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HomeMy WebLinkAbout069-130-01811 RECORDING REQUFATEDZY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 r� �� �� �i ' ►tPEI Recorded I Official Records I County of I Butte I CANDACE J. GRUBBS I County Clerk-Recorderl 1 I 011:26AN 18 -Aug -2005 1 REC FEE 10.00 COVORNED COPY 1.00 LV Page i of 2 SPACE ABOVE THIS LINE 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 agency 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 dealing with the real property. ROB & JENNMER ROTH REAL PROPERTY OWNER/LESSOR 3365 APOLLO CIR MAILING ADDRESS ROSEVILLE PLACER CA 95661 CITY COUNTY STATE ZIP 521 SILVER LEAF DR INSTALLATION MAILING ADDRESS, IF DIFFERENT OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILINGADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 04-3312 (530) 538-7541 BUILDING PERMIT NOTELEPHONE NUMBER . SIG ATURE OF LOCAL AGENCY OFFICIAL DATE NONE DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO CMH MANUFACTURING 2005 CM402K MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER ALB 029301 ORA/B/C 40 x 40" 6' ORE470775/6/7 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER 069-130-018 HCD FORM 433(A) REV. 8/91 WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD- Building Dept. 2004 16:31 9167721376 JEN PAGE 03 Exhibit A The following described real property in the unincorporated area County of Butte, State of California: Lot 174, as shown on that certain Map entitled, "Kelly Ridge Estates Unit One", filed in the Office of the County Recorder of Butte County, California, on October 30, 1970, in Book 38, of Maps, at page(s) 5 thru 10. Parcel No. 069-130-018 BUILDING PERMITS NUMBER: 04-3312 Address or location of unit: 521 SILVER LEAF DR OROVILLE Legal Description of Real Property: 069-130-018 SEE ATTACHED (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: BOB & JENNIFER ROTH Owner's address: 3365 APOLLO CIR ROSEVILLE CA 95661 INSIGNIA OR HUD NUMBER: ORE470775/6/7 SERIAL NUMBER OR V.I.N.: ALB029301A/B/C MANUFACTURER'S NAME:CMH MANUFACTURING YEAR: 2005 OFFICIAL APPROVING INSTALLATION: DATE: IT AVD `j PHONE: (530) 538-7541 H.C.D. 513C P TOF STATE OF CALIFORNIA NUMBER: �q BUSINESS, TRANSPORTATION AND HOUSING AGENCY DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT 8724686 A Q (� s• DIVISION OF CODES AND STANDARDS Q 4} V V MANUFACTURED HOUSING PROGRAM MANUFACTURER CERTIFICATE OF ORIGIN DISTRIBUTION: ORIGINAL (PINK) FORWARD TO THE INVENTORY CREDITOR UNLESS THERE IS NONE, THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY.1 MHFTE) FORWARD TO THE DEPARTMENT AT P.O. BOX 1828, SACRAMENTO, CA 95812-1828, WITHIN FIVE (5) DAYS OF RELEASE. COPY 2 (YELLOW) DELIVER TO THE TRANSPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION. COPY 3 (GOLDENROD) TO BE RETAINED BY THE MANUFACTURER HCD 483.0 - Side 1 - (7/97) Fo­CHECK IF THIS ISA DUPLICATE MCO -ENTER ORIGINAL MCO NO. MANUFACTURED HOME OR MULTI -UNIT MANUFACTURED HOUSING NUMBER OF .n X0 SFD (SINGLE FAMILY DWELLING) ❑ MUMH (MULTI -UNIT MANUFACTURED HOUSING TRANSPORTABLE SECTIONS Z Comm RCIAL COACH: OCCUPANCY GROUP MANUFACTURER NAME: MANUFACTURER LICENSE NUMBER: rpt pO; ACTURRING VEST, IFIL. MANUFACTURER ADDRESS: SUGGESTED RETAIL PRICE: - tt (;• t r. RE". 22 221 Ci State Zi MANUFACTURER TRADE NAME: MODEL NAME AND/OR NUMBER: DATE OF MANUFACTURE: • x]17 Y7 ' _ t•„ NAME 'DEALER OR TRANSFEREE (OWNERSHIP TRANSFERRED TO):' CALIF. DEALER NUMBER OR 4% i DATE OF TRANSFER: TRANSFEREE DESIGNATION: OA/1/05 CUSTMf tf>aPAk(�I;lUMD MU1 DEALER OR TRANSFEREE ADDRESS: stme l t+IC,iiiAY let WI'�LITS. CA 954W Ci State Zi INVENTORY CREDITOR NAME: INVENTORY CR D) RAD ESS:, ;65;,11, 77i! 6CI?r4UM SUITC 6N, Si LOU15, Ma C,3m, State Zi S4iee��l% (City) SECTION MANUFACTURER SERIAL NUMBER HCD INSIGNIA OR HUD LABEL NUMBER LENGTH INCHES WIDTH INCHES WEIGHT (POUNDS) 1b ^ "� r -, t. I i ;�E.x"'`97i11QR 11 i18E4?@';5 ��� .�l.P4�^ca.iatGft P r• ,_� 9k­1-Wkf1R F r., 471177-11 4M 1 17. 342 THIS CE IFIEO TO BE A TRUE ANO ' TRANSPORTER NAME: TRANSPORTER ADDRESS: (Street) C Slats Z DESTINATION FOR UNIT DESCRIBED ABOVE: NAME . 'n C' Slate(Zip1 I certify under penalty of per)ury urtdw ft lows of the Stals of California that the above farts we true end correct :SED TO •'._ R TKeJEA?jC Exeolrtedon at-" •_ -I 0IFTHF., k%i:dnA:. , � . • •a. • i1p) (County) (Stals). ., (D SIGNATURE OF AUTHORIZED AGENT: DISTRIBUTION: ORIGINAL (PINK) FORWARD TO THE INVENTORY CREDITOR UNLESS THERE IS NONE, THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY.1 MHFTE) FORWARD TO THE DEPARTMENT AT P.O. BOX 1828, SACRAMENTO, CA 95812-1828, WITHIN FIVE (5) DAYS OF RELEASE. COPY 2 (YELLOW) DELIVER TO THE TRANSPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION. COPY 3 (GOLDENROD) TO BE RETAINED BY THE MANUFACTURER HCD 483.0 - Side 1 - (7/97) RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 18 -Aug -2005 2005-0049028 Has not been compared with original BUTTE COUNTY COUNTY RECORDER SPACE ABOVE THIS LINE 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 agency 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 dealing with the real property. ROB & JENNIFER ROTH REAL PROPERTY OWNER/LESSOR 3365 APOLLO CIR MAILING ADDRESS ROSEVILLE PLACER CA 95661 CITY COUNTY STATE ZIP 521 SILVER LEAF DR INSTALLATION MAILING ADDRESS, IF DIFFERENT OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME MAILING ADDRESS SAME COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 04-3312 (530) 538-7541 BUILDING PERMIT N0. TELEPHONE NUMBER h&g '3' s-05 SIG ATM OF LOCAL AGENCY OFFICIAL DATE NONE DEALER NAME (if not a dealer sale, write 'NONE") NONE DEALER LICENSE NO. CMH MANUFACTURING 2005 CM402K MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUIvMER ALB 029301 ORAIB/C 40 X 40" 6' ORE470775/6/7 SERIAL NUMBERS) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) SEE ATTACHED ASSESSOR'S PARCEL NUMBER 069-130-018 HCD FORM 433(A) REV. 8/91 WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD -Building Dept. 2004 16:31 9167721376 JEN PAGE 03 Exhibit A The following described real property in the unincorporated area. County of Butte, State of California: Lot 174, as shown on that certain Map entitled, "Kelly Ridge Estates Unit One", filed in the'Office of the County Recorder of Butte County, California, on October 30, 1970, in Boob 38, of Maps, at page(s) 5 thru 10. Parcel No. 069-130-018 08/17/2004 16:31 9167721376 .. RECORDING REQUESTED BY: Union Estate Planning 3494 Camino Tassajara Road Suite #209 Danville, CA 94506 MAIL TAX STATEMENTS AND WHEN RECORDED MAIL TO: Robert R. Roth and Jennifer Roth 3365 Apollo Circle Roseville, California 95661 JEN GRANT DEED PAGE 02 20Q�4-0�02919� Recorded I R2C FM lis.IN Official Records I Cou__ nty_Of I CANDACE J. DRUM I Recorder 1 ROSEMARY DICKSON I Assistant I Jason 6919PAM 20-Jah—=4 I page f of 2 NOTICE: THIS CONVEYANCE IS TO A TRUST NOT PURSUANT TO A SALE AND IS EXEMPT FROM TAX AND THE -UNDERSIGNE-33-ACRE-T1IE DECLA,PANTS AND TRUSTEES ON THF—EFFECTLVE DATE OF THIS INSTRUMENT. Tax Parcel # 069•-130-018 Robert R. Roth and Jennifer Roth, hereby grant(s), sell(s), convey(s) and assigns(s) his/her rights to Robert R. Roth and Jennifer Roth as Trustee(s) of The Robert R. Roth and Jennifer Roth Revocable Living Trust; Dated: 02/25/2001, all of his/her/their right, title and interest in the property described in Exhibit "A" which is attached hereto and made a part hereof, Dated: Dated:/2 Z.(r •—o ACKNOWLEDCMENT NOTARY PU13LIC STATE OF CAL NIA )ss. COUNTY OF ) Robert R. Roth ✓. i� On before me, IZ,� L�{�^ a notary public in and for the State of California, personall ppeared Robert R. Roth and Jennifer Roth, r ,i proved to me on the basis of satisfactory evidence to be the rson s hose m s subscribed to the within instrument and acknowledged to me that a ecutcd the same Kiat h ear uthorized ca acities, and that by ear i r s n the instrument, the piTso or the entity upon behalf of which t person(s ed, executed the instrument. N (SEAT.) Signature �K.Zw KIM BOWER DOCUMENTARY TRANSFER TAX: zero COMM. a 1344971 NOTARY PUBLIC ♦ CAUFOR" EXPLANATION: GOING INTO REVOCABLE LIVING TRUST PLACER COU?M EXEMPTION REVENUE AND TAXATION CODE: 11930 j(0Comm. Exp. MARCH 1, 2A SIGNATURE OF DECLARANT OR AGENT DETERMINING TAX 08/17/2004 16:31 `' 9167721376 JEN Exhibit A. The following described real property in the unincorporated area ' County of Butte, State of California: Lot 174, as shown on that certain Map entitled, "Kelly Ridge Estates Unit One", filed in the Office of the County Recorder of Butte County, California, on October 30, 1970, in Book 38, of Maps, at page(s) 5 thru 10. Parcel No. 069-130-018 PAGE 03 COPY,.of Document Recorded .2004-0078343 Has not been compared -with �7 original BUTTE COUNTY RECORDER AND WHEN RECORDED MAIL TO: BUTTE COUNTY OVILDING DIVISNX? COUNTY CENTBR DRIVE OROVILLE, CA "945 AGRI Cu LTuRAL STATEMENT OF ACKNOWLEDGMENT FOR ItESilDENTLAL DEVELOPMENT Section 26-8 of'the Bute County Code requited this "know'ledgmeat to be recorded prior to issuance of a building pennit. The property described herein is adjacent u, lartd or included within an area zoned for agricultural purposes, and residents of this propem- may be subject to inconveniences. or diacornfort from theuse se of atricultural chemicals, including, but not limited to he,-bicides, pestieider;, and fertilizers; and froim the pursui* of agricultural operations including, but not limited to cultElation, plowing, spraying, pruning, anal harvestingwhich ocetuionally generate dust, smoke, noise, and odor. Butte C.'ounhi has established agricultural purposcs and residents within said zones and on adjacent property should be pn::pared to accept such inconvenience or discornfort from normal, necessar;: fa -m operations. A.11 that real property situat> in the County of BuAa. State :,f California, described as fo,lews: as 5koW-7t, o -'t, tkat n e_et,,, MRp e h.fi /rte, I /<�llY lei�ye Fs-�A-rc5 24-?LfD-"re ��� �"� the 0-�'�'!ce o Coa.iLfy Qe�e�a'c i- uf't3u;fite �' o��y G��.