HomeMy WebLinkAbout069-190-022Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Facsimile
www.buttecounty.net/dds
ADMINISTRATION * BUILDING * PLANNING
7/10/2006
Gail Snow
P.O. Box 5001
Marysville, CA 95901
RE: Permit No. 04-3523 APN#069-190-022 Owner: same
On 12/15/2004, a deposit was made in the amount of $1,700.00, of which $1,645.01 was
retained. Please sign, date, and return the enclosed claim form to this office. Once we
receive the claim form, we will then process your refund in the amount of $54.99.
Should you have any questions, please contact this office Monday through Friday, 8:00
a.m. to 4:00 p.m., at 538-7601.
Sincerely,
Diane Lewellen
Account Clerk, Senior
Administrative Division
enclosure
04-3523.1tr
County of Butte
Oroville, California
GENERAL CLAIM
CLAIMANT: Gail Snow
ADDRESS: PO BOX 5001
CITY & STATE: Marysville CA 95901
DATF nF CLAIM• 07/10/06
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY
AMOUNT
Refund Claim - See attached calculation sheet APN: 069-190-022
Permit No.: 04-3523
PAID
RETAINED
REFUND
Develo ment Services
$ 1,605.00
$ 1,550.01
$ 54.99
THERM DRNG
$ -
$ -
$ -
SMIP
$ -
$ -
$ -
-
SHR
$ -
$ -
$ -
SRA
$ 95.00
$ 95.00
$ -
TOTAL
$ 1,700.00
$ 1,645.01
$ 54.99
>....
:: >:Bi-EAKDOVG!1V :: :: >:::
SCJDG T"
-AC.CEiI NW.—
:AMOUL�tI>
101001 DVLPMNT SVC
440-001
4210500
$ 54.99
1011822 THERM DRNG
1800
280
$ -
1011430 SMIP
1001
280
$ -
1011811 SHR
1800
280
$ -
101001 SRAI
01001
4617240
$ -
TOTAL
1
$ 54.99
$ 54.99
1, Ine unaersigneo, aeclare unaer penalty or penury inar me services or articles claimed nave been performed or delivered, and that this
claim is true and correct as stated.
Dated this day of , 2006, at Calif.
Signature of Claimant
I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or
delivered and that there is a Budget Appropriation or Specific Board Approval (Check one) for the same.
Dated this day of , 2006, at Oroville Calif.
Department Head or Authorized Deputy
Dept. SEE Exp.
Code BREAKDOWN Code PAYABLE FROM FUND
UV RU 1 YYRI I C 6CLUYY 11110 LInIC - AUUI I UKJ USC UNLT
EPT 8 SUB PROJ SUB. OBJ I CLAIM NO. I INV NO. I INV. DATE I ENCUMB. GROSS AMT.
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Facsimile
www.buttecountV.net/dds
ADMINISTRATION * BUILDING * PLANNING
6/19/2006
Gail Snow
179 Kokanee
Oroville, CA 95966
RE: Permit No. 04-3523 APN#069-190-022 Owner: same
On 12/15/2004, a deposit was made in the amount of $1,700.00, of which $1,645.01 was
retained. Please sign, date, and return the enclosed claim form to this office. Once we
receive the claim form, we will then process your refund in the amount of $54.99.
Should you have any questions, please contact this office Monday through Friday, 8:00
a.m. to 4:00 p.m., at 538-7601.
Sincerely,
Diane Lewellen
Account Clerk, Senior
Administrative Division
enclosure '
04-3523-r1tr2
f VY\ CO
o�U �
�s
County of Butte
Oroville, California
GENERAL CLAIM
CLAIMANT: Gall Snow
ADDRESS: 170 KOkanee
CITY & STATE: Oroville, CA 95966
DATE OF CI AIM- nF;/19/nr%
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELA
AMOUNT
Refund Claim - See attached calculation sheet APN: 069-190-022
Permit No.: 04-3523
PAID
RETAINED
REFUND
Develo ment Services
$ 1,605.00
$ 1,550.01
$ 54.99
THERM DRNG
$ -
$ -
$ -
SMIP
$ -
$ -
$ -
SHR
$ -
$ -
$ -
SRA
$ 95.00
$ 95.00
$ -
TOTAL
$ 1,700.00
$ 1,645.01
$ 54.99
....r...•..•
> i* >
'
:..................::':BitEAK:DOWN "'>:::::::::BUDG:ET::::ACCOUN—
:AMOTJXT.'
101001 DVLPMNT SVC
440-001
x210500
$ 54.99
1011822 THERM DRNG
1800
280
$ -
1011430 SMIP
1001
280
$ -
1011811 SHR
1800
280
$ -
101001 SRA
0100
4617240
$ -
TOTAL
$ 54.99
$ 54.99
• •--^--•-•n••��. --.- -'— r— —y v v-rv" r as --b V. annulus aa.meu nave peen perrormea or delivered, and that this
claim is true and correct as stated.
Dated this _ day of , 2006, at Calif.
Signature of Claimant
I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or
delivered and that there is a Budget Appropriation or Specific Board Approval (Check one) for the same.
Dated this day of , 2006, at Oroville Calif.
Department Head or Authorized Deputy
Dept. SEE Exp.
Code BREAKDOWN Code PAYABLE FROM FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
DEPT & SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT.
OUTTE.° Butte County Department of Development Services
ADMINISTRATION * BUILDING * PLANNING
-7 County Center Drive
Oroville, CA 95965
RETURN SERVICE REQUESTED
65
r
Gail Snow
P.O. Box 5001
Marysville, CSA._ OsOn 1 _ -- ---_—
012H16205578
$00.371
05/03/2006
Maned From 95965
US POSTAGE
BUTTE
COUNTY
JUN 0 5 2006
DEVELOPMENT
SERVICES
X 957 NO 1. B04 C 21 08/01/06
RETURN TO SENDER
UNABLE TO FORWARD � {
RETURN TO SENDER
DIUMP 95901
SS96S%9397 -- II,I111111111)1111111111111►IID„II1111,1111►II1lillll11 fill 11
1
1 �
Gail Snow
P.O. Box 5001
Marysville, CSA._ OsOn 1 _ -- ---_—
012H16205578
$00.371
05/03/2006
Maned From 95965
US POSTAGE
BUTTE
COUNTY
JUN 0 5 2006
DEVELOPMENT
SERVICES
X 957 NO 1. B04 C 21 08/01/06
RETURN TO SENDER
UNABLE TO FORWARD � {
RETURN TO SENDER
DIUMP 95901
SS96S%9397 -- II,I111111111)1111111111111►IID„II1111,1111►II1lillll11 fill 11
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Facsimile
www.buttecounty.net/dds
ADMINISTRATION * BUILDING * PLANNING
5/1/2006
Gail Snow
P.O. Box 5001
Marysville, CA 95901
RE: Permit No. 04-3523 APN#069-190-022 Owner: same
]BUTTE MA
COTrivTV
JU." ��ss
DEVEL,Ori"NT
;„,, SERVICES
On 12/15/2004, a deposit was made in the amount of $1,700.00, of which $1,645.01 was
retained. Please sign, date, and return the enclosed claim form to this office. Once we
receive the claim form, we will then process your refund in the amount of $54.99.
