HomeMy WebLinkAbout069-220-046AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
1.'007--00071 44
Recorded I REC EEE 7,00
Ufficial Records I
County of I COPIES 2.00
ButteCMDAI
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AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building
permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes,
and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals,
including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations
including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm
operations.
All that real property situate in the County of Butte, State of California, described.as follows:
LOT 226, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "KELLY RIDGE ESTATES
UNIT NO. 3", FILED IN THE OFFICE OF THE COUNTY RECORDER OF BUTTE COUNTY,
CALIFORNIA, ON JULY 26,1974 IN BOOK 43 OF MAPS, AT PAGE(S) 44, 45, 46, 47 AND 48.
AP NO. 069-220- 046
Date (9-7 PROPS TY OWNERS: p \rAMc, M .
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State of California ,V �h,
County of go T- L- )
On 02 j 1 Coq t 2-06-7 before me,
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personally appeare C1h r Ue,Z- 'PI r1a'M . MQ✓? pers ffM
#Hewn -to- ne-(or proved to me on thW basis of satisfactory evi ence) to be the person whose na e(s) ' re subscribed
to the within instrument and acknowledged to me that ludske/they executed the same in hi~their authorized
capacity(ies), and that by hisAw/their signature(s) on the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, executed the instrument.
WITNESS my hand a d official seal. JANET G. FIORE TENNAM
Commission # 1663858
Signature Seal:i@'MVCW==mAw4=1r9$Jun
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REQUEST -FOR CONNECTION - PERMIT
APPLICATION FOR SEWER CONNECTION AND.SERVICE FROM
LAKE..OROVILLE AREA PUBLIC UTILITY DISTRICT
hereinafter referred to as ".Applicant:, .
being the property owner or owbee.s agent.desinng sewer service, hereby requests Lake Oroville Area Public Utility
District, hereinafter referred to.as "District", to connect Applicants sewage disposal line:to' District's sanitary sewer
system and to provide sewerage service. r n /r
1 ^r�finn of nrnnprh/ I I l�% (I (1(�WI nA C�l� _ A.P.M.be 1— 0 22--�`�
❑ Property Annexed
❑ Property Not Annexed
Property Annexation in Progress
Kind of Service:
10 Residential
❑ Residence of Owner Connection Fee.
❑ Rental (single family)
❑ Rental (duplex) ❑ Apartment SC -OR Facility Charge:
❑ Industrial
❑ Commercial Total Amount Payable This Permit:
Site plan reviewed 0 Jobsite reviewed
Low.'
ot# 2-2-& Block#:
No. of E.D.U.'s this permit:
Multiplication Factor:_
*Monthly Charges:
Capacity Charge:
The service applied for hereby shall be in accordance with the conditions hereinafter set forth and the ordinances,
rules -,'regulations and policies. adopted, or:to be adopted,.by-the Board of Directors of District, all of which Applicant
agrees to abide by and fully perform... Applicant agrees to pay for such service at'. rates and charges as are
established by District from time to time.
Signature of Applicat. Name of Owner if not Applicant
342-� CV\ D1 w1 , o ,4
Mailing Address of Applicant c. Ct Mailing Address of Owner
Phone # of Applicant: � — 0 5 S U Phone .# of Owner:
CONDITIONS OFACCEPTANCE.OF. SEWERAGE SERVICE
1. In accepting this application, District does not hold itself liable to Applicant for failure to perform any of
the obligations imposed upon it or assumed by it under this application if such failure be caused by accident, Act of
God, fire, -strikes, riots, war, lack of capacity in.SC-OR treatment/disposal plant or Districts lines to handle the
sewage or nay other cause beyond reasonable control of District.
2. Installation of the. sewer service line pertinent to this application shall conform in all respects to District's
specifications. -
4. Applicant shall secure. permits) .as. necessary from . the County of Butte prior to doing any work,
including encroachment permits when work is within county right of way.