�/t/ia. f 672 (9Ct�abele 30� /970) �7z .boob 39) of /h•��s, �f p�y�Cs) 3" NROPIERD WNERS'. 17 07 It - State of California County of &_AeR11704WT0 on 6615-& 0. o y .- before me, CeAl .D, S 0�.4/C- ff�:I- �.�J�CIved to me ars - D__ the baA5 of satisfactory evidence) to ht thy, person(s) whose rtarne(s)idare subscribed to the within instrument and acknowledged to the that 4rdsherthey exm:uted the same in h~'thiir authorizers cspaclty(les1, aad th9t by hWhev..'their signature(s} on the 'instrument, the personly) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my stand and official seal. signature__R� Beet: LINDA SHOEMAKER signature_ --- N Comm. # 1464793 rn NOV;RYaLgUC•CALIFORNIA vt sacramenlo count A.P. �;� �d r. Q/� Pay comn Expi,es Janes X9,2 9R -+)ve4 S1I11IM S3WOH woisno 5Z6969floZ '-Z'6T b00L,'_LJi,i NOTES I Ksfcc (, o til w7 RESIDENTIAL PERMIT NO. — (,6a-130-0 IS 04-3312 ROTH, R()BI RT .`.;2 1 SILVFRL,E' F DR. OROV[LLE Cont: COV T i_N•1PORARY CONST NEW N114 PERM FND e THE HCD FORM 433A FOR THIS MH CANNOT BE RECORDED UNTIL ONE OF THE FOLLOWING HAS BEEN TURNED IN TO THE BUILDING DIVISION: (1) LICENSE PLATE(S) OR DECAL (THE INSPECTOR MUST RETREIVE). (2) STATEMENT OF FACTS (ONLY ON NEW MH'S). INSPECTOR TO VERIFY SERIAL & LABEL #'S. C�� OFFICE COPY Address ��� 5�G ►/Crn G (!�F U% ` GAS Meter By Date ELECTRIC / _�xi + Meter By Date k O(Zrc 4-),0,1-7s s 71 JOB FINALED (Date) R - S -05 Signature S"MMc" SPECIAL CONDITIONS i CHECKED / BY SRA _ �Q FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. 1 SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS i SUB -STANDARD HOUSING LETTER OFFICE COPY Address ��� 5�G ►/Crn G (!�F U% ` GAS Meter By Date ELECTRIC / _�xi + Meter By Date k O(Zrc 4-),0,1-7s s 71 JOB FINALED (Date) R - S -05 Signature S"MMc" J=OK 4. 0 = Not OK Date NotReadyahle MORILE HOMES . = 6. Date MOBILP<OME UTILITIES (Plans) OK except #'s 7. onin quirements-Setbacks-Easements 3. 2. s; Special MH Support Sketay Utility Clearance 3. Sewer; Location -Test -Fall- -Concrete M 1 4. Water; Location -Test -Easement Needed (Sketch) Date 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 1. 6. Gas;,Location-Test-Wrap;-/ P' L 'ft. / /' Nat. or/ P' L "ft./ P LPG 2. 7. Well Clearance & Disconnect 3. 8. Utility Clearance 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures Date 3•- 0 Carports; Windows -Doors Card B-1 Date Card 8-1 Date Electric Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 9. 1. Zoning Requirements -Setbacks -Easements 10. 2. Footings; Size -Spacing -Marriage Line 11. 3. Gas; MH Test -Demand -Valve -Connector 12. 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval ( ,SB. Gas a A'Q- 1C,,AS Setbacks -Easements 9. Tie Downs -Type -Installation Cert. Soils; Compaction -Structure Stability 10. Exits; Insp.-Sketch Pool Structure; Steel -Connections -Thickness Dead Men -Lining 11. Cert. of Occupancy Elec.; Receptacles and Lighting, Distance-GFI i 5. Elec.; Pool Lighting; 15 Volts-GFI Date Elec.; Enclosures; Conduit Entries -Terminals -Listed Card B-1 Date Card B-1 Date Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2 F gs; Size -Sp cin -Marriage 6Ee Blo.,cking 6, ; MH Test- 6em nd-Valve 6. Electricity; MH Test j Water; MH Test Ue�Water and Sewer Connected and Electricity Tagged xits License Decals 11. Verify #'s with Office Dat --Z -per Card B-1 , Date Card B-1 Date 5- Card B-1 S , Date Card B-1 M 1 Health Department Approval MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s Light Niche 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel Card B-1 Date Card B-1 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability I F 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI i 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater i 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 f1n f -A Q 1 f1..1.. �__ 0 1 J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection Bedroom Exiting 20. Shower Pan; Test, First Floor -Tub Access G.F.I. & Bath Fixtures & Tub Access -Spa 21. Test Tub & Shower, Second Floor -Tub Access Elec. Trim & Subpanel, Breaker Sizes & Labels 22. Gas Pipe; Sixe & Anchors Stairs & Rails 23. Fire Sprinkler; Test Fireplace or Stove, Clearance -Hearth 72. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 75. 24. Fixture & Transformer Clearance -Ins. Protection 76. 25. Elec. Receptacles Spacing -Lights & Switches at Doors 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 26. Size Boxes & No. of Conductors Stapled Plb.; Elec. & Mech. Equip. Listed for Location 27. Romex Installed Close to Edge of Studs & C.J. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Insulation -Foam -Looked in Attic 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI Guard Rails & Deck Construction -Post Caps 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral ❑ Yes ❑ No Clearance Looked under Floor ❑ Yes 32. Service -Riser Conductors & Ground Main Disconnect Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No 33. Equip. Clearances Panels-Motors-Mech. Equip. Stucco Brown -Finish 34. Clothes Closet Light -Shower Light -Spa Light A.C. Unit Disconnect, Electrical -Plumbing 35. Smoke Detector Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 90. 36. A.C. Ducts Insulation & Support 91. 37. Vent Fan, Exhaust above insulation 92. 38. Condensate Drain & Overflow, Size & Grade 93. 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 94. 40. Attic Access & Platform if Furnace in Attic Date Address Posted Card B-1 Date Card B-1 Date Fire Sprinkler Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Date 41. Sills Proper Materials & Anchors Date 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound Comments at Final: 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties- Purl in -Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. , 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes _ 83. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVIL'LE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.net\dds LICENSED CONTRACTORS 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: License Number. Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale 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 properly, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Profdsslons Code. The Contractors' Slate 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: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply ith ose 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 PERMIT NO. BP043312 Issued Date: 12/29/2004 APN: 069-130-018-000 Site Address: 521 SILVER LEAF DR ORO Map Index: Description: NEW MH ON PERM FND(1676) Owner: ROTH BOB & JENNIFER 3365 APOLLO CIR ROSEVILLE, CA 95661-3965 Applicant: PAGE, TAYLOR CUSTOM MFD HOMES INC 16730 N HWY 101 WILLITS, CA 95490 707-459-7000 707-459-5925 Contractor: CONTEMPORARY CONSTRUCTION 16730 N HWY 101 95490 707-459-7000 License #: 806196 Architect: Engineer: Total Square Ft: 1676 S.F. Valuation: $108,940.00 Census Code: This to do work Ind �S under the applicable provisions of the 1310 tted,Qove for which fees have been paid. PERMIT EXPIRES ON:__v. ounty Cods anryor Date: / ^ // iJ,S ❑ 1 hereby cerlify 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 thall 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 tie Cou I hereby authorize representatives of Butte County to enter upon the above mentioned property for Inspection purposes Print Name: Al GI Signature: Date: ❑ Owner ❑ Contractor Agent for Owner ❑ Agent for Contractor 0 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVIL'LE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds 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 : License Number: Date: Contractor. 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' Slate 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 Profdssions 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' State License Law.). ❑ '1 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: Cl 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. ❑ 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: �] 1 certify that in the performance of the work for which this permit is 4 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 ith ose provisions. 01 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 wod< for which this permit Is Issued (Sec 3097 Civ.) Name: Address: PERMIT NO. BP043312 Issued Date: 12/29/2004 APN: 069-130-018-000 Site Address: 521 SILVER LEAF DR ORO Map Index: Description: NEW MH ON PERM FND(1676) Owner: ROTH BOB & JENNIFER 3365 APOLLO CIR ROSEVILLE, CA 95661-3965 Applicant: PAGE, TAYLOR CUSTOM MFD HOMES INC 16730 N HWY 101 WILLITS, CA 95490 707-459-7000 707-459-5925 Contractor: CONTEMPORARY CONSTRUCTION 16730 N HWY 101 95490 707-459-7000 License #: 806196 Architect: Engineer: Total Square Ft: 1676 S. F. Valuation: $108,940.00 Census Code: This permit is hereby issued under the applicable provisions of the Butte Cnunty Code and/or Resolution to do work Indicate ,6 ove for which fees have been paid. l �- By;� \� W&l? i I1�I•fflfl�� Date: ^'T 0 PERMIT EXPIRES ON: ! - // d 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. O 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 owner or the duly authorized agent 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 substance of any official form or document of He Cou . I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes Print Name: 'Signature: Date: ` ❑ `Owner 0 Contractor Agent for Owner ❑ Agent for Contractor 01/03/2005 15:33 9167721376 JEN PAGE 02 f� X 5RC1 S3 7wif. December 29,2004 Butte County Billing Dept. ,Attn: To Whom it may concern.: Our Contractor will .he Phil BeC,am for the property at 521 Silver Leaf Drive, Oroville at Kelly Ridge. Dorm Lord has our p=missiou to pick up the building permit plans from the billing dept. Robert and Jennifer Roth 1801 Eureka Rd. Apt 23 Roseville, Ca. 95661. 