Should you have any questions, please contact this office Monday through Friday, 8:00
a.m. to 4:00 p.m., at 538-7601.
Sincerely,
Diane Lewellen
Account Clerk, Senior
Administrative Division
enclosure
04-3523.1tr
fiCo�
C),tv i 11Q
County of Butte
Oroville, California
GENERAL CLAIM
CLAIMANT: Gall Snow
ADDRESS: PO BOX 5001
CITY & STATE: Marysville, CA 95901
nATF nF: CI AIM- n5m1m
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY
AMOUNT
Refund Claim - See attached calculation sheet APN: 069-190-022
Permit No.: 04-3523
PAID
RETAINED
REFUND
Develo ment Services
$ 1,605.00
$ 1,550.01
$ 54.99
THERM DRNG
$ -
$ -
$ -
SMIP
$ -
$ -
$ -
SHR
$ -
$ -
$
SRA
$ 95.00
$ 95.00
TOTAL
$ 1,700.00
$ 1,645.01
$ 54.99
`....'
�......
%+ '
......
.. .
<:`:STJDGE.01
:
:
f::.A
OCNTG6:::::B2EA�DOVN:: ?
101001 DVLPMNT SVC
440-001
4210500
$ 54.99
1011822 THERM DRNG
1800
280
$ -
1011430 SMIP
1001
280
$ -
1011811 SHR
1800
280
$ -
101001 SRAI
01001
4617240
$F-7, -
TOTAL
1
1
$ 54.99
$ 54.99
tiro unueibiyneu, ueciare unuer penairy or perjury mat me services or articles claimed nave been performed or delivered, and that this
claim is true and correct as stated.
Dated this daft 2006, at Calif. _
cc..,.�r.a s rim �•i
i, the unaersignea, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or
delivered and that there is a Budget Appropriation or Specific Board Approval (Check one) for the same.
Dated this day of 2006, at Oroville Calif.
Department Head or Authorized Deputy
Dept. SEE Exp.
Code BREAKDOWN Code PAYABLE FROM FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
=PT 8 SUB PROD SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT.
APPROVAL
Date Reviewed
Scott Rutherford
Chief Building Inspector
5/1/2006 DIFFERENCE: $0.00
(Should be blank)
REFUND CALCULATION SHEET
CLAIMANT:
ADDRESS:
CITY & STATE:
DATE OF CLAIM:
Gail Snow
PO Box 5001
Marysville, CA 95901
05/01/06 APN: 069-160-022
RECEIPT NUMBER:
RECEIPT DATE:
ISSUED TO:
CHECK #:
AMOUNT:
PERMIT u:
PRIOR REFUNDS:
FEES VERIFIED
RECEIPT INFORMATION
418784
12/15/2004
Gail Snow
508709
$1,700.00
04-3523
Yes No Yes
No
Yes No
X
X
REFUND BREAKDOWN
Title
Fund
Dept
Accnt
Cashl
BLDG
0010
440-001
4210500
101001
THRM DRNG
1800
rHRM DRN
280
1011822
AUD SUSP
1001
(SMIP)
280
1011430
SHER DEV FE
1800
(SHR)
280
1011811
DETAIL
PAID RETAIN
REFUND
BLDG
Time 109.98
1495.02
::::::::::: :::::
::::::::::
...............................
::::::::::::::::::::::::::::::::
ii:::::: i?
:::::::::::::::::::::::::::::
>::
..........
...............................
..........
...............................
..........
..........
: :::::::::::::::::::::::
::::::::::
: '
i:::::
..........
..........
>:: »»:::::::::::::
..........
.....................
»>:::::::::::
..........
: ::::::: :::
*:*:*:*::::':": :
: : : ::::::::::::::
..........
..........
..........
..........
Filin from Plan Check 0.00
0.00 0.00
Plan Check/Filing0.25 27.50
1495.02 1495.02 0.00 0.00
Inspection 0.00
109.98 109.98 109.98
BLDG FEES
OTHER BLDG
REFUND PROCESS FEE 54.99
0.00 0.00
0.00 0.00
54.99 -54.99 54.99
BUILDING TOTAL
1605.00 1550.01 54.99 54.99
THERM DRNG
0.00
0.00:::':::
SMIP
0.00
0.00
..........
SHR
..
- _ _
0.00 - - _ - _ r
' 0.00
SRA
95.00 95.00 0.00
APPROVAL
Date Reviewed
Scott Rutherford
Chief Building Inspector
5/1/2006 DIFFERENCE: $0.00
(Should be blank)
J'
Ir
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Facsimile
www.buttecounty.net/dds
ADMINISTRATION * BUILDING * PLANNING
Gail Snow
P.O. Box 5001 I
Marysville, CA 9590
Permit No. 04-
,.�Illo 6
APN#069-190-022 Owner: same
On 12/15/200�eposit was made in the amount of $1,700.00, of which $1,645.01 was
retained. Please sign, date, and return the enclosed claim form to this office. Once we
receive the claim form, we will then process your refund in the amount of $54.99.
Should you have any questions, please contact this office Monday through Friday, 8:00
a.m. to 4:00 p.m., at 538-7601.
Sincerely,
Diane Lewellen
Account Clerk, Senior I
Administrative Division
enclosure ��
04-3523.1tr
County of Butte
Oroville, California
GENERAL CLAIM
CLAIMANT: Gall Snow
ADDRESS: PO Box 5001
CITY & STATE: Marysville, CA 95901
nATF OF: C:I AIM- n5/n1/ni
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELA
AMOUNT
Refund Claim - See attached calculation sheet APN: 069-190-022
Permit No.: . 04-3523
PAID
RETAINED
REFUND
Development Services
$ 1,605.00
$ 1,550.01
$ 54.99
THERM DRNG
$ -
$ -
$ -
SMIP
$ -
$ -
$ -
SHR
$ -
$ -
$ _
SRA
$ 95.00
$ 95.00
TOTAL$
1,700.00
$ 1,645.01
$ 54.99
>:: %*>:..:
.:.:. .::•: :
:::::'Q ::::::::::
:::BREADO'►?Vly"':'SUT}E:`
:ACCOUNT`
;::A1UCJ1T:;
101001 DVLPMNT SVC
440-001
4210500
$ 54.99
1011822 THERM DRNG
1800
280
$ -
1011430 SMIP
1001
280
$ -
1011811 SHR
1800
280
$ -
101001 SRA
0100
4617240
$ -
TOTAL
1
1 $ 54.991$
54.99
1, ale unaersignea, oeciare unoer penalty or pegury that ate services or articles claimed have been performed or delivered, and that this
claim is true and correct as stated.
Dated this day of 2006, at Calif.
Signature of Claimant
I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or
delivered and that there is a Budget Appropriation or Speck Board Approval (Check one) for the same.
Dated this day of 2006, at Oroville Calif.
Department Head or Authorized Deputy
Dept. SEE Exp.