5. Installation of the subject sewer fine. shall be at the sole cost and expense of Applicant.
6. Actual connection of the subject.sewer service line to Districts sewer mainline shall be accomplished by
District staff.
7. All work shall be inspected and approved by District
8. Subject tolhe.above conditions.a District Approval and Verification form may be issued as the District's
permit.
9. This permit is valid for one (1) year. If work is not completed within said year, permit renewal will be
required, together with payment of any increase in capacity fee, connection fee .and/or SC -OR Facility Charge.
Payment of Fees/Char9es required prior to final LAKE OROVI R. P.U.D.
inspection. Payment received by:.
Date: Receipt # By J
E].
CASH CHECK # CY7 2-- Date: 0/:S /(
'Permit #:
*Monthly charge payable at the current -rate at time of connection.
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
PROJECT INFORMATION
Site Address: 176 APACHE CIR
Owner:
Permit No: B06-2335
APN: 069-220-046
MARQUEZ, ROBERT & KRIST
Issued Date: 02/12/2007 By KEJ
Permit type: RESIDENTIAL
342 MISSION OLIVE RD
Subtype: SFD-Custom/Model
OROVILLE, CA 95966
Expiration Date: 02/12/2008
Description: NEW SINGLE FAMILY RESIDENC]
(530) 589-0558
Occupancy: R-3 Zoning: RTI
Contractor
Applicant:
Square Footage:
MARQUEZ, ROBERT & KRIS
Building Garage Remdl/Addn
342 MISSION OLIVE RD
1,749 484
OROVILLE, CA 95966
Other Porch/Patio Total
(530) 589-0558
329 96 2,658
FEE INFORMATION
County Impact - SFD $2,244.02 SMIP - Residential $0.50
DBSMIP Residential $12.51
Dwelling - Custom, Model $1,085.26
Dwelling - Custom, Model $1,627.90
Fire Ping Appl Fee (SRA) -Fire- $95.00
Impact Processing Auditor $50.00
Impact Processing DDS $50.00
Total Charged: $7,170.28 Fees Paid: $7,170.28
Res Impact Fees -SFD $2,005.09
Balance Due: $0.00 Receipt No: B332
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
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
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
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect.
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
X
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
of not more than five hundred dollars
02/12/2007
penalty [$500];
the following:
&N,
Contractors Signature Date
F THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
WORKERS'COMPENSATION DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
HAVE AND WILL
the work himself or herself or through his or her own employees, provided that such improvements
❑I MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
❑❑
Section
I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
3700 of the Labor Code, for the performance of the work for which this permit is issued.
My Workers' Compensation insurance carrier and policy number are;
The Contractors License Law dows not apply to an owner of the property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
Carni Policy Number: Exp. Date:
(T ' section nee not be competed if the permit is or one hundred dollars ($100) or less.
❑ I AM EXEMPT under Se n B. & P.C. for this reason:
I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED, I shall not am Piany person in any manner so as to become subject to the Workers'
%Compensation
laws of Cal omia, and agree that if I should become s <act to the workers'
X U2/12/200
compensation provisions o Section 3700 of the Labor Code, I sh orthwilh comply with those
Owners Signature Date
provisions.
X 02/12/2007
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Sign re Date
WARNING: FAILURE TO SECURE WORKE S' COMPENSATION COVERAGE IS UNLAWFUL,
WARNING: FAILURE TO SECURE WORKELCOMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
injury, including death, and property damage caused arising out oof, or in any way connected with
o
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
the issuance of this permit. I hereby acknowledge thatt is issuance of this permit does not authorize the
sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
AuseMorcupancany
bove mentioned property for inspection purposes. I hereby certify that I am the
authorized to act on the property owners behalf.