916-772,1376 w�I...'.v..:. «..�-.n+.r--�..ti,.j:..�,+; ..H .,N., `S-,.. Tr'�7'(+'. �--w,•:�T»' .aAvy.:yw.+{"'«w' i+"wl,..niw ...� . .-w..-.�+a.:,-..-,,.-,..-r `.r- p ..� t.,/��,. COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET J-1-�����r OWNER: ASSESSOR PARCEL NUMBER p Proposed Building Use: Counter Technician: Date: b Items required in order to apply fora permit. AI P oxes MUST be checked OR marked NA in order to apply. 1. Site plans, 3 or 4 sets, signed by the "preparer of the plans. . ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. 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) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) T.ieAown 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 cf these must be stamped and wet -signed by the engineer. ❑. , 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. r �] 16. Other_�1A IeL '� Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ 20. Erosion Control Plan Required........................................................................ ........ 2 7 ees as shown on the attached Schedule of Fees Due Sheet .............................. 22. City of Chico Plumbing permit........................................................................ 23. California Department of Forestry plan approval (paid. Sent by: ............. S F l� 24. Planning approval (A) Use: �(B)Parking: (C) Parcel Check: I b'{ r a54- ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ES Form............................................................................................. � 27 roachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... er of Signature authorization......................................:............................. orded copy of Agricultural Acknowledgment Statement ................................. r:3N4M2cnufactured home utility clearance............................................................... ❑ 35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... f _ 37. 1 Grant Deed, 1jM4 T411e49tatement of Facts, 0-Le4er-€rena-Le9aL0m=r, 04i eek-te H.G. ❑ 38. Other: ❑ 39. Other: When issued Telephone - - QW and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: 4' Date: 1. Index permit applica on for the a ov s n b Plan Check Letter 2. Additional items required . " Contractor, designer, owner, was advised of the abov�lTby 8 hone,mai , ❑ counter, by Date: Contractor, designer, owner, was advised of theabov at phone, ❑ mail, ❑ counte Date: Plans reviewed by: Date: 2 Plans approved by: Date : L Structural reviewed by: Date: Structural approved by: Date: ZZ Note transfer by: Date: Yellow: Building Division MW rirsr American i me company, vvnuns PR. 06243 Ofc. 2302 (RB/RB) CHECK No. 2302107052 BUYER: Roth SELLER: —Custom Manufactured Homes J Property Address: 521 Silver Drive, Oroville, CA ` A A4E j3 J. ) ) Funds Due, Re: ( . Charge Details:i C Bldg & Planning 1`1:=69 N Thank you for doing business with First American Title Company COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER PROPROSED BUILDING USE 1. BUILDING PERMIT FEES --- Balance Due ..................... $ --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units A.P. # — LJ D-0 [ DATE RECEIPT # DATE REC. Commercial (sq. ftg.)..... X $0.03 = $ _ Sq.Ftg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Fig. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) .6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK FEE �$89:t10Wid at Building Division) 8. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... X = $ Sq. Ftg. Amt. 10. OTHER V At time of permit application, I bvas adviseedkhe above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checki process. APPLICANT. IDU M 41 .. DATE Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) PERMIT NO.: -IL5' 0+ 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: OCTOBER 7, 2004 Applicant: ROBERT& JENNIFER ROTH (.CUSTOM MFG. HOMES) 3365 APOLLO CIR (116730 NORTH'HWY 101) Applicant Address: ROSEVILLE, CA 95661 (WILLITS, CA 95490) (.916)772-1376 Applicant Phone No.: (.530)-773-2956 ((.707)459-7000) Property Locations(s): 521 SILVERLEAF DR. OROVILLE CA 95966 KRE UNIT 1 LOT #174 A. P. No. (s): Fees due: 069-130-018-0 $2,717.00 Total consisting of $1,027.00 LOAPUD� C and. Application for service approved: $1,690.00 LOAPUD Capacity Chg RQ 1_'-1�1- 59 o 4'OROVILLE AREA C UTILITY DISTRICT Inspection(s) made and successful test(s) observed: Location: Date: Lake Oroville Area Public Utility District release to close permit: Date: M BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM' (One form per Building) School District Building Department No. A.P.Number Jurisdiction: city County Property Owner Property Location/Address; e2 4, Or-, Subdivision Lot No. .......................... . .................................. ...................................... Residential Development Q 0 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 . t New A Addition Department District Identification No. [� 0r e./. i kp- E (e- v%— School District certifies that Sq. Footage (Including Exterior Roofed Areas) Date (Applicant) (Phone Number),,, (Street Address) 4 (City) (State) (Zip Codi) has complied with the requirements of Resolution No. 3 —0 by payment of $ representing square feet. 2926 $ FULL MMGATION School District I a — k. Date Paid by Check # —0 k & 37 *..X,4 f+loSoe: You may protest the Imposition of the ton Identified above by subs ting a wiftlen protest to the District, In compliance Oq 6�' V GovernCode Section 66020(a), within 90 days from the date ton are paid. Failure to 9 . ubn* a timely wrtftn protest wllrpro;:�b�lt� you fforn chel"Ing the Imposition of the fen In anicourt action. N, subsequent to the School District Represerrudive signing Oft Butte County Schools Impact FU�dwftfictl F4M the Scho& Wi66dIs-'/ 0 / two by the applicable Local Planning Agency thal� this project Is being reviewed under do Caltlornia EnvIronin.sr" Quality Act (CEQA) 011s; may be added to addithmal school %*6 to fully n*%**.ft Impact on the school district's schools. White (applicant), Yellow (building depiiiment), Pink (school district.) feeform.xis (10/03)dm.m 08/17/2004 19:06 9167721376 JEN PAGE 02 u•�� o± ; „�w� t 1 o .9 r a �'�77t CUSTCiH HOMES kIlLL; IS PAGE: 0-= - O y !'0 WhOM it May CCQC-J�rn : allow 0w.1(1g .PPop to cLtF.iil a.rmy Ueryr.,Cs aa Pay ary tier@s;axy fees, ECT on fqv behai` rega_dinu Oe Installation w� a new mann ac ured 1-0me atr rYie acitiseav li 3t.^U te].ow. The :iollowi,n.g pogo:1e Wrio az•e luthoO.2?U are. Terri "beaten, KIM Lebo, Taylor- Page, Liz Hackworth, :,u.a-me Lawreice, Robir. 'Srnir. ,, . and 'LS4rti'n fi_llia;.:-e_ S inCGre y, Customer Name it0 iy�J Site ikdd r e S S _,.:�, �•�� � , .it}, 2:;p, anti Cc.%anta'.___ aez�r '� - Department r e% 11 n t t J. Michael Crump, Director of Public f B u t Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville. CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase Prevention Construction Storm Water Permit and Storm THAN 1WaterPollution Plan (SWPPP) Acknowledgement (LES Project Description: ��% A/e, qJ Proiect Location and/or Parcel Number: a� T J/,v By signing below, I, the project owner/owner's agent, certify that this project `Storm WaterPe L NOT RB 1 acre or more of land and that I, therefore, do not need to apply for a Construction 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. Siped: Title: Date: Less than 1 Acre NPDES & SWPPP Compliance Certification Alt..... t.au.......t Proeram NOTES RESIDENTIAL PERMIT NO. _'-069-I30-018 OS-1290 ROTH, ROBERT 521 SILVERLEAF DR, OROVILLE Cont: PHIL DECANN NEW DECK ; c oq-332a Gia I tl i Ir i SPECIAL CONDITIONS CHECKED BY SRA 4 FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY 3 USE PERMIT CONDITIONS SUB-STANDARD HOUSING LETTER i t JOB FINALED (Date) -OS Signature-�����^'� ; J=OK o= Not OK - = NotApplicable . =Not Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Water, Location -Test -Easement Needed (Sketch) S. Electricity, Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 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 5. Drain; MH Test -Fall -Flex Connector 6. Water, MH Test-Regulator-Connectoe 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 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Carta B-1 -.,,--MISCELLANEOUS Date C bECKS,3ERS, CARPORTS, GARAGES (Plans) OK except #'s Hing Requirements -Setbacks -Easements 2. Footings; Soiis-Size-Depth-Spacing-Connectors-St Girders and/or Joists-Decking-Bracin tai - s 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. Rog#c .Shthg-Roofing ; Steps -Doors -Landings 12. Braced Wall Panels Date'W-2-OS Card B-1Date Card B-1 DateR_c; -OS Card B-1 S,` Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.-, Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. • Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = Not Apprrcable = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth 3. Ftg_, Garage; Soils-Steel-Elec. Grnd.-/ /' Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped _ 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting: Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. 