Code BREAKDOWN Code PAYABLE FROM FUND
VV R%01 YYRI I C 6CLVYY I r1lQ LAIC -AUDI I UKS USC UNLT
EPT & SUB PROD I SUB. OBJ I CLAIM NO. I INV NO. I INV. DATE I ENCUMB. GROSS AMT.
APPROVAL
Date Reviewed
Scott Rutherford
Chief Building Inspector
CHECK: $54.99
03/16/2006 DIFFERENCE: $0.00
(Should be blank)
REFUND CALCULATION SHEET
CLAIMANT:
ADDRESS:
CITY & STATE:
DATE OF CLAIM:
Gall Snow
PO BOX 5001
Marysville, CA 95901
07/13/86 APN: 069-160-022
RECEIPT NUMBER:
RECEIPT DATE:
ISSUED TO:
CHECK #:
AMOUNT:
PERMIT #:
PRIOR REFUNDS:
FEES VERIFIED
RECEIPT INFORMATION
418784
12/15/2004
Gall Snow
508709
$1,700.00
04-3523
Yes No Yes
No Yes No
X
X
REFUND BREAKDOWN
Title
Fund
Dept
Accnt
Cash
BLDG
0010
440-001
4210500
101001.
THRM DRNG
1800
THRM DRN
280
1011822
AUD SUSP
1001
(SMTP)
280
1011430
SHERDEVFEE
1800
(SHR)
280
1011811
DETAIL
PAID RETAIN
REFUND
BLDG
Time 109.98
1495.02
..............................
::::::::::
................................
................................
::::::::::::::::::::::::::::::::
..........
...............................
..........
: :::::::::::::::::::::::::::::::
..........
..........
.......
....
::::::::::
..........
..........
..........
..........
...........
.....................
..........
..........
:::::::::
..........
....
..........
..........
..........
.........
..........
..........
Filingfrom Plan Check 0.00
0.00 0.00
Plan Check/Filing 0.25 27.50
1495.02 1495.021 0.001 0.00
Inspection 0.00
109.98109.98 109.98
BLDG FEES
OTHER BLDG
REFUND PROCESS FEE 54.99
0.00 0.00
0.00 0.00
54.99 -54.99 -54.99
BUILDING TOTAL
1605.00 1550.01 54.99 54.99
THERM DRNG
0.00
SMIP
0.00
0.00::
>:::::::
SHR
0.00
0.00
SRA
95.00 95.00 0.00
APPROVAL
Date Reviewed
Scott Rutherford
Chief Building Inspector
CHECK: $54.99
03/16/2006 DIFFERENCE: $0.00
(Should be blank)
O �110TrF0 Butte County Department of Development Services
o Building Division / /
r 0 7 County Center Drive �{ Z
cou Nay Oroville, CA 95965
(530) 538-7541
REFUND REQUEST APPLICATION
REFUND POLICY - Butte County Code 3-41(t)
1. Refunds can only be made upon written request by the person who paid the fees, whose name is on
the receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt.
2. The request must be made within two years from the date of fee payments on permits not issued, and two
years from the date of permit issuance for permits issued - if no construction work has been done.
3. Filing fees and plan check fees for work plans checked are not refundable.
4. Fees paid to other County Departments are not covered by this claim.
INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be
generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the
receipt) and return to Develo ment Services for payment processing.
CLAIMANT'S NAME:
T1 S ,/
20.
MAILING ADDRESS:
(53o ) 7 � 1 - 71 j _3
PHONE:
ASSESSOR'S PARCEL NO.:�-
[Please use one claim form per permit.]
BLDG PERMIT NO.:
RECEIPT NO.:
Receipt No. 1
Receipt No. 2
Receipt No. 3
f 7 8-Y
RECEIPT DATE:
1� I1
RECEIPT AMOUNT:
r7 0,
REASON FOR REFUND REQUEST:
A-ro't'` f— ✓q-i%J 1, C- aj" w
Check those fees which you wish to have considered for refund:
Building Permit Fees Sheriff Fees SRA Fees (CDF Fire Planning)
DOther (specify): a yQ R tid l
Plans for cancelled permits will be disposed of within 10 working days upon submission of a
Request for Refund. If you want the plans, you may ick them up prior to that time.
/�& J- '��
Signature
K:/Forms/Refund Application 082203
Date
04-3523 = B10 I ' 069-190-022
LAST NAME • FIRST NAME
CONTRACTOR • CITY/CTY
STREET NO STREET NAME • ' CITY • ' •
N SF I MZ21EMNEW SINGLE FAMILY
B �
VALUATION
P MSE M M-
FEES PAID RECEIPT
FEES 2 RECEIPT 2
FEES 3 RECEIPT 3
FEES 4 RECEIPT 4
PL.gN CHECK ACTIVITY
Plan Chk-1+• Chkd
Plan Chk-2: Chkd
PlOTC Uk
13: Chkd
FLOOD _
X255 char. max.
F25 char. max
APPLIED
ISSUED 1
FINALED
B,�y�.;� Return -1: Str Chk-1:
Return -2: Str Chk-2:
Approved: Str Appr: .
12/15/04 SRA paid. 12/16/04 sent to Willdan for p/c. 1/25/05 p/c Itr sent by Willdan. 2/16/05 p/c approval Itr sent by Willdan.
2/22/05 note transfer completed, phone # has been disconnected, Itr sent AAM.
Tuesday, January10, 2006
Counter Karen
Person
Payment Date
Permit Number
Receipt Number
Check Number or Cash
Parcel Number
Applicant
Received From
Development Services
BUILDING DIVISION ver. 1.0
Fund 10 (Bldg Permits)
SRA Fees (Fire)
12/15/2004
( SHR Fees (Sheriff)
04-3523
SMIP
418784
C Copies/Document Sales
508709
i CUA (Chico Urban Area)
069-190-022
( TUA (Therm. Urban Area)
SNOW
( Water Tender Btln #=
West Chico Fire Station
SAME
Witness Fees
Total Received .$1,700.00
$1,700.00 Recorders Fees (N.O.C)
_ Thermalito Drainage
Total Fees To Collect $ , 700 00
��� • ����) Oroville Area Traffic _
NSF (Non Sufficient Funds)
Notice of Violation
NCSP Trails System
NCSP Roads/Bridges
NCSP Storm Drainage
NCSP Fire Station
NCSP Parks Type
Value
$1,605.00
$95.00
$0.00
$0.00
$0.00
�- $0.00
$0.00
$0.00 1
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
DEPARTMENT OF DEVELOPMENT SERVICES
DEPOSIT SHEET
BUILDING DIVISION
DEPOSIT # 255
BAG # 329
MONEY COLLECTED: I 0210812006
COMPILED BY:
auditor:yellow
DIANE LEWELLEN extn 6869
DATE 1 02/09/2006
P•
GRAND TOTAL TO BE DEPOSITED
MONEY COLLECTED: I 0210812006
COMPILED BY:
auditor:yellow
DIANE LEWELLEN extn 6869
DATE 1 02/09/2006
The Sum of
For
Received:
CASH [-]
CHECK
Received
Title
By
L)AVL;U 13USINESS FORMS • (530) 743-8511 Form 75702
COUNTY OF BUTTE
j� ' I OFFICIAL -RECEIPT 418782
�Aq
OFFICE
iOR DEPARTMENT ISSUING RECEIPT
20*
Received from
The Sum of t_j
For
Received:
ASH
CHECK
DAVCO BUSINESS FORMS - (530) 743-8511 Form 7570r,
Received By r
Title
By
COUNTY OF BUTTE 418783
OFFICIAL. RECEIPT
OF-- UM UtrARTMENT ISSUING RECEIPT
20
Received from e,
The Sum of•
For :S,,
Received:
Received By
CASH
Title
CHECK
By
-Ub1Nt55 FORMS - (530) 743-8511 Form 75702
COUNTY OF BUTTE.