CONSTRUCTION LENDING AGENCY
02/12/2007
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
me o mi ee [SI Pont Date
the performance of the work for which this permit is issued. (3097 civ. code)
caner ❑ Contractor OR;Agent for Owner ❑Agent for Contractor
FILE COPY
Lenders Address City State Zip
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
PERMIT APPLICATION DATA SHEET
Reference Number: B06-2335 Date: 09/29/2006
Location: 176 APACHE CIR By: TMP
Parcel Number: 069-220-046 Sub Type: SFD-Custom/Model
Owner Name: MAROUEZ, ROBERT & KRISTYN Phone: (530) 589-0558
Description: NEW SINGLE FAMILY RESIDENCE
The above permit application has the following Clearances required prior to permit issuance. Please contact each department
indicated below regarding specific requirements pertaining to your permit application.
Yes No DRAINAGE DISTRICTS
❑ ❑ Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740
a❑ LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000
❑ ❑ City of Chico, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711
PARKS & RECREATION DISTRICTS
❑ ❑ Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711
❑ ❑ Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921
❑ Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011
1:1 ❑ Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393
SCHOOL DISTRICTS
❑ ❑ Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281
❑ Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006
❑ ❑ Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675
Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723
❑ Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000
`-�+�V ❑ Orooville E_lenientary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000
Ell
OrovilloeQUU
❑niioon High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext:105
❑ ❑ Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400
OTHER
�e�¢�o�dead�cBopy of Agricultural Acknowledgment Statement- See Attached Instructions
❑ ❑ City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447
LI ❑ Other: jr)p;PC�
❑ ❑ Other:
❑ ❑ Other:
Signature of Property Owner: ELVADate: 09/29/2006
FILE
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
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 you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° 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.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° 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 perforin their work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractor 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's automated telephone information system at 1-800-321
-CLSB (2752) or by accessing thier website at www.CSLB.ca.gov.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
1. I PERSONALLY P TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMPROVEMENT. (YES)DR NO)
2. ((HAV�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:
ADDRESS CITY
PHONE CONTRACTORS 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:
ADDRESS - CITY
PHONE CONTRACTORS LICENSE NO
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
Description: NEW SINGLE FAMILY RESIDENCE
Reference Number: B06-2335 0
Applicant Name: MARQUWf, ROBERT $F IdiISTYN
Signature of Property Owner:
BUTTE COUNTY FEE SUMMARY
7 County Center Drive
Oroville, CA 75965
Department of Development Services
Phone (530) 538-7541 Fax (530) 538-2140
Permit Number: B06-2335
Job Address: 176 APACHE CIR
Contractor: DAVE ALVES
958 BIRD ST OROVILLE, CA 95965
Printed: 09/29/2006
11:52 am
Fee Description
Account Number
Fee Amount Paid Date Pmt Amt
County Impact - SFD
SF - Public Works - Veh/Egp
1851-0-280-1011853
$658.17
SF - Public Works - Roads
1831-0-280-1011001
$1,244.88
SF - Public Works - Facility
1851-0-280-1011852
$340.97
Dwelling - Custom, Model
N - Permit Fee
0010-440001-4210500-1010
$1,627.90
N - Plan Review Fee
0010-440001-4210500-1010
$1,085.26 09/29/2006 $1,085.26
Fire Ping Appl Fee (SRA) -Fire -
0100 -450001-4617240-1010
$95.00 09/29/2006 $95.00
Impact Processing Auditor
0010-050-4617998-101001
$50.00
Impact Processing DDS
0010-440001-4617999-1010
$50.00
Res Impact Fees - SFD
SF - Gen Govt - Veh/Egp
1810-0-280-101001
$285.37
SF - Sheriff- Jail
1800-0-280-1011811
$288.00
SF - Library Vehicles
1825-0-280-1011828
$4.50
SF - Sheriff Facility
1840-0-280-1011841
$291.31
SF - Library Facility
1825-0-280-1011826
$224.20
SF - Sheriff Veh/Egp
1840-0-280-1011842
$142.14
SF - Gen Govt - Facility
1808-0-280-101001
$618.75
SF - Library Materials
1825-0-280-1011827
$150.82
SMIP - Residential
Printed By: Tammie Powell
1001-0-280-1011298 $0.50
79157.77 $19180.26
Balance Due: $5,977.51
At the time of permit application, I was advised the above fees are required prior ro issuance of the permit. These fees may be changed during the plan
checking process.
