Footage New Addition (Including Exterior Roof d Areas) 1, XIX,/ //// Building Departmen epresentative Date (Floor Plans reviewed by School District Personnel) District Identification No. ;2 0 6.2 , School District certifies that — 6 (Applicant) CJD (Street Address) has complied with the requirements,of Resolution No. representing I SW 6 square feet. —7) aAj--� (_A School.District Representative 16, (Phone Number) 0- ` 9.J"9, 93 - 9 (Zip -/U by payment of $ �'Jo27, 9Z AB 2926 $ FULL MITIGATION $ Date Paid by Check # Remarks: Bank Number: Paid by Cash If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White. (applicant), Yellow (building department), Pink (school district) feeform.wki (11/94)dmm