OFFICIAL-RECE,IP-T 418784
4
OFFICE OR DEPARTMENT ISSUING RECEIPT
20,4
4- fteived f•rom ;�7/
e Sum f
'For
LlRece
iVed: CILI - i
Received By -
CASH
Title
CHECK
_j By
t 99 NESS FORMS. (530) 743 8511 Form 75702
Bute County Department of Development Services
ADMINISTRATION * BUILDING * GIS * PLANNING
7 County Center Drive
Oroville, CA 95965
(530) 538-7541 Telephone
(530) 538-2140 Facsimile
January 6, 2006
Gail & Maria C. Snow
PO Box 5001
Marysville, CA 95901-5001
AP#069-190-022 (Location: 170 Kokanee, Oroville, CA)
BP#043523
Our records indicate that your building permit application has expired and was never issued. We are
unable to provide continuous plan storage for inactive permit applications. If you would like to have the
plans returned to you, you or your agent must pick up the plans at our office prior to January 19,
2006 or they will be destroyed (plans will not be mailed). ,Our office is located at 7 County Center
Drive, Oroville. Our office hours are 8 a.m. to 4 p.m. Monday through Friday.
If you have any questions concerning this matter, please contact a permit technician at our office, at the
following number (530)538-7541. Please have this letter with you when you call or come into our
office. Thank you.
1 � 1
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
February 22, 2005
Gail and Maria C. Snow
PO Box 5001
Marysville, CA 95901-5001
Dear Mr. & Mrs. Snow:
This letter is to inform you that your plans have been approved. In order to issue the permit we require
the following items:
1. The balance of building permit fees $1,218.14.
2. The Oroville Elementary School district fees paid to the school district. The form has been
attached, along with their phone number and address.
3. Sheriff fees of $360.00 collected at our office.
4. SMIP fees of $12.38 collected at our office.
5: A copy of the issued encroachment permit for the driveway from the Public Works
Department.
6. Copy of the recorded Agricultural Acknowledgement statement.
The balance of building permit fees, sheriff fee and SMIP fee can all be paid with one check, made
payable to Butte County Treasurer.
Once all of the above have been received, your permit can be issue.
If you have any questions concerning the above, please contact this office at (530)538-7541. Thank
you.
Sincerely,
lice Mefford
Supervisor, Permit Center
47WILLDAciesN
Serving Public Agen
Fe�brua T6 2005
Scott Rutherford
Butte County Building Department
7 County Center Drive
Oroville, CA 95965
(530) 538-7169
(530) 538-2140 FAX
SUBJECT: - COUNTY OF BUTTE PLAN REVIEW APPROVAL
117 C Street
Marysville, California 95901
530/749.2373 fax 530/749.2199
www.willdan.com
Willdan Project No:
14353-1301
Jurisdiction Job No:
04-3523
Assessor's Parcel No:
069-190-022
Description:
Snow New Single Family Dwelling
Dear Mr. Rutherford:
Willdan has completed a plan review of submitted plans and documents for the above referenced project
and recommends your approval with the conditions noted on the 2nd page of this letter. The plans and
documents provided for this review that have been found in compliance with the applicable codes are:
* Plans: Two (2) copies sheets 1 through 9 by Gail Snow
* Energy Calculations: Two (2) copies dated 12-11-04, by Michael Sroka.
* Truss Calculations: Two (2) copies dated 12-10-04, by Larry Messamer, P.E.
The plans have been stamped with the Willdan approval stamp and dated the date of this letter. According to
our previous letters relating to this project, the superseded plans and documents will be discarded within 10
days unless we receive other instructions.
On the pages to follow is the identification of the codes and standards applicable to the project, a code
analysis, conditions -of -approval and identification of any deferred submittals.
A7WILLDAN
Ma s Street
Marysville, California 95901
Serving Public Agencies 530/749.2373 fax 530/749.2199
www.willdan.com
APPLICABLE CODES
Unless noted otherwise, all comments are based on requirements of the 2001 California Building
Standards Code found in the California Code of Regulations, Title 24:
• Part 2, known as the California Building Code and abbreviated herein as "CBC"
• Part 3, known as the California Electrical Code and abbreviated herein as "CEC"
• Part 4, known as the California Mechanical Code and abbreviated herein as "CMC"
• Part 5, known as the California Plumbing Code and abbreviated herein as "CPC"
• Part 6, known as the California Energy Code, and Energy Commission Standards, and
abbreviated herein as "CECS"
CODE ANALYSIS
Our plan review revealed the following information regarding the occupancy designation, type of
construction, and other pertinent features. This information is consistent with that shown on the plans.
Type of
Type of
Sprinklers
Stories
1" Floor
2nd Floor
Total Sq Ft
Occu anc
Construction
S Ft
S Ft
1728
R-3
V -N
No
1
1728
NA
U-1
V -N
No
1
440
NA
440
Cov. Porch
V -N
No
1
56
NA
56
CONDITIONS OF APPROVAL
1. Approval is contingent upon the review, requirements and approval of other departments
and/or agencies that have jurisdiction over this project.
2. Revisions and/or notes as red -lined on the plans.
DEFERRED SUBMITTALS
Our plan review reveals no deferred submittals noted at this time.
SPECIAL INSPECTION NEEDS
Our plan review reveals no special inspection needs pursuant to CBC 1701.
Sincerely,
Isaac Kuster
Plans Examiner
Cc: Alice Mefford, E-mail: amefford@buttecounty.net
Gail Snow, P.O. Box 5001, Marysville, CA 95901
1'a<w 2 of 2
Ricardo Guzman, S.E.
Plan Check Engineer
County of Butte Perini.t .Nuniber 04-3523
Wil.ldan P.roiect Nutnber 1135:,-:1301.