Signature: L�Z�
Date: 09/29/2006
Pursuant to Government code Section 66020, you are herby notified those items listed above may been imposed on your project. You have 90 days from
the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a
protest are specified in Government Code Section 66020(a).
Buttd County Department of Development Services
fIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
NOTICE TO BUILDERS
Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In
addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental
Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to
expedite your permit:
• Make sure your application is complete.
fry Be responsive to requests from County departments for any additional materials or requirements.
The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes
without a complete application adds to processing time.
Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not
started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to
expiration an indefinite number of times, provided construction progress has been documented by the Building Division during
each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In
order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking
and documentation may be required. Upon completion of work covered by this permit, please contact this office for final
inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is
issued without a final inspection.
EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY
Application for which a permit has not been issued will expire one year after date of application.
Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications
(not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are
for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn
before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of
$54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration
of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any
refund amount) to determine no work was done.
Fee/refund information can be read on-line at http://municipalcodes.lexisnexis.com/codesibutteco/
Reference Number: B06-2335 Date: 09/29/2006
Location: 176 APACHE CIR
Parcel Number: 069-220-046
Owner Name: MARQUEZ, ROBERT & KRISTYN Phone: (530) 589-0558
Description: NEW SINGLE FAMILY RESIDENCE
Signature of Property Owner: Date: 09/29/2006
FILE
Butte County Department of Public Works
T. MICHAEL CRUMP, DIRECTOR
LAND DEVELOPMENT DIVISION
Storm Water Managment Program
7 County Center Drive
Oroville, CA 75965
(530) 538-7266 Telephone
(530) 538-7171 Fax
www.buttecounty.net/dds
National pollutant Disharche Elimination System (NPDES) Phase II Construction Storm
Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment
[LESS THAN 1 ACRE 1
Reference Number: B06-2335
Location: 176 APACHE CIR
Parcel Number: 069-220-046
Owner Name: MAROUEZ, ROBERT & KRISTYN
Description: NEW SINGLE FAMILY RESIDENCE
Date: 09/29/2006
By: TMP
Sub Type: SFD-Custom/Model
Phone: (530)589-0558
By signing below, I the project owner/owners' 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 buildouts 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 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 this project that disturbes one acre or
more of land may result in revocation of grading and/or other permits or other santions provided by law.
Signed:
Title:
FILE
Date: 09/29/2006
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
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 you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° 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.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° 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 unders state law, contact the Department of Benerit Payments and the Division of lndustrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform thier work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons prefessing to be contractor 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 requir3ed 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's automated telephone information system at 1-800-321
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
1. I PERSONALLY 1' TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMPROVEMENT (YES R NO)
2. I (HA E/HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK.
3. I HAVE CO CTED T THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION:
NAME 7�
ADDRESS ",TY_0(0 0ll
PHONE CONTRACTORS LICENSE NO
4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE
THE MAJO RK:
NAME
ADDRESS CITY
—0a"] � 0
PHONE S Sj -I� ,05z,� CONTRACTORS LICENSE NO
5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED:
Description: NEW SINGLE FAMILY RESIDENCE
Reference Number: B06-2335
Applicant Name: MARQUE ROBERT & KIRISTYN
Signature of Property Owner: Date: _6 6
'�0TrF0& department ®f Public ®rks
> O
0 C o u n t y o f B u t t e
0
7 County Center Drive
C OrovWe, CA 95965
o (530) 538-7681
00Utll J. Michael Crump, Director (FAX)538-7171
Crc WOR�S Shawn H. O'Brien, Assistant Director
Assessors Parcel Number: �, —/)y Building permit #,
Owners Name:
Owners Mailing Address: 'S q'
Property Address:
iX 41:7.(L 6> i
ENCROACI3MENT PERMIT ACCEPTED:
PERMIT NUMBER: C
ENCROACIIIVIENT PERMIT EXEMPTION:
Reason for exemption:
R Not a County maintained road
F1 Existing driveway conforms to County S-31 standard
Other
Approved by r
Printed Name �oc� i - ✓ '�n ��
Title _
Q
Date 7Z 3
ZO-4
CONDITIONS FOR EXEMPTING A DRIVEWAY PERMIT
1. An existing home with a driveway 10 years or older and doesn't cause any problems with
the county road or drainage.