1 nfittration-Walls-Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Cana B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes 83. Following InstldJDrive D Yes O No/Walks O Yes O WI lantern O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fre 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: Date Card B-1 Date Card B-1 Date Card B-1 Date Cana B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes O No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. _ 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Cana B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting: Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. 1 nfittration-Walls-Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Cana B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes 83. Following InstldJDrive D Yes O No/Walks O Yes O WI lantern O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fre 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: 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. BP051290 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 a I hereby affirm under penalty of perjury that I am licensed under Issued Date: 06/03/2005 APN: 069-130-018-000 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. Site Address: 521 SILVER LEAF DR ORO License Class : License Number: _ Map Index: Date: Contractor: Description: deck (455) OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' Slate License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: ROTH BOB & JENNIFER permit to construct, alter, improve, demolish, or repair any structure, prior 3365 APOLLO CI R 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 ROSEVILLE,.CA the Contractor's State License Law (Chapter 9 commencing with Section 95661-3965 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 1, as owner of the property, or my employees wilh.wages as their sole compensation, will do the work, and -the- structure Is not ROTH, ROBERT AND JENNIFER intended or offered for sale (Sec. 7044, Business and Professions Applicant: Code: The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who does 1801 EUREKA RD #23 such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for ROSEVILLE, CA sale. If however, the building or improvements are sold within one 95661 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 916-772-1376 sale.). ❑ 1, as owner of the property, am excluslvely 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, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contra ctors' Stale License Law.). ❑ 1 am Exempt under Article 3 of the Busi ss and Professions Code Date•' 3 Owner' License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ t 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: ❑ 1 have and will maintain workers' compensation insurance, as Engineer: 9 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: 455 S.F. Policy fE: Valuation: $4,550:00 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. C '— d Date: +' Applicant.�- WARNING: Failure to secure workers' compensation coverage is shall subject an employer to criminal penalties and one 4179v unlawful, and hundred thousand dollars (8100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. b -I 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�ctedfor which fees have been paid. � 5 performance of the work for which this permit is issued (Sec 3097 Clv.) Date: ") Name: By. ( 05 PERMIT EXPIRES ON: Address: Date O 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials..: ❑'• Notification In accordance with Section 11)827.5 of California Health & Safely 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 owner or the duly authorized agent of the owner. I agree to comply with 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 .all 2uthorize representatives of Butte Co t to enter upo the above mentioned property for Inspection purposes. ` Print Na/me: 1/3 Signature: Date: Cv . — 'n Owner ❑ Contractor 0 Agent for Owner 0 Agent for Contractor COUNTY OF !BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1 7 County Center Drive - Oroville, CA - (530) 538-7541 ; CORRECTION NOTICE BOTH ns -17_70 OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. t s PRO0106 S-rAlZ HAniDGRIP S �� ( Rot�r0F kpIc.S �4T L/ MA -X S 4E '► v Date Inspector &AZ4H p . n„ REV 4/05 Phone # .S39' —� O 2_7 - a FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 ,. SITE PLAN REVIEW APPLICATION Date: %�/2 /6 AP# �� _/_70 ` G� Permit Number (if applicable) d y 3 3ieZ - /� y - 33 APPLICANT INFORMATIO,4V Parcel Size: Owners Name: Ara Owners Address: P o et4 0 el+ 9 _-rz 6 Telephone No:: / r ' 77.2- —137(o Situs Address: X02 l dvt 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 0 _ 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) u IN Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval IM Site Plan Stamped Approved' By aiL Date�- 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) ® Expansive Soils (Test for expansive soils and if verified proper foundation design required)/Lt) SRA - (CDF to determine specific requirements) v ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: i • Flood Panel No.: Q p4 C 0 $'•2-$C, Index Date: (Q ❑ Sacramento River Reclamation District (Approval must be obtained from the C ifornia Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ❑ Detached Building Use Form ❑ Encroachment -Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: kT— GP-j)2 Applicable Building Setbacks: Front Side Zoning Code .2D ► Streets & Highways Fire Prevention Subdivision Map Side Street Rear 5 3o , 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 4 ❑ Fire r ' ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ Other A Amount Formula --------------------------- ------------------------------------------------------------------------------------------- Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By ❑ Deeds: 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 Comments: ❑ 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 Map: 9�Q Map Date of Recording: Lot: Book: 0 Page: 15— ❑F1 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 Page 4 of 5 4j ❑ a W 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. CALarrys\Building Permit Site Plan Reviewl.doc Page 5 of 5 No DELTA RADIUS LENGTH m rr � w• esr sa.00• mm ..moa eek m m•ad ee• � m•aa 'ld ae'n• ee od mad al ze'esI goad M.m' -4d aam' b• w'm' ,e• sawed 9 OTeOfY 0».00 �o1e• s b 1ea0N � e' +d 4eeo.ad 11.00' boa' ate•' edn "o• o.oa ,o.ad ee.ie e+"m• vend weed NOT e�..a A PART •ape. .r ."T � _{y '. ` OUDoiv� �-- b - $ ivy 6 eo 8 silo as o $ia $ g 8 `$o _ o =$ g gaiCT'p se �• a�3 K� s., �`--------- ..59 pGREpGES PAF e lOn ® Tcv va dT� R F KELLY RIDGE ESTATES unit one Southern California Financial Coxpore tion sled Au too County Title Company Truetea u der recorded Deed of Treat, os owners o4 the land, ndh included within "Kelly Ridge Eateta' Unit One^ a shown with - 'n the colored border line an the anne zed map, do hereby certify that we a the persona whoa c r. ant ie ne....:ry to pea. cleat title to said land and we consent to the prepare tion and r....detion of said map es shown wi thinthecolored border linen. Those plr- tions of L.dgevlew give, Silver Leel Drive, Krietee Plate, Green- brier Drive, Chaparral Drive end Hil'.rest Avenue ae ehovn within the colored border lino. o aid ma ere hereby offered far dedica- tion for public u e for co my readopulp...a end for instelloiion and me intaine nce of Public uUtility lines. We also offer for dedica- tion, and do hereby do III Cate far .pec ific purp...8, the following: (A) Fights of way .red e..e ante for water, gas, sewer, drainage pipe., and undvrground,wi rev for electr ie ar,d tal.phana aez- ' together with any and ail eopurtano nese appertaining thereto, on, ov r end under those atripa 4 land deo igne ted "PUBLIC UTILITYeEASEMENT". (B) EA-emanty for lig ht e d air over those -trips of lend lying between the frpnt end/ar ei deliree of lots end thea. lines thereon des igne ted 'SET SACK LINE". Said -trip. to be kept open and free of building.. (C) Hight% of way and ne ante of dza in age pipes end .they dr.in- ege ways together with any old eli nppurtenancea appertaining thereto, on over and under those strip. of land de-igneted "DRAINAGE EASEMENTS". (D) Ee-amen[. for e. rth .lopes, u ergrcund w s and conduit' far alartric and tale ph.,a wetez'oa.— and gas a [ together with any end .11 eppuri.n—, thereto on, over nndeunder strip. of land eight (e) feet i width within the lots and contiguous to any ntreat or other oublie we y, togoth.r with the right t - trio; or remove the neceAsary trees, tree limbs or brush. (E) Fight. -.f -o y and —scants for water, gas, sewer, drainage t. as n ddt. tear r nage ys, and dergroundww r e for let- pnon% a vice-, togathvr with any end ellappur- tenar. e. ta'n' g thereto. cn, over and under ell of Parcels A, B. C and E as ah—. (F) Reaervatitn prohibiting vehicular in rasa end/or agrees o and .c a these -tripa -'!and abutti a ng Ko lly over Ridge Read andceeig- neted ^NO AC CE 55 STRI P'�, PSUTTE COUNTY TITLE COMPANY amL m. (Officer) 1 ---_t (Cfficer) S;ftc v SOtJTUERN CALIFORNIA FINANCIAL CORPORATION Std to of California ) I County of On Yo Debt ie, in an for dfa:e nty, $pate yr persona llr pGee �Gc-d(-0�(J a to 6a theorpare- tion thatma ted the within instrument, end oleo known ntocme to ba the p_.On whoue xecu ted it on behalf of such corporation and ecknowl- rdgad:tq.e ..tb.L•svo xp.rntion e?71.y d the e. a.c. beaaaaa woo.. env w �� blit My Commission "pi lea ^a ryAwrAeavl,wwr h5 Cenvnlumn [metre Jew 2 Int St. to of [e 'tor ) , Count /eJ n 197f9 for .b `'r ' 1 to Puhlic, in and 4or O It y, t". 