BUTTE COUNTY Io85, a6
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
"PLEASE PRINT CLEARLY"
APP CANT SIGNATURE
X J21� )
For office use only:
OWNER
Last Name
-2Y
irst Name
v�
Address c D
CP 0 x o e)
City m
�
S ( (-I-
State C
Zp D
Phone
Phone �3
. 0%
Fax
E-mail
State License Number
APP CANT SIGNATURE
X J21� )
For office use only:
CONTRACTOR
Name
-2Y
Address
D !'P o
City
State
Zip
-Phone
Phone
E-mail
Lic. #
Class
APP CANT SIGNATURE
X J21� )
For office use only:
ARCHITECT/ENGINEER
Name
Flood Zone SRA No
Address
D !'P o
City
%—r S� J i
State
Zip
Phone
530 — 7�l1- 074
Fax
E-mail
Date Approved:
State License Number
APP CANT SIGNATURE
X J21� )
For office use only:
APPLICANT NAME
Name
Flood Zone SRA No
Address
D !'P o
City
%—r S� J i
State
Zp gs 7o r
I
PhoneFax
530 — 7�l1- 074
Planner
E-mail
Date Approved:
APP CANT SIGNATURE
X J21� )
For office use only:
AP#
Zoning
Flood Zone SRA No
Occ.
WORKER'S COMPENSATION
Type Const.
Subdivision Name
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of pennit issuance.
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
FB
ERMIT
, • �i�3
P
I BIN # 616
l'1 I
LOCATION
AP#
Prope ress
-V K o Kcz .c/ e-
City
10,-,:;
Cross Street----'
" d ") -j
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of pennit issuance.
LENDING AGENCY
Address
Description or Scope of Work:
Sq. Footage 17z-55_
❑ Structure Built without Permits
❑ Proposed Change of Occupant
(Note previous use):
lo� C),
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.
K.lFORMSIBUILDING FORMS\BldgApplSubRgmts.doc Page 1 of L
ecel b Amount: -5' -0,'r,)Bldg
SRA
Receipt M Sheriff w- &- SMIP
Date:1 )- Other
IO� Total
RCv
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND /N INK
❑
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 papers) 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).
_❑_ 13,Sanitation_and site plan appmvalfromtbe En ironmejotaLlealihDeparfinent.
Remaining
items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's).
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530)538.7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 RE/ 7.27-04
utte County Department of Development Services
)NNE CHRISTOPHER, DIRECTOR
007
County Center Drive
Oroville, CA 95965
N
(530) 538.7601 Telephone
(530) 538.7785 Facsimile
TO:
'
O
FROM:
r
1
SUBJECT:
O
DATE:
WILLDAN
Scott Rutherford
(530) 538-7160
srutherford aaMuttecounty.net
Plans Transmittal For Review Per Contract
12/16/2004
Applicant: ISnow, Gail I Permit 04-3523
Project Type: NSF/Gar/Cov APN: 1 069-190-022
100% 70%
Plan Check Fees $ 1,085.26 $ 759.68
$ 1,085.26 $ 759.68
WILLDAN Fee $ 759.68
Copies Attached: Qty
Chk
Application
Site Plan Review
FEMA Elevation Certificate
Building Plans
Truss Calculations
Energy Calculations
Structural Calculations
Residential Plan Review Guide
Residential Construction Requirements
Other
Other
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: G" ,Ok^/ ASSESSOR PARCEL NUMBER 9!5 `I 1 '10 - on P 2
Lov Po�2 C56
Proposed Building Use: til S F (17.7 93 � A rt 6 ,4e- e g QD) Counter Technician: Date:
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to pply. (� F
1. Site plans, 3 or 4 sets, signed by the preparer of the plans. :J
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) 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. 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.
1 16. Other_ 14,ng5 k #:,-;, LcTiF-,? g 4? ,I A, , r,
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 ........................................... ........
❑rosion Control Plan Required........................................................................ ........
,pi 631 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 .............
g.. 24. Planning approval (A) Use:(B)Parking: (C) Parcel Chec : OS
❑ 25. Contact Land Development about _ Improvements, _ Drainage .........................
26. NPDES Form.............................................................................................
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) .....................
❑ 32. Letter of Signature authorization......................................:.............................
33 Recorded copy of Agricultural Acknowledgment. Statement .................................
❑ 34. Manufactured home utility clearance...............................................................
❑ 35. Existing violations and/or expired permits.........................................................
❑ 36. De Restriction.........................................................................................
❑ 37.rant 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: - //A, ,, ) ,,� ----N Date: J-2-
1. Index permit application r foie ab a items num eyed: J� Plan Check Letter
2. Additional items required
Contractor, designer, 00 was advised of the above data by ❑ phone,ail, ❑ counter, b 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 ,v' Date: Structural approved by: Date:
Note transfer by Date:
Yellow: Building Division
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 t-ld A.P. # C)Uq
PROPROSED BUILDING USE DATE
RECEIPT # DATE REC.
1. BU LDING PERMIT FEES
--- Balance Due ..................... $�
--- Additional Fees Due...........
--- Revised Plan Checking Fee.... $
2. SCHOOL DISTRICT FEES OrD
(paid at School District Office) (form available after Plan Check)
3. SHERIFF FEES (paid at Building Division)
Residential........... X $360.00 =$�
its
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)
O7. SRA FIRE INSPECTION AND PLAN CHECK. -EEE ,
maid 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. Fig. i� Amt.
10. OTHER
At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees
may be changed during the plan checking process.
APPLICANT
DATE /Z—/6 —01 -i
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)
' �te'�, Y .C"0,>'i'u�.d.� ki.4_. '4.�"x .x q€5,.��:v �, � � �>.EW... e.^,�Tt...R �'£� i.,X,_ i. . _.:. _.. A �. 5 •;:�.'Y'+�.%
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 Dzj NO [ ].
2. I HAVE
k."[ J.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: / Z / 5" ` p C/
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
pen -nit. 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.
N
Mic el C. Vieir4 C.B.O.
Ma4ager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
O�?WTMEN-r
PA -
0
�uTTF,
'a
O c
O c
O ^ O�
Y 9
��Uc WORD
Department
J. Michael Crump, Director
Public Works
LAND DEVELOPMENT DIVISION
Storm Water Management Program
7 County Center Drive
Oroville. CA 95965
(530) 538-7266
(FAX) 538-7171
National Pollutant Discharge Elimination System (NPDES) Phase II
Construction Storm Water Permit and Storm Water Pollution Prevention
Plan (SWPPP) Acknowledgement [LESS THAN 1 ACREI
Project Description:>�-2—
Project Location and/or Parcel Number: /ie K. o k, , ('q_> -7 — zZ
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 1 Acre NPDES & SWPPP Compliance Certification
Butte County Storm Water Management Program
Revised 5/24/04
PERMIT NO.:
88-04
Lake Oroville Area Public Utility. District
1960 Elgin Street
OROVILLE, CALIFORNIA 95966
533-2000
DISTRICT APPROVAL AND
VERIFICATION OF INSPECTION
BUILDING SEWERS
This verification form must be submitted to the Butte County Department of Public Works Building
Department prior to issuance of a building or occupancy permit, whichever is applicable.
Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification
form, signed off by Lake Oroville Area Public Utility District, must be submitted to Butte County.