2. An existing home with only minor remodeling or repairs.
SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF
Doris F. Miller
Document Date: August 17, 2005
State of Califomia
County of ?(L 1,k SS.
On �'1 dj , before me, the undersigned, a Notary Public in and for said County and State, personally
appeared Doris F. Miller
e (or proved to me on the basis of satisfactory
evidence) to be the person() whose name) istm subscribed to the
%%!thin instrument and acknowledged to me that.helshcUlmy executed
the same in +is/herMtt!lr authorized capacitykies%— and that by
his/her/theirsignaturcW on the instrument the person(%), or the entity
upon behalf of which the person(* acted, executed the instrument.
WITNESS R1T&and'Wrd-6lTicia1 seal.
Signature
J. Br+ n. NWM PUMP;
FOR NOTARY SEAL OR STAMP
wscooN
l:;7puc
51300
MFORIJIANR' Ci. lo, 2009''
MAIL TAX TAT ENTS TO : Same as Above
BTECJGRANTDEED
2005-0049623
:- C
149CORDING REQUESTED H'
Recorder: I REC FEE 10.08
Bidwell Title &Escrow Company
Offtciai Records I TAX 63,88County of I
Butte I
J. 1
AND WHEN RECORDED MAIL, TO
RecordSUBS
County Clerk-Recorde:'I
Nome Robert Marquez
I
I SA
Strny
/►dellen 1889 Stanford Ave
:08
09MA 23 -Aug -,2086I I Page 1 of 2
Cay.Sna
�IIi1 Ii1 iI 1l
UIIIIIIIIIIIII�IIII ��ll IIII'IIIII
„p Oroville CA 95966
o'aKN.. 00223687-001
SPACE ABOVE THIS LINE FOR RECORDER'S USE
Parcel No. 069-220-046
GRANT DEED
THIS FORM FURNISHED BY BIDWELL TITLE 81, ESCROW COMPANY
The Undersigned Grantar(s) Duclare(s)
Documentary Transfer Tax is $63. 8 0
❑ City/Town of
✓ computed on full value of interest or property conveyed, or
✓ Unincorporated Arca
O full value less value of liens or encumbrances remaining at
the time of sale
❑ Monument Fee of $10.00
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Doris F. Miller, An Unmarried Woman
hereby GRANT(s) to
Robert Marquez and Kristyn Marquez,
Husband and Wife as Joint Tenants
the following real property in the ❑ City of
✓ Unincorporated Arca
County of Butte, State of California:
SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF
Doris F. Miller
Document Date: August 17, 2005
State of Califomia
County of ?(L 1,k SS.
On �'1 dj , before me, the undersigned, a Notary Public in and for said County and State, personally
appeared Doris F. Miller
e (or proved to me on the basis of satisfactory
evidence) to be the person() whose name) istm subscribed to the
%%!thin instrument and acknowledged to me that.helshcUlmy executed
the same in +is/herMtt!lr authorized capacitykies%— and that by
his/her/theirsignaturcW on the instrument the person(%), or the entity
upon behalf of which the person(* acted, executed the instrument.
WITNESS R1T&and'Wrd-6lTicia1 seal.
Signature
J. Br+ n. NWM PUMP;
FOR NOTARY SEAL OR STAMP
wscooN
l:;7puc
51300
MFORIJIANR' Ci. lo, 2009''
MAIL TAX TAT ENTS TO : Same as Above
BTECJGRANTDEED
EXHIBIT A
THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS:
Order No. 00223687-001
ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, DESCRIBED AS FOLLOWS:
LOT 226, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "KELLY RIDGE ESTATES UNIT NO.