9a o v parsons eppee a6•/ kno to me to ba th of the co po ti o. that a acutatl th wl th in ins creme ., end slat known to be the per.bn who a toted it an behalf such corporation and acknowl- .eCg4,{I, xsuch corporation eze ut the �1 V !Vary PaYl[Tk UXX Naa^J K_ CommiAAior. 0xa3rea IC- "T �•1, //7/. lar cmn^mla fmk.. Jou rs. V— State of California ) e County A of On OEC, % 1970, afore nown�N tory Public, in andfarCo nty, to bapthv Y lly ap a/ of the corpozs- tion that a etuted the within instrument, and elan known to me to be the para on who executed it on behalf of ouch corporation and ackn..I_ edged two that...o'.1, corporatio eutvd the sem I M YIRfAtdq L}t105EY. i' e . Cau h Bulla otaiy Public Of State of California ) County of (/PAI '/ / On t 7 1970, of me „ �a l�ezyo Public, in and for e f my St L pez.nenI�y eppee red known t e tc 6a the sSFG JPG///Y of tneoeorppre- tion 'that -e etuted the withi r. ins tzum n end slop known tO ca to 6e the person who exe ted it an behalf of •s uch co rporotion and acknowl- edged to ee that ouch corporation a ec ted the some. IA. VIRGIMA U-- u' S`laiD^1 dYae GG No ry Public Hy Ccmmiavxon expirer�VA/E AQ/ 471 I, Dan J. Cook, hazahy certify that I a e Rey ie to red Civil Engineer of the Ste to of California; that tr a rad map of Ka13y Ridge Catatea Unit Or.e c eptly r.prea. nt. a vey mad. under my super- tn t_ o+-w_�aQ 1970; that the survey i amp late a shown; that 'h. a omenta shown thereon a int end era of t11 character and eecupyn thaopasitionn irdice tad andxe re suffic'.r.t to %nab la th. s1r- v to be retraced. Dan J. CookR�C.E. 130 2 I, Albert J. Walsh, Director of Planning, of the Planning Commission of the [aunty of Putts, 5te to of Cal ifs rnie, do hereby certify that the annexed final map of Kelly Ridge Estates Unit One co 1—a sub- nntially with the subdivision design he.o Snee Tentative Nap• U was npp—ad by this Comm isaior. on the n /` day of f •U, 1970. Alba t J. Welsh Director of Planning 1, Clay Ce-tleberry, Director of Public Work. of the County of Botta, stat. of calif-rnie, da hereby certify chat 1 nese examinee the rival rap of Kelly Ridge Estate. Unit Ona and that it da sub a ten tin lly the e shot eppee ze on the Tentative 11.o on file and any approved oltecatians; that .11 the px.v i -ions of the Subdivision Map Act of the State of California and Any l.... ..di.... as applicable at the time of approv.l of said Teta tive Map has been complied with and i ea eetisf cad that the map is te.hh�..11y c ec t. C ey tleborry H. .E. 14224 1, F. H. S..ly, Jr., Auditor of the C.unty of Butte, State of California, do hereby certify the there are no tax liens age inet Kelly Ridge E.tatae Unit On. as horaon eat forth or unpaid Ste ter County, Nunicipal, or local ac a.l t-xa9, r spec int eases en t- not yet peyeble. Is— a ase a which re lie but not yet payable, .e/. timate/t. be or theaemaurt of ja.J Jo ,f By: _ 1.,._affi. ll �4 A21 Count A 'tur Id hereby uertify that on the .2a -day of 0�g, 1970, the Butte County Board of Supervisor' officially approved the Sub- division Map of Kelly Ridge Eatetes Unit '**Tpf tie- fectory security Sn the Puditor'e e.timated a..unl of 3. S2 L. OA to insure payment of t..'u which ere alien but not yet peye6la w acknowledged. Lodgeview Or iva, Silver la of Drive, Kristee Ple ce,.. Groenb.i.r Drive, Chaparral Drive and Hillcrest Avenue, shown on aid map and offered fez dedication are accepted on behalf of the public for road purpo. e.. By: Recorded in the office of the Recorder f Butte L'ou ty, State of Celifo[n Sa, at the eq• eat of ii._ �� L once 3e � day of yam, 1v,0, a: �[L :notes Raa '/.1� o'clock �.M„ in Map 900: .1D at page J-L__1. 1_in Recorder Number /0.170S Louis. Kluendo, �UBOIV1910N NC KELLY RIDGE ESTAIs TES unit -,.-one BEINO A PORTtOPL OF TNB EAST YZ OF SECTION 12 AND TUE, EAST k OF 'SUCTION I. T. 19 N., R.4E. M.C114. BUTTE COUNTY,CALIFORNIA OWNeR ANO BUbOIVIOeR1 Shu-FHeRN CAL-IF02NIA FINANCIAL -CORPORATION 9250 WIL45NIR.6 BLV O. FjEVERLY N I LLS CALIFORNIA �4COO ASSOCIATES ENGINEERING CONSULTANTS OROVILLECALIFORNIA 6J5ET 1 OF o 5:1 c_T6 n PLAN REVISION/RETURN Owner's Name: AP#: o6q j -;,6- b BP#: Received By: Date: Time: Contact Person & Phone Number: LQ ?�6 ' (D 56 (J PURPOSE OF RE -SUBMITTAL OR REVISION ❑ Permit Application Data Sheet Item * ❑ *Engineering \ / * 1 Plan Revision ❑ *Requested by Building Inspector's Correcti`n,Notlt = I p tor's e: ❑ Requested by Plan's Examiner —Plan Examin *� e. ❑ Other: If revising a plan which has already been issued, submit two ) dr w-1 -r fl ti` "g� e revision ! TON\, for plan review along with your approved plans. If engineering is v 1. ed 'n this r' isiY61 engineer must put his requirements on these drawings an&,wet stamp ` A a , i �` engineered drawings. Revised drawings must clearly show changesa d ocations involved. WHEN APPROVED, PROCESS AS FOLLOWS: ❑ Mail to Owner/Contractor at this address: ❑ Call and hold for pick-up. o Deliver with next inspection. Minimum revised plan check fee to be collected at time of submission of revision, plans examiner will determine if additional plan checking fees areneeded: Minimum $54.99 Receipt #: J ❑ Fee not required for revisions requested by plans examiner prior to issuance of permit. ❑ Additional Fee ou Receipt #: Revised 2/04 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. BP05129,0 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 Issued Date: 06/03/2005 APN: 069-130-018-000 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. Site Address: 521 SILVER LEAF DR ORO License Class License Number: : Map Index: ; Date: contractor: Description: deck (455) OWNER -BUILDER DECLARATION •• I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: ROTH BOB & JENNIFER permit to construct, alter, improve, demolish, or repair any structure, prior 3365 APOLLO CI R 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 ROSEVILLE, CA the Contractor's State License Law (Chapter 9 commencing with Section 95661-3965 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).): GLI, 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 Applicant: ROTH, ROBERT AND JENNIFER Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does 1801 EUREKA RD #23 such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for ROSEVILLE, CA sale. If however, the building or Improvements are sold within one 95661 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 916-772-1376 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, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). O 1 am Exempt under Article 3 of the Busf ss and Professions Code Date4./ 0 >-- Own r* WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: O 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. Architect: ❑ 1 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: 455 S.F. Policy #: Valuation: $4,550.00 1 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. CP r 6 S� Date: Applicant. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and one b hundred thousand dollars ($100,000), In addition to the cost of compensation, damages as provided for in Section 3708 of the Labor code, interest, and attorney's fees. r 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 w c ted ab a for which fees have been paid. performance of the work for which this permit is Issued (Sec 3097 Civ.) Name: By: Dale. PERMIT EXPIRES ON: Address: 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. O', Notification In accordance with Section 18827.5 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 owner or the duly authorized agent of the owner. I agree to comply with .all county and slate 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 rep`resent�ati�ves of Butte CoUnty Countyto enter upo the above mentioned property for Inspection purposes. g Print Name: /' D (� Signature: Dale: /15�wner 0 Contractor 0 Agent for Owner ❑ Agent for Contractor i BUTTE COUNTY PERNUT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891.2834 BP 05 � — OFFICE #: (530) 538-7541 BIN # A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" Name Address / / �L/CANT NAME OWNER Last Name /y irst Name Address , p /C City Phone State Zip Fax E -ail _11 Name Address / / �L/CANT NAME CONTRACTOR Name /y Address 67 City (V ate Zip Phone i ,/ E-mail r— F Lir' `�a°'tic ^ ass Name Address / / �L/CANT NAME Name y � Address City o . /,�,j Z P 10 Phone�3�/ 7 ``77 +Fa E-mail F office use only: Zoning Flood Zone SRA I (Yes4 No Occ Type Const. Subdivision Name Map Book I Page Lot # Planner Date Approved: LOCATION /,, AP# a(U " Property Address g✓/ City Cross Street WORKERt COMPENSATION Policy Number ®l Carrier r 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 OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Description or Scope of Work: 5-5- Sq. Footage Structure Built without Permits O 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: y� i Receipt P J ` V "I Date: (Amount:Bldg SRA Sheriff SMIP REV 7-27-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: l �� �r / �/I,v, ASSESSOR PARCEL NUMBER Proposed Building Use: V (.:. `��� Permit Technician: � Date: \ Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. IfN 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. / U1� 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. 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............................................................................................ ❑ 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... 19. Erosion Control Plan Required........................................................................ 20. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 21. City of Chico Plumbing permit........................................................................ ❑ 22. Site plan and business license approval from the City of Biggs .............................. \ O- 23. California Department of Forestry Ian approval ❑ paid. Sent by: 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check:.... Sloe ❑ 25. Contact Land Development about _ Improvements, _ Drainage ........................ __-0 //� 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.................................................................... q 32. Recorded copy of Agricultural Acknowledgment Statement ................................. -D 33. Existing violations and/or expired permits......................................................... t734. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone %Zr�% 491'0 5-3 V -76 7t'�nd hold for pickup. OYt 60 I have been informed of the abo ite and requirements for obtaining a building permit. Applicant: Date: -Of 1. Index petit application fora e alawe items numbe•r , Plan Check Letter tems required C_/ designer, owner, was advised oft above data by phone, ❑ mail, ❑ counter, by Aa Date: Contractor, designer, owner, was "advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division ON- A * ­ r"�,l ukxxsa aorta xo+.v,.. r reseCarar akvr ss Y fix. . Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is.received. 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: YES ru"- NO [ ]. 2. I HAVE [x] HAVE NOT [ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: DATE: e" -- p e --- NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department of Development Services ADMINISTRATION * BUILDING * GIS * PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. X Micltiel C. Vieir4 C.B.O. Mailager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. Q ?pSTMENV , 0& �vTTF 0 �i, 0 o ��a 1 0 < 5 AUC WC�� Department C o u n t J. Michael Crump, Director of Public o f B u t t Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville. CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge 'Elimination System (NPDES) Phase ll Construction Storm Water Permit and Storm Water Pollution. Prevention Plan (SWPPP) Acknowledgement ILESS THAN 9 ACRE.1 Project Description: JD Project Location and/or Parcel Number: �(p • / y ' �� 1�- 2% By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: Date: Less than l Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 IQ ?WTMENT 0,o �6VTTF 0 ` �/� o 0 0 1 0 J < \ O O Ac�UNI 19 �tic WORD Department C o u n t y J. Michael Crump, Director of Public Works o f B u t t e LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution. Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE1 Project Description: Project Location and/or Parcel Number: By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. V Signed: Title: Date: Less than I Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 COUNTY OF BUTTE 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.buftecounty.net/dds OWNER A:P. # PROPROSED BUILDING USE LMC ryJ , DATE RECEIPT # DATE REC. IB�BUILDING PERMIT FEES p --- Balance Due ..................... $ --- FEMA Flood elevation review ... $ --- Additional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... X $0.03 = $_ Sq.Ftg. 4. RECREATION DISTRICT FEES (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 # .00 (paid at Building( Division) �( SMIP :70 9. OTHER 10. OTHER 11. OTHER At time of permit application, I was advised th above fees are required to be paid prior to issuance of the permit. These fees may be changed t g the plan chec ' g pr ss. APPLICAN DATE 5 e Pursuant to Go mment Code Section 020, yo are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your proj-ct. You have 90 days rom the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 3/05) ; )Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX HANDRAIL DETAIL HANDOUT Nailing shall comply with Table 23 -II -13-1. Minimum underfloor clearances from finish grade to wood joists is 18";.(UBC 2306.3) and minimum 12" from the finish grade to wood girders or treated wood is required. Minimum concrete compressive strength shall be 2,500 psi at 28 days. (UBC 1922.2.4) Stairs serving 3000 sq.ft.and greater, risers shall be 7" max and treads 11" min. The dimension difference between the smallest and largest tread run or riser height within any flight of stairs can not exceed 3/8" (UBC 1003.3.3.3.3) Stair stringers shall be anchored to primary structure. Toenails subject to withdraw are not acceptable anchors (2320.13). 3-1/2 1-tla • 3-1/2 • Max ro Mai 1-12 • Min. 2-1r2 4" Max. Intermediate rails 4" Max. spacing shall prevent the passage of a 4" 3-t2 Max. 36" Min. diameter sphere. 1.11x- • a,2 4• Max. HANDRAILS --�'� 1 .12 • Min. Top of 4" Max. Top of Deck W Handrail Joist ® height 34"-38" Anchor stair T )0 stringers to the 4"- 8"Min- Not Acceptable primary structure with an approved 4 x 4 post min. joist hanger and 9"Min screws, lags, M.B. Min. clear width I •• Girder at stairs shall Pier posts greater 6'Max be 36" than 3 feet in height need to be diagonally IPosttMin. 2 - 1/2" braced between dia. thru posts. An approved post cap connection or connect girder & post with 1/2" plywd bolts required gussett & 3 - 16d nails top & bottom 4 - 16d nails or an approved 3- 2 x 12 i py� ensure post base 6" Min. Stringers dwi * alate connection , If using i precast piers, 8" Min. embedment i� wet set`]. 12 x 12 footing A Tac r stringer to precast pier sill plate with into concrete footing. angle clip TYPICAL PIER FOOTING Handrail 1997 U3C.xls Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX GUARDRAIL DETAIL HANDOUT Nailing shall comply with Table UBC 23 -II -B-1. Lumber shall be at Ieast.Douglas Fir #2 or better (D.F. #2).. Minimum concrete compressive strength shall be 2,500 psi at 28 days. (UBC 1922.2.4) Minimum underfloor clearances from finish grade to wood joists is 18'; (UBC 2306.3) and minimum 12" from the finish grade to wood girders or treated wood js required. No wood shall be placed closer than 6" to earth unless it is foundation grade or pressure treated. (UBC 2320.13) 4- Max] . TM4-36" Min. m Top of ZE V= Deck SIDE VIEW Min. 2x pressure treated ledger Min.2-3/8"z" • lag bolts or screws. —� .ri . TYPICAL LEDGER If the deck/porch is 30" Pier posts greater or greater above the than 3 feet in height finish grade a guardrail is need to be diagonally required. braced between post 4 -.16d nails or an approved post base connection If using precast piers, wet set precast pier into concrete footing Guardrail 1997 UBC.xIs Min. 4 x 4 post @ 5'- 0" o.c. Intermediate rails spacing shall prevent the passage of a 4" diameter sphere. 4' Max. Top of 3/4" cleararfce Joist to the edge of -- �he wood member joist Min. 2 - 1/2" dia. thru bolts required GUARDRAIL An approved post cap connection Girder or connect girder and post with s lul 1/2" plywd gussett Post and 3 - 16d nails = �!�� & bottom All", nAFTWO 12" x 12" Footing I 8" Min. embedment TYPICAL PIER FOOTING y l a ji �4 cow- Af? 1�05T 00, i rJ TU1� t 7, �f So u`r� tY ACU", t ppV. ENCROACHMEN 1l PERMIT County of Butte Department of Public Works 7 Count Center Drive Orovilic, CA 95965 Phone (530) 538-7157 Fxt 2016 Fax: (530) 5394356 Download Fonns: www.butterounty.nct/ptiblieworks/forms.htmi NOTIFY COUNTY 7.4 HOURS BEFORE WORK 1S TO BE DONE Permir Phone (530) 538-7157 Ext. 2016 APPLICKHON District /.�— y I WE, the undersigned, bereby apply to the County of Butte for an encroachment permit to do the following work under or over the County roads 1d hi ways, all in accordance wilt County ordinances and general laws All information cxq: t si ttaturc muni be tined or legibly printed.)..,._ Applicant's Name �- -71-a' Company Nan1c: R t9TFF R � �.T � SEN t.l ► F_ �. Address: �— ALA 1 t_ A- D71Z ES 5aI SiU/1✓121..Eft F � a ov1 t_t.i=�(ff✓-1 _3mg,�7APOL-W Cllzct_ Phon �4_AAMor'sParcclNurn RE-d1Lt,C- 956& C11 (p ) '7 -79L - f -S 710 _ ��_q l'�a__ c� 18— Lootion of Work to be Dom: — 541 Df?-�)2ov►�LC _--........_ Applicant's Sigaat —�-- 7. Date: i 5 06-7 044 •� w t onEractor s 2. Contractor's LictnseNuml9W_. 5. Authorized Agcnt , CTOR'S INFORMATION I _ Fax:�- r� i3.CutifiwteofInsurance: Yes U No: ❑ 14a. Date Signed: -- TYPE OF WORK TO BE DONE 6. Mw (.'heck:17. if veway List Type: Curb: ❑ G_r utter: ❑ Sidewalk: ❑ u� DriCO NGe-15TC X. Otho Work -Describe 19. I'laus Anached: . _ O Yes No PERMIT GRANTED _ a compliance with the above roquest, and subjmt to a0 terms, conditions (including those oa page 2 ofthis permit form) and d=ial conditions -mitten below, -emission is.btnby granted. -- O. Conditioas j0daground Service Alert LVS.AQ must be notified two wAiftf prior to arty atwyation. I:00-227-2600 :1. O All work shall conform to accompanying: Dactil ❑ Plans ❑ Special Conditions U Date Paid.l�_l 24. surety: o zo viike Crump, Diractor of Public Works By: 29. Final Inspcclion Date:30. Inspected 3Iy: U Completed - OK ❑ Completed -Not OK O Additional Comments Attached Use oalT 31. Comments: r Totc IIf pettnits arc faxed to any number bcsidu (530) 538.4356, they can be delayed up to one week. - -- — - -- page 1 of 2 J -d TLTL-8ES (Deg) sAjoM otTgnd F%un03 az1na dSTtai �,0 80 '400 lRAINAGE RECOMMENDATIONSfiK .. _ NONE � � �� � � MAX. 1 FOOT VERT. RISE 'OR DROP • CULVERT PER 10 FEET HORIZ. ATI O N: DATE /�� EDGE OF EXISTING PAVEMENT . MIN. DEPTH TO FT. ems i (EP) EXIST. DIST. MIN. ;EMAN: MIN. DISTANCE: DIST. I O OTHER (EXPLAIN)j,_ ` 290 rRIG T. z:� MIN. DEPTH_ MAX 109; NOTE. ►MITA: R PAVEMENT TO EXTEND �s. R AT 27. CROSS SLOPE �5 OR MATCH EXISTING " :ED WAIT OF ROADWAY NT.& PRIVATE FIELD RIVEWAY LOCATION: 3� .DRIVEWAY TANCE TO NEAREST INTERSECTION. z z -' 12' MIN. ["'��AREA ' IHT DISTANCE 2f MAX, TO 8E G000 _ N POOR PAVED = POOR - RECOMMENDATION TO IMPROVE: RAW CUT BANK ] REMOVE VEGETATION (TEMPORARY) 3 OTHER (EXPLAIN) 4 10' MIN, ,, . )JACENT TOPO D FLAT - O CUT SLOPE FT. ' FILL SLOPE As -,- 9 FT. K' O CURB AND GUTTER AC DIKE _ NOTE: ❑ EXIST. DIST. I TO EP FT, "IF GREATER THAN 107. UP' OR DOWN REFER TO ENGINEERING. lRAINAGE RECOMMENDATIONSfiK .. _ NONE 0 SwALE MAX. 1 FOOT VERT. RISE 'OR DROP • CULVERT PER 10 FEET HORIZ. DISTANCE . , FT MIN. DIST., MIN. DEPTH TO FT. EP DIAMETER IN. EXIST. DIST. MIN. LENGTH FT. DIST. I O OTHER (EXPLAIN)j,_ ` 290 z:� MIN. DEPTH_ MAX 109; NOTE. PAVEMENT TO EXTEND AT 27. CROSS SLOPE OR MATCH EXISTING " ROADWAY CROSS SLOPE. NT.& PRIVATE FIELD REVIEW • �j •Q� .DRIVEWAY • F ENCROACHMENT PER. IT County of Butte Department of Public Works— 7 Count Center Drive Oroville, CA 95965 Phone (530) 538-7157 Ext 2016 Fax: (530) 538=4356 Download Forms: www.buttecounty.net/publicworks/forms.html NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE Permit Number District Phone (530) 538-7157 Ext 2016 APPLICATION I WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the County roads td highways, all in 0scordance with County ordinances and general laws. (All information except signature must be typed or legibly rinted Applicant's Name: ., la. Company Name.- ame:Address: Address: 4. Assessor's Parcel Number. Phone Location of Work to be Done Applicant's Signature 7. Date: CONTRACTOR'S INFORMATION Contractor's Name' Address L 3. Phone: 11. Fare SM a _ ) _ C.Q f„ — � �J Y� Z. Contractors License Number. 13. Certificate of Insurance: Yes No: ❑ 4. Contractor's 14a. Date Signed: ��LL V 5. Authorized Agent 6. TYPE OF WORK TO BE DONE Please Checic17. ]f Driveway Curb: ❑ Gutter: ❑ Sidewalk: ❑ Other Work - Describe 19. Plans Attach, List 1 ype: O Yes ❑ No PERMIT GRANTED i compliance with the above request, and subject to all terms, conditions (mcluding those on page 2 of this permit form) and special conditions written below, ermission is h ted 0. Conditions Jnderground Service Alert .SA must be notified two workin da rior to any excavation. 80D-227-2600 1. ❑ All work shall conform to accompanying: Detail O Plans ❑ Special Conditions ❑ =Datesucd 23. Expiration Date 24. Surety , 26. Amount Paid: 27. Paid By: 28. Receipt No.: S. Date Paid: / dike Crump, Director of Public Works By: 29. Final Inspection Date==It ❑ mpleted ❑ Completed —Not OK O Additional Comments Attached :o� coaory Use onir. 31. Comments: tote: If ocrmits ate faxed to any numbs besides (530) 5384356, they can be delayed up to one week. STATE OF CALIFORNIA BUSINESS, TRANSPORTATION AND HOUSING AGENCY Mra DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT r DIVISION OF CODES AND STANDARDS REGISTRATION AND TITLING PROGRAM`"'hDF'� . STATEMENT OF FACTS This unit is a: 0.1mobilehome 0 Commercial Coach 0 Floating Home Truck Camper Decal (License) No.(s) Trade Name Serial No.(s) Y I/We, the undersigned, hereby state: I/We further agree to. indemnify and save harmless the Director of Housing and Community Development, State of California, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the above-described unit in California, or from issuance of a California certificate of title covering the same. I/We certify under penalty of perjury that the foregoing is true and correct. Executed on/0 /S�d Y at &:K- 41 � (Date) (City) Signature(s) Printed name(s) i;'' S ,,.) ./ Ty (State) Address -5 "_;2 City <>(j (// /A_ State �M II__ - / /T T.t711 /Al l BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds ,511p*c y3.3 00 PERMIT NO. BP043320 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: 12/29/2004 APN: 069-130-018-000 the Business and Professions Code, and my license is in full force and effect.( License Class: 1 Ci License Number: S 0 (O Site Address: 521 SILVER LEAF DR ORO Date: �2- �D"0 Contractor. ` A\ 7-- E "TAI 0E Map Index: Description: PRI DET GARAGE(400) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: ROTH BOB &JENNIFER permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 3365 APOLLO CIR signed statement that he or she is licensed pursuant to the provisions of ROSEVILLE, CA 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 95661-3965 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 Applicant: PAGE, TAYLOR Code: The Contractors' State License Law does not apply to an 16730 N HWY 101 owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, WILLITS, CA provided that such improvements are not intended or offered for 95470 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 707-459-7000 proving that he or she did not build or improve for the purpose of sale.). ❑ 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 Contractor: CONTEMPORARY CONSTRUCTION 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 16730 N HWY 101 95490 Date: Owner: 707-459-7000 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: License #: 806196 ❑ 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. Architect: 10, 1 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. 5TA'« FUNVD Total Square Ft: 400 S.F. (yrT y a 1 ( Policy#: Valuation: $9,600.00 ❑ 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. Date: 1 - Len E C b L4 PA Applicant: I, G #- E Q R- J. �? O 11 -1 - 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 un er the applicable provisions of the Butte County Coda and/or I hereby affirm that there is a construction lending agency for the Resolutions46do work indied bove for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) / A/ -CJS J Name: ey: Date: Address: PERMIT EXPIRES ON: Z— ( Date O I 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. 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 owner or the my 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 an officia or-docrmren f Butte County. 1 hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name:-rAILDP— PAGt T:CP— J'J1N1VrV `LRQB6RprRQ1H Signature: Date: ILP -D�C O4 ❑ Owner 0 Contractor Agent for Owner Agent for Contractor BUTTE COUNTY 0 '0 rF0 DEPARTMENT OF DEVELOPMENT SERVICES o C BUILDING PERMIT APPLICATION O AND SUBMITTAL REQUIREMENTS O 24 HOUR INSPECTIONM OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REO UIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" OWNER Name,CC 0TC�Y1 Pn P2AP_CdKSmUc.-Ti n Last Namen O Rng��, JEniutFER Address :5 3 (0 © L LO Cl jZ'C L_ City r� n Sr_- V I L L A State CA Zp q 5 ('6 1 Phone 1 �. 7 7 Z- Fax Fax E-mail Planner CONTRACTOR Name,CC 0TC�Y1 Pn P2AP_CdKSmUc.-Ti n Address i t0 -73L_? No.y ( b City V\) l L L 1-r 5 State C /9 Zp of cq 7 Phone•-7� 5q_700 Fax j 0%- q 5C - 5q2 S E-mail Uc. # 10101 p � Glass I APPLICANT NAME ARCHITECT/ENGINEER Name CdyOC2 t V � LUE Address Zp � �� City Fax State Zip Phone Book Fax E-mail Planner State Ucense Number APPLICANT NAME Name EOT41 R05MT4 J C_NP[F- Address -�_) 3 ('0,5 A 100 LL0 (K 0- CdyOC2 t V � LUE State C/ Zp � �� Phone �y j L --� -72_ 3_r `fit 1� Fax E-mail 1__--APPUICANT SIGNATURE P2 OT S For office use on y - Zoning Property Address 5o.I SlL_V RCAF D21VGQVtLLC- Flood Zone Cross Street D�0- VIEV✓ A(2,tVE SRA Yes No Occ. Type Const Subdivision Name Map Book Page Tot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERNIIT NO. BPOLl T BIN # LOCATION An O _ Property Address 5o.I SlL_V RCAF D21VGQVtLLC- City Cross Street D�0- VIEV✓ A(2,tVE WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a cdMcate of worker's compensation must be shown at the time ofpermit issuance. LENDING AGENCY Name Address Description or Scope of Work: f NST O N b r N Cw hed a 0' )< ao� Sq. Footage 10 ❑ Structure Built Othout 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 pennit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable Received b Amount S Oldg Receipt #: q I g ( Date: 1 1'11 Cw SRA Sheriff • D SMTP Other Total 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 LEGIBLEAND /N/NIC ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paperl ❑ 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 faxesl ❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. � 11. Detached Accessory Building Form filled out by the owner (if required). 12. Hazardous Material Form (for Commercial Buildings only). D 13. Sanitation and site plan approval from the Environmental Health Department. 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 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). :1 2. Impact Fees. 3 3. California Department of Forestry plan approval (if required). 1 4. NPDES Form. 7 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). :1 6. Contractor's license information. (Number, Name Style, Classification). 7 7. Worker's Compensation Carrier and Policy Number. 7 8. Owner -Builder Verification (if required). 3 9. Letter of Signature authorization (if required). 7 10. Recorded copy of Agricultural Acknowledgment Statement. 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). F you have questions or would like additional information regarding this process, contact a Permit 1pplication Assistant at (530)538-7541. EXPIRATION OF APPLICATION pplications for which a permit has not been issued will expire one year after date of application. In order to renew action n an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS efunds can only be made upon written request by the person who paid the fee. The request must be made within two ?ars from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits sued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan leck fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION FORMSSUILDING F0RMS\Bld9APPlSubRamts.doc pane 7 .,a )' ��/zz/ey c�-5 I Q�NL—'72 wi LL %2��T-v�lJ �i�`/'l.