Date: November 23, 2004
Applicant: Gail & Maria Snow
PO Box 5001, Marysville, CA 95901 k
Applicant Address:
Applicant Phone No.: 741-0744
Property LOcationS(S): 170 Kokanee Dr. Oroville CA 95966
KRE Unit 3 Lot 53
A. P. NO.(S): 069-190-022
Fees due: $1,690.00 LOAPUD Capacity Chg.
Application for service a
PUBLIC UTILITY DISTRICT
Inspection(s) made and successful test(s) observed:
Location:
Lake Oroville Area Public Utility District release to close permit:
Date: By:
Date:
�y
SITE PLAN REVIEW APPLICATION
Date: �—� `� AP# % 67
Permit Number (if applicable)
APPLICANT 17VFORMA TION Parcel Size: • 2_3 aaL_&5
Owners Name: Z`'"`" 2 o7,J
Owners Address: p0.
9,-�o
Telephone No.: 7q l --Q 7 V 9
Situs Address: / 70 �� a !%liz�66
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 .
0 -Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
Other
❑ Septic
❑ Agricultural Exempt Building
❑ Other:
Brief Explanation (if necessary):
❑ Single Family Remodel
❑ Commercial Remodel .::.. _.
❑ Industrial Remodel
Well
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SERVICES INFORMATION (For Staff Use)
10 Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
10 Site Plan Stamped Approved*
By Cts►-`Ct rl Date
Page 1 of 5
ALL ITEMS CHECKED APPLY TO THE PROPERTY r.
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)
SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain: (See attached)
o Flood Zone: X
Flood Panel No.: 4600 7G08'.zSL Index Date: %
❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements)
❑ Chapman/Mulberry (See attached standards and requirements)
❑ Cohasset Area (See attached standards and requirements)
❑ Grading Zone (See attached handout)
Use Requires:
❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit
❑ Minor Variance ❑Variance
❑ Detached Building Use Form -°-❑ EncroachmentPermit '
❑ Agricultural Worker. Affidavit .❑_ Agricultural Acknowledgement Statement -
Zoning: gT' %
Applicable Building Setbacks:
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
Side
Side Street
O,
s
30'
Q
S�Cw pu.:
Rear
s- r
Sol
Height
Waterway
N/A
N/A
N/A
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Applicable Development Fees:
Standard Fees Amount Formula
❑ Fire
❑ School*
❑ Parks/Recreation
❑ Roads
❑ Sheriff
❑ Drainage
❑ NCSP/CSA 87
❑ Chico Urban Area — Road
❑ Thermalito Impact
❑ Other
-------------------------------------------------------------------------------------------------------------------------
Subdivision Map Special Fees
❑
Water Tender
❑
Road Improvement
❑
North Oroville Area
❑
Other (per map)
* Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of
the building permit: --.
Parcel Created B
Deeds:
Date of Creation: Legal Access Provided: ❑ No
Deed of Reference: - Legal Access Required ❑ No
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 [:1 Obtain a Lot Line Adjustment
El 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:
Map Date of Recording: 2�' N
Lot: 6- 3
❑ Use Permit/Minor Use Permit
Permit Number:
Book: 4/3 Page: Y3 F
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 di'-
sturbance.+ The Erosion Control Plan'-
must
lanmust be, prepared by a registered civil engineer or. other qualified- ..professional and be
submitted to and approved by the Department of Public Works:: a
❑ 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
El
u
Page 4 of 5
C
n
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
OWNER'S CERTIFICATE
WE, SOUTHERN CALIFORNIA FINANCIAL CORPORATION, AS OWNER OF THE
LANDS 'INCLUDED WITHIN "KELLY RIDGE ESTATES UNIT 3." AS SHOWN
WITHIN THE COLORED BORDER I.INES ON THE ANNEXED MAP. DO HERECV
CERTIFY THAT WE ARE THE ONLY ON WHOSE CONSENT IS
NECESSARY TO PASS CLEAR TITLE TO SAID LAND AND WE CONSENT TO
THE PREPARATI OV AND RECORDATION OF SAID MAP AS SHOWN }WITHIN THE
COLORED BORDER LINES. THAT PORTION OF ROYAL OAKS DRIVE. SCHMID
ORIVE,MOOTHART ROAD, PITKINCOU RT.N ATMROP COURT, KEY COURT, LORI
COURT, OTELLO COURT, PHEASANT PLACE. QUAIL COURT, TOM COURT.
AND TREE COURT. AS SHOWN WITHIN THE COLORED BORDER LINES ON
SAID MAP, IS HEREBY OFFERED FOR DEDICATION FOR PUBLIC USE FOR
COUNTY ROAD PURPOSES. WE ALSO OFFER FOR DEDICATION, AND DO
HEREBY DEDICATE FOR -SPECIFIC PURPOSES. THE FOLLOWING:
(1) .EASEMENTS FOR LIGHT AND AIR OVER THOSE STRIPS OF LAND
LYING BETWEEN THE FRONT AND/OR SIDELINES OF LOTS AND THE
LINES SHOWN HEREON AND DESIGNATED "SETBACK LINE"
("S.B.L. "I SAID STRIPS TO OE KEPT' OPEN AND FREE OF
BUILDING.
(2) RIGHTS OF WAY AND EASEMENTS FOR WATER. GAS, SEWER AND FOR
OVERHEAD AND UNDERGROUND WIRES FOR ELECTRIC AND TELEPHONE
SERVICES, TOGETHER }'11TH ANY AND ALL APPURTENANCES APPEOTAIN-
ING THERETO, ON. OYER, UNDER AND TOGETHER WITH THE RIGHT
TO TRIM OR REMOVE THE NECESSARY TREES, TREE LIMBS OR
BRUSH ON THOSE PORTIONS OF LAND MORE PARTICULARLY DESCRIBED
AS FOLLOWS:
(A) A STRIP OF LAND EIGHT (B) FEET !N WICTII WITHIN THE LOTS '
AND CONTIGUOUS '1'0 ANY STREET OR D'I'HER PUBLIC WAY.'
(8) A STRIP OF LAND SIX (6) FEET IN WIDTH WITHIN iMELO'I'S AND
CONTIGUOUS TO ALL SIDE AND REAR LOT LINES. '
(CI THOSE STRIPS OF LAND DESIGNATED AS PUDIC UTILITY EASEMENT
,P.U.E.) IN THE LOCATION ANP OF THE WIDTH SHCWN HEREON
(3) RESERVATION PROHIBITING VEHICULAR INGRESS AND/OR EGRESS
OVER AND ACROSS THOSE STRIPS OF LAND ABUTTING KELLY
RIDGE ROAD AND ARROYO DRIVE AND DESIGNATED "NO ACCESS
STRIP."
(4) RIGHTS OF WAY AND EASEMENTS FOR DRAINAGE PIPES AND OTHER
O RAIN GE WAYS TOGETHER WITH ANY AND ALL APPURTENANCES
A PPE R'rAINING THERETO ON. OVER, AND UNDER THOSE STRIPS
OF LAND DESIGNATED "DRAINAGE EASEMENT l"O.E."1 AN THE
LOCATION AND OF THE WIDTH SHOWN HEREON.