311
, FILED IN THE OFFICE OF THE COUNTY RECORDER OF BUTTE COUNTY, CALIFORNIA,
ON JULY 26,1974 IN BOOK 43 OF MAPS, AT PAGE(S) 44, 45, 46, 47 AND 48.
AP NO. 069-220-046
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DMSION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
a007-0007-144
Recorded I REC FEE 7.88
Official Records I
County of I ITMES 2,80
Butte I
CkWDALE J. atim5 I
Couky Clerk-Recorderl
I
i JC
011:603,112+eb-M7 I Page I of I
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building
permit. The property described herein is adjacent to land or included within an area zoned for Agricultural purposes,
and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals,
including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations
including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm
operations.
All that real property situate in the County of Butte, State of California, described as follows:
LOT 226, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "KELLY RIDGE ESTATES
UNIT NO. 3", FILED IN THE OFFICE OF THE COUNTY RECORDER OF BUTTE COUNTY,
CALIFORNIA, ON JULY 26,1974 IN BOOK 43 OF MAPS, AT PAGE(S) 44, 45, 46, 47 AND 48.
AP NO. 069-220-046
Date "[ " PROPEF,:rY OWNERS:
N
State of California )
County of X66 T- "'( )
On 02 l bq t 200'7 before me,
p�mG. M
s
personally appearedJOhtl MCAC906-L, PI y1a `NI • MGl✓ P.L r`1'D.r'IQ� ' K(i 1-1 Mersoacatly
Imewn-to-me-(vr proved to me on thY basis of satisfactory evi ence) to be the person whose na e(s) ' re subscribed
to the within instrument and acknowledged to me that hie/they executed the same in hisfheWtheir authorized
capacity(ies), and that by hisAer/their signature(s) on the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, executed the instrument.
WITNESS my hand a d official seal.
JANET G. FIORE TENNANT
O&ISignature �T/y% Seal: 14A,MyComm.
Commission # 1663858
g Notary Public - CcOonla
8 Camly
Cres Jun 1, 201
A. P. # OG `a?a0 'Q��
a— �:,..,.,...t+zr ... , I r ..._i--• - a w.w rc:v• ^,,;r �x;� r. } Fx'°:*rr� tib.'.•..« �_,04sx,, , ., a.:+..,......
ri. ,
•t. ��
BUTTE COUNTY SCHOOLS*IMPACT FEE CERTIFICATION FORM
(One form per Building)
School Districtv' :• Building Department No.
Tax ate Area No.
A.P. NumberQl �� O`O��
(�' � Jurisdiction: � City County
Property Owner
Property Location/Address 17cn �s�a�l�e or. Oroy' l k pA
Subdivision Lot No.
................................................... _............................................
,
Residential Development
No of Living Mobile Hom_,::'—Addition/ s'Supplemental to
Units Installation ConversionPe mitV#
'(No foundation inspection)
:........:........................................................................................
Commercial/Industrial 0
New Addition
r Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
Sq. Footage
(Including Exterior ,
Roofed Areas). '
2-f eJs41
Date
Sq. Footage I
(Group R)
Cr. Demo -
existing sq. ft. see attached
Net total sq. ft.
District Identification No. , if Z O
6r6� School District certifies that
(Payor)
_ 1-1 ke A-12 0 OY J'�- l 1-e °t SOL to G
(Street Address) % (City) (State)
(Zip Code) (Phone Number)
has complied with the requirements of Resolution No.
representing 1"1 `E Ck square feet.
ocnooi uistnct
�7
0 S —,o b— a ok by payment of $ 4S 5. 1.
B 2926 $
FULL MITIGATION $
Paid by Check # Remarks: V (, q —Z10 0440
1-) % 9 )--ILD 3
--5--o 1
Date
Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with
Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit
you from challenging the imposition of the fees in any court action.
H, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is
noted by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA),
this project may be subject to additional school fees to fully mitigate its impact on the school district's schools.
White (school district), Yellow (building department), Pink (applicant) feeform.xls (12/06)dmm
i
LP
BUTTE 9OUNTY DEVELOPMENT ELOI'MENT FEE CERTIFICATION FORM
�f FEATHER.RIVER RECREATION AND PARK DISTRICT (FRRPD)
❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD)
0 PARADISE RECREATION AND PARK DISTRICT (PRPD)
0 DURHAM RECREATION AND PARK DISTRICT (DRPD)-
Assessor Parcel Number (s) C) COq + 9 0" ` q, �� Building Permit Number JOG 2335
Propeity Owner (s)
Project Location /Address I� �ht (� jr_��r V�� �fi . I
Subdivision Name Assessable Sq. Ftge
Typ% of Residential Development (check one)
New Development Single Family -Detached Single Family -Attached
g Y
Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling
Mobile home Mobile home replacement verified by Assessor Department
Demo Permit (date issued ) verified. by Building Department
Comments:
102G*22;01�, NO
�����1 �� 1. _��• :� �' �
Number
Mailing Address
State
Has complied with requirements of the Butte County Board of Supervisors Resolution No.
by Payment of:
Dwelling Units @ $
Square Feet @ $ _
Remarks:
Paid by Check No: 0-1 Paid by Cash:
Recreation and Park District Representative
KAF0RMS\81)n.n NnT FnP.MS\naflc-rec standard form rev Ldoc
per unit for a total of $
per sq foot for a total of $
Receipt No:
Zip
PERMIT NO.: 08-07
Lake Oroville Area Public Utility District
1960 Elgin Street
OROVILLE, CALIFORNIA 95966
(530) 53:9-2000,
DISTRICT APPROVAL AND VERIFICATION
OF BUILDING SEWERS INSPECTION
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 of a Building or an Occupancy Permit by Butte County, a copy of this verification
form, signed off.by Lake Oroville Area Public Utility District, must be submitted to Butte County.
Date:
Applicant:
Applicant Address:
February 12; 2007
Robert Marquez
342 Mission Olive Rd., Oroville, CA 95966
Applicant Phone No.: (530) 589-0558
Property Locations(s): 176 Apache Circle
Kelly Ridge Estate, Unit.3, Lot '#226
069-022-046
A. P. No.(s):
Fees due: all fees paid as of 2/5/07.
Application for service approved:
`LAKE OROVILLE AREA
PUBLIC UTILITY DISTRICT
Inspection(s) made and successful test(s) observed:
Location: Date:
Lake Oroville Area Public Utility District release to close permit:
Date: By:
❑ - In Service ❑ - Locked Out
White - Customer Green - Office Final Yellow - Customer Fina/ Pink - FOSFinai Gold -FOS
REQUEST FOR CONNECTION -PERMIT
APPLICATION FOR SEWER CONNECTION AND SERVICE FROM
LAKE. OROVILLE AREA PUBLIC UTILITY DISTRICT
hereinafter referred to as "Applicant',
being the property owner or ow er'.s agent.desinng sewer service, hereby requests Lake Oroville Area Public Utility
District, hereinafter referred to.as "District", to connect Applicants sewage disposal line to -District's sanitary sewer
system and to provide sewerage service.
Location of roe �1 ?GUS A.P.#: bbc L OZZ-04(0
P P rtY
Subdivision: i4�ul t�S - �' Low Block#:
❑ Property Annexed
❑ Property Not Annexed
❑ Property Annexation in Progress
Kind of Service:
No. of E.D.U.'s this permit:
Multiplication Factor:
*Monthly Charges:
Capacity Charge:
Residential
/ ❑ Residence of Owner Connection Fee:
❑ Rental (single family)
❑ Rental (duplex) ❑ Apartment SC -OR Facility Charge:
❑ Industrial
❑ Commercial Total Amount Payable This Permit: •�<i�l
❑ Site plan reviewed ❑ Jobsite reviewed
I
The service applied for hereby shall be in accordance with the conditions hereinafter set forth and the ordinances,
rules, 'regulations and policies adopted, or,to be adopted, by -the Board of Directors of District, all of which Applicant
agrees to abide by and fully perform. Applicant agrees to pay for such service at. rates and charges as are
established by District from time t6time.
Signature -of
Name of Owner if not Applicant
Mailing Address of Applicant 5�� Mailing Address of Owner
Phone # of Applicant: S Q Cy Phone # of Owner:
CONDITIONS OF ACCEPTANCE OF. SEWERAGE SERVICE
1. In accepting this application, District does not hold itself liable to Applicant.for failure to perform any of
the obligations imposed upon it or assumed by it under this application if such failure be caused by accident, Act of
God, fire, strikes, riots, war, lack of capacity in SC -OR treatment/disposal plant or District's lines to handle the
sewage or nay other cause beyond reasonable control of District.
2. Installation of the. sewer service line pertinent to. this application shall conform in all respects to District's
specifications.
9 A // f--- ;n" 'cnna mafariale antyinpPrpd fill. and retaining walls shall be placed on the
licant shall secure. permits) as: necessary from the County of Butte prior to doing any work„
4. W
including encroachment permits when work is within county right of way.
5. Installation of the subject sewer line. shall be at the 'sole cost and expense of Applicant.
6_ Actual connection of the subjectsewer service line to Districts sewer mainline shall be accomplished by
District staff.
7. All work shall be inspected and approved by District
8. Subject to the.above conditions.a District Approval and Verification form may be issued as the District's
permit.
9. This permit is valid for one (1) year. If work is not completed within said year, permit renewal will be
required, together with payment of any increase in capacity fee, connection fee and/or SC -OR Facility Charge.
Payment of Fees/Char9es required prior to final LAKE OROVILLE-AREA P.U.D.
inspection. Payment received by-.
Date: Receipt #. By.
[J CASH (CHECK # (_ Date:
$�, ZZS�Permit #:
*Monthly charge payable at the current rate at time of connection.
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
ARCHITECT/ENGINEER
OWNER INFORMATION
Last Name
MW
r irst Name
Address
G 1�� t
City
Phone
State'
Zip
Phone SJ
J
Fax
E-mail
Page
ARCHITECT/ENGINEER
CONTRACTOR
Name
Address
`
r
CityState
City `
1
StateA.
Zip
Phone
Fax
Fax
E-mail
Fax
Lic.#3SA677
Class
ARCHITECT/ENGINEER
Name 1
a5 vt. G
Name
Address
p _
City `
1
StateA.
Zip G
`J
Phone , D `
Fax
E-mail
State License Number
For office use only:
APPLICANT INFORMATION
Name
Z� j
Address
L
City
I es
Stat A—
Zip
I
Phone
Type Const. of
Fax
E-mail
Map Book
For office use only:
OCATION
Zoning I
Z� j
I Flood Zone
SRA
I es
No
Occ. 3
1
Type Const. of
Subdivision Name
Carrier
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
Q�D '
BP
Description or Scope of Work:
OCATION
AP# �
rOJECT
^ �r1
�[ U
Property -Address
l /q
Cit
O
Cross St et
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must he shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
2,q
v
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
required.
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by: Amount: ` �`S Bldg
SJ, U� SRA
Receipt #: B — �1- 3 -z
Sheriff
Date:
Other
q,-2rl -C)( I t� . Z
Total
REV 8-12-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑ 2. Impact Fees.
❑ 3. California Department of Forestry plan approval (if required).
❑ 4. NPDES Form.
❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 6. Contractor's license information. (Number, Name Style, Classification).
❑ 7. Worker's Compensation Carrier and Policy Number.
❑ 8. Owner -Builder Verification (if required).
❑ 9. Letter of Signature authorization (if required).
❑ 10. Recorded copy of Agricultural Acknowledgment Statement.
❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer., or MCO.
❑ 12. Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The `request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 5-12-05