�-.r.iL�.l..2 .,� `..^�" �.vt1.^i„ir:y�.., f..+.--5-'rift •-i++'t. .!-'�+'kM� �•W"r��J•.'�` .. �� '� COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: �' w ASSESSOR PARCEL N4order l/ ! ' ^0 Proposed Building Use: Counter TechniciDate: D Items required in order -to pply for permit. All boxes MUST be checked OR marked Npply. �t�l 1. Siteplans 3�) 4 sets, signed by the preparer of the plans. 2. Complete ' p"(ans02r 4 sets, signed by the preparer of the plans. 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. 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. ❑ f 8. Manufactured homes: (A) Data sheets and installation inst, (B) 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 be stamped and wet -signed by en ineerand wet -signed by the en ineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs . Letter of intent for non-residential buildings 13. Detached Accessory Building Form filled out by the owner ❑k 14. Hazardous Material Form )VA 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ion Control Plan Required........................................................................ ........ 2 's as shown on the attached Schedule of Fees Due Sheet .............................. Tity�of 22. Chico Plumbing permit........................................................................ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. S t= r I • Z3 •d4 l� 24. Planning approval (A) Use: 61C (B)Parking: (C) Parcel Check: 2 d f ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form .............................. :............................... ...... ......................... 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... 4authorization 32. Letter of Signature ......................................:............................. 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ 35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: ma A Date: 1. Index permit app�or the above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, ow r as advised of the4aotab ❑ phone, ❑ mail, ❑ countebr, Date:Plans reviewed by: Date: Plans approved by: Date:Structural reviewed by: DateStructural approved by: Date: Note transfer by: Date: Yellow: Building Division 4. COUNTY OF BUTTE �vLJGi� DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES hhr,� f'� OWNER A.P. # V V� �w—O IV PROPROSED BUILDING USEDATE 11 v RECEIPT # DATE REC. 1. BUILDING PERMIT FEES --- Balance Due ..................... $ --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ _ Units Commercial (sq. ftg.)..... X $0.03 = $ _ Sq.Ftg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Ftg. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) 8. WATER TENDER FEES BATTALION # $200.00 (paid, at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... X = $ ,M Sq. Ftg. Amt. l0.OTHER At time of permit application, ��Asedgthfl)hove fees are required to be paid prior to issuance of the permit. may be changed during the plan checking process. APPLICANT DATE These fees Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) 08/17/2004 19:06 9167721376 JEN ae"; Uvjc+ ;je4--:JVj _1 CUSTOM HOMES WILLIIi' Ua"�__ To whom it Vlay ccrieern allow �.hc c.�a�wiitg pPo�f � to obt 4..in 5,T)y UP.rmits as day 2r..y tlGct-;3;axy fee;;, ZCT on Piv behai zzgardinci L'`l& instil la titin of a view mane , actuied home at rlie li.Stc-d Celow, Vhe follow3,n.9 pe,.�-p;,.e „itloSae .rnori,Z.e are: erri '.,barren, Kim Lebo, Taylor Page, Liz Har_. ft+�ort:�, :%u.a7e. Lawrence, Robir. Smit-^, and ►lartlr. 5ir,CGre �?, MR. // /�, customer Name^ site ._ty, 2Jk'p, and C:�-,,Jnty_ j PAGE 02 FIAGE' 07 ENCROACHMENT PERMIT County of Butte Ueral-tinent oi; .Public Works 7 Comfit Ccnicr Drivo OrovillC, CA 95965 Phone (534) 538-7157 Rxt, 2016 Fax: (530) 539.4356 Download Fonn5' wv^v.buttecounty,nct/publicworkJforms.html NOTIFY COUNTY :z4 BOURS B1sYOXF WORK IS TO BE DONE Phone {530) 538 ?1 S7 Ext.. 2016 )'ooze+ ma ilMf L]I$IfIC�� APPLICATION W, WE, the undersigned, hereby ap;rly to th¢ County of }Sudo (or an encroachment pconit to do the followint; wor7c Roder or over the Covnty ro ld5 Id h+ htvays, all in accordance with County ordinnncre and ,ener,l laws. A11 information execpt si nature mu41 be typed nr Ie;. ibly prinlrJ,) A licant's Name,: - `r pp (� co -r u P, F_ 12,T / AL_ A Di7>zE S AdJrw"s: CJ I L� EX L -E A' 1= T) P, !� O Y I I 1 L E Fl 3I�� In s ,4 J'� «o C+ r2_c t - '-- `- -0. As C•^^ot's Pnrccl T1umLcr; IZa Phon, ' cgIto ) 7-7 :;L - 1375 ' .... Lmalion�nT Vu,k to Lc Don.! V gM L_t—j— 12 l2 D V i LL r = ��-- T. Iantc, Applic:ult's tiitnatnr -~ -- ` ( - r!� ! �� (��� 0'4 2. Contractor's License 141nn1 ger: l,i. (>m ficatt ofhssvrance: Yes .❑ H6: ❑ 1. CunGBclor's $iEnature: Co N T�i-P 14a. Date Nipacd: 5. Authorized Agcnr. ^,-yp� OFWORK TO BE DONE 6, T^icn;e (1,ccx; ��.p 17. it Driveway List Type; Co G' ?`C Curb: 13 Gurtar: ❑ Sidewalk: ❑ _ x, usher Work- S7ucnAe: -- IA PlausAnhched ❑ Yes 'No PERMIT G RANTED n compharice with the above request, and subjcd to slt terms, cOndirlons (induding Ihms On page Z ofthis pertnit ftlml) and special wnditiuns mitten blow. .crmissiun is In.t6V grhnmcd. 0. Conditions lndcrgmund Suvicc Alan Ut.A). most Ix nnriLcd rwo w0rkin} days prior to any_etccwSlon, l bD•).77-7fiDD a. ❑ Ail work shall conform to accompanying: Detail El Plans ❑ Special Conditions U :2. Date lssucd 23. L't l,iratiun Date _ QJ z4, $urcty: 15. Date Paid_zA ��� iG. Amonut 1 aitl: ��� � + 13 Mike Crump, Uiroctor of Public Works By:"X_ff_(]70mpleted T4. Finslintpealon �ztc: 3U. Inspect d i;y: U Completed –Not OK T 0 Addithmal Comment; Atrachad um only: [)�I.f:nmmenL•:: — _ qute: IC permi% are faxed to any nurnbcr bc5incc (AO �3B•435G, they can Ire delayed up t0 Ono week. j'agc t of f T 'd TLTL-8cS (DES) S-.fjom of Tgnd R-4uno0 o•a,.na dST =ZT 00 80 '400 2 -Cl 99Et, 869 069 sA.aoM of ignd o0 a,4,4nH eBb sBO 40 62 "a i e JNROAC.L T PERM IT -'ount of Buttce T)e art>nel-tt of Public, Works...__ � y � 7 Count Center Drive Orovillc, CA 95065 Phone (530) 539-71S-1 Ext. 701 G l ax: (530) 53'8 -43.515__. - Download Forms:%,i%vw.buticcounty.net/publicworkrJforms.httul Itrrnit NumUcr District NOTTFY COUNTY 24 HOURS BL'1 OI Y- WORK 1S TO BE DANE / - Phone (530) 539-7157 Ext. 2016 t2 F WE, i.hc undersigned, Id highways, all in ya Applicant's N;,,ric: (✓T APPLICATION hereby apply to the County of PUtte for an encroachment pe nth. T trait to do the following work under or o'er ,tir,n except si 'nh ature must he tyLd or Ie CoMpany Name: Address: _ - 4-Assws(,e YareeiNlunUer Location of Vdotk, to he Donc Applicant's S;rnaturc -l::ontrattor's Na,nc .1'..J Address/ 1 ' ( 2, Contiaclnr': Liccn;eNumbcC d, 'onlr,Clor's 0 a S. Authorized Agrnr, 7. pate: CONTRACTOR'S TNFOR.MATTON ]-Fax; 13. Certifie;,ie of Insurance: rtes 14.( Da t,Signcd: TYPE OF WORK' TO B DONE Cllcet;: - 17. ]f Urivc�vay List Type: Curb: ❑' Gutter: ❑ Sidewalk.: ❑ Odic( Wark - County No: ❑ 19. Plans Attached: C] Yes 0 No Put RlWIT GRANTED those on pa I eomplianoe with Cie above rcque,t, and :object to all terms. conditions (ineludin. ge 7• of ihii permit iotTrt} ;u,d Spaial conditions writll ,t below, omission iS hcrebl' ranted. _ - h rr,nri �,;nnc ]oderl;round Scrviee Alen S.A must be 7,otifrcd two workin ,dray; prior 1D awn ,xe?vntlon. 80t) 7.27-2GOD ], ❑ All \�ork shall conform to accompanying: Detail d Plans D Special Conditiorl., O 23. Ft pirotipn Uatc; 24. Surety: 2- Dnr ssucd - 27. P")id.13y: 29. KecciptNo.. 5. Date Paid: 7-G,-+vnpunt P.::id: • %Mike Crurnp, Director of Public Work: Y2-ompplelea i9: final ]nspection fjalt _(D, ]nspcctcd B Q 0 Complclend - Not OK O Additional Comment; Attached _. n,..p.dy: 31, CnmmcnIs: ' _ . r-. _w rn nr...., mh r h,,,des (530) 536.1356, t1,cy can br, detayeJ up to one �T d 9SEb BES OES sAjo.M of Tgnd o0 •az,4nH eBb sBO b0 62 0aa ;AVON: REMAIN: --- iTRICT. R M IT=: DATE 110 / l r/ 4oq MIN_ DISTANCE: -I=EDLI?, IT OF' ROADWAY -� DRIVEWAY LOCATION: 3� STANCE TO NEAREST INTERSECTION: :GHT DISTANCE k" GOOD - D POOR IF POOR - RECOMMENDATION TO IMPROVE: p CUT BANK O REMOVE VEGETATION (TEMPORARY) [] OILER (EXPLAIN) ADJACENT TOPO O FLAT 0 CUT SLOPE FT. FILL SLOPE r O FT. O CURS AND GUTTER k AC DIKE 0 EXIST, DIST, � TO EP F?• EDGE OF EXISTING PAVEMENT (EP) z c� z __j 1 12- MIN, 2q' MAX- 1S� R \AREA TO BE --PAVED R/W 10' MIN. • .NOTE: TF GREATER THAN 107 UP- OR DOWN REFER TO ENGINEERING. b �l DRAINAGE RECOMMENDATIONS. NONE a swALE MAx i FOOT VERT. �- RISE 'OR DROP O CULVERT PER 10 FEET HORIZ. DISTANCE • MIN. DIST. FT., , MIN, DEPTH TO FT. EP DIAMETER _ IN. I EXIST. DIST-MIN.'_ j LENGTH FT. DIST, O 0t -HER (EXPLAIN) L? -o 2� ` i Mqx 107 MIN. DEPTH NOTE:. PAVEMENT TO EXTEND AT 2% CROSS SLOPE OR MATCH EXISTING ROADWAY CROSS SLOPE. 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ADJACENT PARCELS NAA eir nm M L- T-2AI/ile.1ce, - 4 1- Zoning.. * I Address / Phone No. lite Location contact: _Name 99b General Plan Desig: Size, Abres 4.00" S11 -t (A ZONING: GEN PLAN: USES: / ' SITE PLAN ............................................... ,a8 ........... :...... :..... ...... :............ :...... :...... :............ .. x`11.:.. , 1C. .. :. .. .. .. .. ............ .. .....<......;.......... ........ .. .. . y................ .. .. .. ....... ........ ............._....----......:........:.........:�- __ _ ................... ..... _... ya:� --_...:.. _ ..... Sj ................................_ .. _ .. _ ... ........_.: ............... .... .. .... z : : :.....:...... :...... :.....:...... ..... ......:......:...... :.....:...... :..... l A .;'.iVifV u luiSi d- BU L O O P..LAN APPROV L ...... .....:...... ... ....................... _ se: v :.. . 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