(5) RIGHTS-OF-WAY AND EASEMENTS FOR INGRESS AND EGRESS AND
PUBLIC UTILITIES ON. OVER AND UNDER THOSE STRIPS OF LAND
DESIGNATED AS COMMON PRIVATE DRIVEWAY EASEMENT (°C.0 E.")
IN THE LOCATIONS AND OF THE WIDTHS SHOWN HEREON, MORE
SPECIFICALLY DEFINED AS FOLLOWS:
(A) THO SE 'STRIPS OF LAND LYING BETWEEN THE FRONT LINES OF
LOTS_ AND THE S.B.L.
(B) THE ENTIREACCESS OR NARROW STRIP OF THE FLAG LOT'S 95,
96. 107, 106. 256, 8 257, AS SHOWN HEREON.
(C) LOT'S 16.
22. 25. 26, 29. 41, 42, 45. 46. 47, 4B. d3.
50, 70. 75. 76, 112. 117, 126, i7.9, 132. 139. 143. Idd.idS
146. 147. 150. 151. 152. 15G. 159. 167. 1]0. 171. 172.
181, IB4, 187. 199. 206, 218. 227, 241. 242, 245-. 246^
249, 252. 253, 254. 8 277 ARE SUBJECT TO COMMON DRIVEWAY,
EASEMENT.
SOUT ERN CALIF RNIA` FINANCIAL. CORPORATION
ASSISTANT VICE PRESIDENT
STATE OF CALIFORNIA )
COUNT
yY. OF�B I SS
ON /eea-,/ /-�� , 1974• BEFORE ME KAnrA_i L. Zn, tie
A NOTAP Y'PUBLIC• IN AND FOR 1-2-414Z COUNTY, STATE OF
=. PERSONALLY APPEAREQq K%wls was N
KNOWN TO ME TO BE THE /%`�- ✓)e• Poe.;Ar •.� OF THE CORPORATION
THAT EXECUTED THE WITHIN INSTRUMENT AND ALSO KNOWN TO ME TO BE
THE PERSON WHO EXECUTED IT
ON BEHALF OF SUCH CORPORATION AND
ACKNOWLEDGED TO ME THAT SUCH CORPORAT OO ;E;XE SAME.
- /-- /
MY COMMISSION EXPIRES LPC�L f1 NOTARY PUBLIC
OF SEAL
KAREi L MB1ER
rwrARrlAq[u�ea1IueamRA
IIY¢®e.mBM rmlalXcu lm
SURVEYOR'S CERTIFICATE
1. DONALD 0. MCCORMICK, HEREBY CERTIFY THAT I AM A REGISTERED CIVIL
ENGINEER OF.THE STATE OF CALIFORNIA; THAT THE ANNEXED MAP OF KELLY
RIDGE ESTATES UNIT 3 CORRECTLY REPRESENTS A SURVEY MADE TINDER MY
SUPERVISION IN OCTOBER 1973: THAT THF SURVEY 15 COMPLETE AS SHOWN;
THAT THE MONUMENTS WILL BE OF THE CHARACTER AND WILL OCCUPY THE.
POSITIONS INDICATED AND WILL BE SET BY :RANCH 31. 1975. AND THAT SAID
MONUMENTS WILL BE SUFFICIENT TO ENABLE THE SURVEY TO BE RETRACED.
DONALD D. MCCORMICK, RCE.9033
to I F�T�L 1
4.2_AA
AUDI TOR'.S CERTIFICATE
I, W.L. LAWRENCE . AUDITOR OF THE COUNTY OF BUTTE. STATE OF
CALIFORNIA. DO I4EREBY CERTIFY THAT THERE ARE NO TAX LIENS AGAINST
KELLY RIDGE ESTATES UNIT 3 AS HEREON SET FORTH OR UNPAID STATE.
COUNTY. MUNICIPAL. OR LOCAL TAXES. OR SPECIAL ASSESSMENTS NOT YF.'I'
PAYABLL. TAXES OR ASSESSMENTS WHICH ARE A L EN OUT NOT YET
PAPA RLE. I ESTIMATE TO BE IN THE AMOUNT OF-✓..2D_°la�
/ ) l/
Yt/ 7T/_. /
COU Y DI TOR TiY `
COUNTY SURVEYOR'S CERTIFICATE
I. CLAY CASTLEBERRY. COUNTY SURVEYOR OF THE COUNTY OF BUTTE, STATE
OF CALIFORNIA. DC HEREBY CERTIFY THAT I HAVE EXAMINED THE FINAL MAP
OF KELLY RIDGE ESTATES UNIT 3 AND THAT IT IS SUBSTANTIALLY THE SAME
AS WHAT APPEARS ON THE TENTATIVE MAP ON FILE AND ANY APPROVED
ALTERATIONS: THAT ALL THE PROVISIONS OF THE SU13DIVISION MAP ACT
OF THE STATE OF CALIFORNIA AND ANY LOCAL ORDINANCES APPLICABLE AT
THE TIME OF APPROVAL OF SAID TENTATIVE MAP HAS BEEN COMPLIED WITH
AND I AM SATISFIED THAT THE MAP ICHNICALLY CORRECT,
CLAY CASTLESERRY RCE 1422
COUNTY SURVEYOR
COUNTY CLERK'S CERTIFICATE ..11 ..LL
1 DO HEREBY CERTIFY THAT ON THE L:DAY OF J L4 1974,
THE BUTTE COUNTY BOARD OF SUPERVISORS OFFICIALLY APP}OVED THE
SUBDIVISION MAP OF KELLY RIDGE ESTATES UNIT 3. THE RECEIPT OF
SATISFACTORY SECURITY IN THE AUDITOR'S ESTIMATED AMOUNT OF
TO INSURE PAYMENT OF TAXES WHICH ARE A LIEN BUT NOT YET PAYABLE
WAS ACKNOWLEDGED. THOSE PORTIONS OF STREET NAMES AS
SHOWN ON SAID MAP AND OFFERED FOR DEDICATION ARE ACCEPTED ON
BEHALF OF THE PUBLIC FOR ROAD PURPOSES.
COUNTY CLERK BY
RECORDER'S CERTIFICATE
RECORDED IN THE OFFICE OF THE COO ER F BLIT TE .0 NTY STATE ATE OF
CALIFORNIA. AT THE RE VEST OF
THIS 2� pAY OF�E_, 1974, AT 32 N. NUTES PAST 9'
O'CLOCK-A.M.. IN MAP BOOK _'�9 `AST PAGER S •/6 fC2 r yp
RECORDER NUMBER -27� age.
LOUISE KLUENDER, COUNTY RECORDER
SUBDIVISION NO.7'6_
KELLY RIDGE
ESTATES UNIT 3
A PORTION OF THE E. 1/2 OF SECTION 12,T19N.,
R.4E., M.D.M. AND A PORTION OF S.W. 1/4 SECTION
6 & PORTION OF W. 1/2 SECTION 7, T.19N., R.5E..M.D.M.
COUNTY OF BUTTE ,CALIFORNIA
APRIL . , 1974
OWNER 9 SUBDIVIDER: SOUTHERN CALIFORNIA
FINANCIAL CORPORATION
ENGINEERS: THE MURRAY-McCORMICK ENVIRONMENTAL GROUP
SHEET I OF 5 SHEETS
BASIS OF BEARINGS
KELLY RIDGE ESTATES UNIT ONE. BOOK 36 M.O.R.
PAGES 5. 6. 7. 8. 9. AND 10.
DR/VE e
16600
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BR. 1667 /O.R./A5.117
AC RE A EeS
LOTS 66.114
57aeE T5 16.676
e 00N0ARY 77.709
J
0
LOCATION MAP
NO SCALE
43-4-5;
J
0
§� 38
�e1
47. r7, o
NO SCALE
p b7 C
LEGEND
N0. RADIUS
DELTA
LENGTH
C OtANON PRIVATE DRIVEWAY EASEMENT... ...... f. r•sr.a ..
Q V5 le
90°00'00"
31.42'
FOUND MONUMENT AS SHOWN....... ................... �
2. 492.:00"
4
01'016'31"
10.95'
3 597.00'
01'016'31"
39
5P
55
17a.�. g • ra ;,. ,t r
�b :: '59 :2
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F 5NPPT 3
55
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1/6E.
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BR. 1667 /O.R./A5.117
AC RE A EeS
LOTS 66.114
57aeE T5 16.676
e 00N0ARY 77.709
J
0
LOCATION MAP
NO SCALE
43-4-5;
J
0
SHEET INDEX
NO SCALE
CURVE TABLES SHEET 2
LEGEND
N0. RADIUS
DELTA
LENGTH
C OtANON PRIVATE DRIVEWAY EASEMENT... ...... f. r•sr.a ..
1. 7.0.00'
90°00'00"
31.42'
FOUND MONUMENT AS SHOWN....... ................... �
2. 492.:00"
01'016'31"
10.95'
3 597.00'
01'016'31"
''
13.29
SET 2" X 3' IRON PIPE 'TAGGED RCE. 9033.... ...
��� �•�
4.. 458.00'
01037'23"
12.97'
5. 353.00'
01°37'23
10.00'
SER' NAIL AND TIN..... ....•.. ....... .. ..... ..0
6. 458.00'
O6°42'30"
53.62'
7. .458.00'
OI°56'32"
15.57'
SET -CENTERLINE MONUMENT. BUTTE. CO.STD. S-17........®
8. 353.00'
01°56'52"
12.00'
9. 20.00'
101°32'14"
35.44'
RADIAL LINE ............ ... ...........(R)
................
i0. 270.00'
04°27'51"
24.04'
II. 293.00'
"
07°55'53.
40.58'
HUI LDINC SETBACK LINE IS. B. L.)...
' ��������•
12. 20.00'
44°24'.55"
15.50'
1 . 7.0.00'
100°33'123 u
35.10'
O CURVE DATA REFERENCE .................................... 1
14. 293.00'
08°29'01"
43.38'
I5. 20.00'
100°17'43"
35.01'
DRAINAGE EASEMENT (D. E. )..
16. 50.00'
33' 16' 50•
29.04'
17. 330.00'
06°03'04"
34.85'
PUBLIC UTILITY EASEMENT (P.U.E. )...........
DEPARTMENT OF WATER RESOURCES ................... LAW.R.
STATE OF CALIFORNIA
ALL LOT CORNERS NOT INDICATED BY THE ABOVE SYMBOLS.
ARE TO BE MARKED BY 3/4"'I RON PIPE WI Til TAG RCE 9033.
SUBDIVISION NO..
KELLY RIDGE
ESTATES UNIT 3
A PORTION OF THE E.1/2 OF SECTION 12 ,T.19N.,
R.4 E.,
M.D.M. AND A PORTION OF S.W. 1 /4 SECTION
6 8 PORTION OF W. 1/2 SECTION 7, T.19N.,R.5E.,M.D.M.
COUNTY OF BUTTE ,CALIFORNIA
SCALE : 1"- 100'APRIL., 1974
-
OWNER 9 SUBDIVIDER: SOUTHERN CALIFORNIA
FINANCIAL CORPORATION
ENGINEERS:
THE MURRAY-McCORMICK ENVIRONMENTAL GROUP
SHEET 2 OF 5 SHEETS
NOTES RESIDENTIAL
PERMIT NO.- 069-190-022 — -
SNOW, GAIL 04-3523
170 KOKANEE, OROVILLE
Cont: OWNER
NEW SINGLE FAMILY
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
JOB FINALED (Date)
Signature
d = OK
0 = Not OK
. = NotReadyable
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Soils; Special MH Support Sketch
3.
Sewer; Location -Test -Fall -C/O -Concrete
4.
Water; Location -Test -Easement Needed (Sketch)
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
6.
Gas; Location -Test -Wrap;-/ P' L'ft.
/ P Nat. or / P' L "ft./ P LPG
7.
Well Clearance & Disconnect
8.
Utility Clearance
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
Date
12.
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
Card B-1 Date Card B-1
1.
Zoning Requirements -Setbacks -Easements
Card B-1 Date Card B-1
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 -Connector
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
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
Date
12.
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
Card B-1 Date Card B-1
1.
Zoning Requirements -Setbacks -Easements
Card B-1 Date Card B-1
2.
Footings; Size -Spacing -Marriage Line
3.
Blocking
4.
Gas; MH Test -Demand -Valve
5.
Electricity; MH Test
6.
Water; MH Test
7.
Water and Sewer Connected
8.
Gas and Electricity Tagged
9.
Exits
10.
License Decals
11.
Verify #'s with Office
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3.
Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4.
Wood Awn.; Posts- Beams- Rftrs-Connectors
Shthg-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
12.
Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance -GA
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 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.
Shear Walls; Nailing -Bolts
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
Brace Interior/Exterior Wall Panels
15.
Access & Ventilation
Insulation -Walls -Ceilings
16.
Insulation
Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
65.
17.
Water Htr.; Vent -Access -Combustion Air Baffle
66.
18.
Water Pipe; Test & Anchor -Nail Protection
67.
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
68.
20.
Shower Pan; Test, First Floor -Tub Access
69.
21.
Test Tub & Shower, Second Floor -Tub Access
70.
22.
Gas Pipe; Sixe & Anchors
71.
23.
Fire Sprinkler; Test
72.
Elec. Outlets at Wood Panel, Int. & Ext.
Date
Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
Card B-1 Date Card B-1
Date
Elec. Outlets & Receptacles at Kit. Counter
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 0 Yes 0 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
87.
Water Well, Disconnect, Electrical, Plumbing
Date
88.
Card B-1 Date Card B-1
Date
89.
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
Glass Protection
36.
A.C. Ducts Insulation & Support
Corrections from Previous Inspections
37.
Vent Fan, Exhaust above insulation
Gas Test -Meters Tagged, Gas -Electric
38.
Condensate Drain & Overflow, Size & Grade
Water & Sewer Connected -C/O to Grade -HD Approval
39.
Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
Energy Compliance Certificate -Other Certificates
40.
Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
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.
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 O 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: