Loading...
HomeMy WebLinkAbout069-240-04206-1370 ySMITH, 069-240-042 SCOTT JACK HILL RD, OROVILLF Cont: OWNER _ 1 "II! .7A .• s •j euolaumu Butte County Department o Development Services Building Division 7 County Center Drive 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 CLAIMANT'S NAME: MAILING ADDRESS: PHONE: ASSESSOR'S PARCEL NO.: [Please use one claim form per permit.] BLDG PERMIT NO.: Recei t.No. 1 Receipt No. 2 Receipt No. 3 X5"5 _91 JAI _�2- ✓ -AD RECEIPT NO.: cV,� RECEIPT DATE: �j� l e57 DB RECEIPT AMOUNT: �-� �d"Z�✓ J�GI���% '�� \ 07 REASON FOP > REFUND REQUEST' co �Q GG�J �%iiG CG/% �ll/IIC/l�C/•' Check those fees which you wish to have considered for refund: ]Building Permit Fees =Sheriff Fees =SRA Fees (CDF Fire Planning) =Other (specify): 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. e' .- �� Signature 41.1 K:/Forms/Refund Application 082203 Date ��3 • 5.'40„"5 . f a < • , UPSTATE CONSTRUCTION- 6299 ONSTRUCTION 6299 Co Rd 25 Orland,, CA 95963 Lic. # 818285 _ 530-865-3712 a November 9, 2006 'Butte County Building Department 7 County Center Drive Oroville, CA 95965 Re: 069-240-042 Dear Tammie: Please accept this letter as our formal request to cancel the permit on the above noted property as - the project has been cancelled due to the recent death of the owner, Scott Smith. k Project: APN: 069-240-042 ' 6586 Jack Hill Drive T Oroville, CA 95965 Attached is the application for refund. - If any additional information is needed, please contact me at (530) 865-3712. Thank you, , b r ,ovz� Christy Pitts Business Manager COUNTY " NOV - 0.4 2006 t - ' DEVEL®PWOT ' SERVICES • - r 2Y/2@/2005 T0':T5' 53@965'25'62 November 9, 2006 UPSTATEGONSTRUGTiON UPSTATE CONSTRUCTION 6299 Co Pd 25 Orland, CA 9.963 LAc. # 616265 530-665-3712 Butte County Building Department 7 County Center Drive Oroville, CA 9S965 Ike: 069-240-042 Oear Tarnmie: PAGE @2109 Please aoaept this letter ae our formal request to cancel the permit on the above noted property as the project has been cancelled due to the recent death of the owner, Scott Smith. Project: APN: 069-240-042 6586 Jack Hilt Drive Oroville, CA 9596;4 Attaohed is the application for refund. N any additional information is needed, please contact me at (530) 865-3712. Thank you, Christy Pitts Business Manager 11/10/2006 10:15 53OB652561 UPSTATECONSTRUCTION PACS€ 03/08 T �� Butte County Department q f Development ;Services s I o a ^ B1titi ding Division O ! o % Cr)WOY CCIF[W Drive S .... •53A 535-7541 c' ���� Orovillc�, CA. 959654 REFUND REQUEST APPLICATION REFUND POLICY - Butte County Codi 3-41(t) 1. Refunds can only be made upon wrftten request by the person who paid the tees, whose name is on the receipt Issued for the fees paid. Any refund dlieckS will be, made payable to the name on file receipt. 2. The request must be made withir5 tyro years from the date of fee payments on permits not issued, and two, years from the date of permit issuance for permits 16rued - 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. 4STRUCTIONS: Submit this application to Development Services for determination of refurfdable fees. A claim will be enerated for any fees to be refunded and sent to the address below f6r signature (by the person whose name is on the CLAIMANT'S NAME: 1i�Ile, MAILING ADDRESS: e�V� PHONE: .0.L,2 ASSESSOR'S PARCEL NO.: [please use one ciaim form per permit.l BLDG PERMIT NO.: .L '" J� 9 dff- -F-7FL--ca/of No. I T Receipt N RECEIPT NO.: - RECEIPT DATE: 111 D �l D RECEIPT AMOUNT: /.Z �D. • ���� REASON FO REFUND REQUEST - ew Check those fees which you wish to have considered for refund: EZ3Building Permit Fees (=Sheriff Fees F--i--jSFtA Fens (CDF Fire Piannirig) =Other (specify): Plans for cancelled permits will be disposed of within 10 wotking days up6n submissions of a Reauest for Refund. If you want the plans. you May pick them uo prior to khat time. Signature K/FormsiRefund Application 082203 Date r 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: 6586 JACK HILL DR Owner: permit No: 06-1370 APN: 069-240-042 SCOTT SMITH SRA Fees Issued Date: 08/15/2006 By CRW Permit type: RESIDENTIAL 6586 JACK HILL RD Subtype: NSF/GAR OROVILLE, CA Expiration Date: Description: NSF/GAR 1547 SQ.FT.*RE-ISSUE* (530) 865-3712 Occupancy: Zoning: Contractor Applicant: Square Footage: OWNER SCOTT SMITH Building .' Garage RemdUAddn 6586 JACK HILL RD OROVILLE, CA Other Porch/Patio Total (530) 865-3712 FEE INFORMATION - Fund 10 BLDG $1,627.90 Fund 10 BLDG $1,195.24 SMIP $4,361.00 SRA Fees $95.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires OWNER I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 08/15/2006 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by . Section 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; R Carrier: Policy Number: Exp. Date: (This section need not be competed if the permit is or one hundred ollars ($100) or less.) I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' mpensation laws of Cali nd agree that if I should become subject to the workers' conipe4ation provisio of Sectic1h 3700 of the Labor Code, I shall forthwith comply with those 08/15/2006 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip $7,279.14 Fees Paid: $7,279.14 Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION 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 pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that ne or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500]; Please check one of the following: KAS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License w does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's 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 Contractor's License Law.). ❑ I AMEX�under Section B. 8 P.C. for this Signature 08/15/2006 Date 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 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 injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. 1 hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorized to act on the property owner's behalf. 08/15/2006 ElOwner ❑ Contractor OR.,{� IAgent for Owner Agent for Contractor - FILE COPY ���� ��t/ f� �-c�/ l/l�s �. l (-�4� S/j �G.6 ��y /��-z __--1 V--\-�-__-.T--_ __ � � _-___._-- __ �_ _�-- �---_� BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION All: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.neAdds PERMIT NO. -AP LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 08/15/2006 APN: 069-240-042-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 6586 JACK HILL DR ORO Date: contractor: Map Index: _- ' Description: NSF +44+P7 GAR (440) OWNER -BUILDER DECLARATION I hereby affirm under penalty' of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner:' SMITH, SCOTT to its issuance, also requires the applicant for such permit to file a 6299 COUNTY RD 25 signed statement that he or she is licensed pursuant to the provisions of ORLAND, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95963 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: SMITH, SCOTT Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does 6299 COUNTY RD 25 such work himself or herself or through his or her own employees, ORLAND, CA provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 95963 year of completion, the owner -builder will have the burden of (530) 865-3000 proving that he or she did not build or improve for the purpose of sale.). O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor:. not apply to an owner of property who builds or improves thereon, . and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Busines d Professions Code Date: ELS - C'G Owner: License #: WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. L3I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 2187 S.F. Policy a: Valuation: $124,115.00 Census Code: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, n ��� L and agree that if I should become subject to the workers' ' compensation provisions of Section 3700 of the Labor Code, I shall 'A 55%� I 5 forthwith comply with those provisions. 4 L(/1'y Date: IS ' © Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one '( hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. - _ CONSTRUCTION LENDING AGENCY — This permit is hereby issued under the applicable provisions of the Birfte County CodA a, nrUOr —_ -- — -1-2 _ a Ihereby affirm that there is a construction lending agency for the -Resoiuti - ns'to oo work indi a ve for which feeshave been-paid.- een aid:" `- p - performance performance of the work for which this permit is issued (Sec 3097 Civ.) Name: 4ed r Q (C By: Date: U' 1 J` 0((6 Address: Q PERMIT EXPIRES ON: l l Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte ounty too enter upon the above mentioned property for inspection p Print Name: yNt�Signature % Date: 05' ❑ Owner ❑ Contractor Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) . OFFICE #: (530) 538-7541 PERMIT NO. BP061823 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I licensed under provisions of Chapter 9 (commencing with Section 700000 ) of Division 3 of Issued Date: 09/15/2006 APN: 069-240-042-000 the Business and Professions Code• and my license is in full force and effect. Site Address: 6586 JACK HILL DR. ORO License Class : License Number: Map Index: Date: Contractor: Description:. nsf (1547) gar (440) OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: SMITH, SCOTT permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 6299 COUNTY RD 25 signed statement that he or she is licensed pursuant to the provisions of ORLAND, CA. the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95963 she is exempt therefrom and the basis for the alleged exemption. Any 530-865-3712 violation of Section 7031•.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: SMITH, SCOTT Code: The Contractors' State License Law does not apply to an 6299 COUNTY RD, 25 owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, ORLAND, CA, provided that such improvements are not intended or offered for 95963 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 530-865-3712 proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. Engineer: ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 1987 S.F. Policy#: Valuation: $111,115.00 Census Code: ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By: Date: Address: PERMIT EXPIRES ON: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505,- 25533, and 25534 of the California Health and Safety Code, which regulate the storage; handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all coubty and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: Signature: Date: ❑ Owner ❑ Contractor ❑ Agent for Owner ❑Agent for Contractor B. C. Building Permit 01-16.04 pg 1 06-13-70 to zg S s BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION I� AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 P OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION BIl % Website: www.buttecounty.net/dds (P "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name irst Nre Address Z c!9 25— City �►� .•t dl State Zip Phone rp 5= 3 �o Fax f 5 -- E-mail CONTRACTOR Name Address City Address ZZ3J L Z L� Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name a z r D. - S , Address ZZ3J L City C to State Zip Phone -3 L/ 2 _ 9 w 7 Fax E-mail D7 J State License Number APPLICANT INFORMATION Name Address City d �lGr'v� State Csf Zip 3 Phone Fax E-mail fir• • .�W_ � For offic a onl Amount: °O Bldg Zoning Flood Zone SRANo Occ• Sheriff Type Const. Subdivision Name / Map Book Page Lot # Planner D7 J I Date Approved: :: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 3 PROJECT LOCATION AP# a Property Address City 1111) D Cross Street WORKER'S COMPENSATION Policy Numbe Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit Issuance. LENDING AGENCY Name cJA, , 4-a Address & �' Description or cope of Work: rvc_✓ t *u_ _. . Sq FT- Living 17 V7 Garage VV Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be 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: °O Bldg a SRA Re eipt #: Sheriff l 1 -SW_ / SMI P Date: ({ Other D7 J REV 8- A? 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!) QR 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 AIC for Non -Residential Buildings. ❑ 6. Manufactured homes:. (A) In Iotl;Tanual, (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. 11 ❑ 5. - ERcroachmerit Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractoe'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, anq two years from the date issued; however, on issued permits refunds can only be made if no construction* work has check fees -for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION of permit issuance for permits been done. Filing fees, plan KAFORMSMILDING F0RMS\131dgApp1SubRgmts.doc Page 2 of 3 REV 8-12-05 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION Y 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 ' . PERMIT APPLICATION DATA SHEET OWNER: ASSESSOR PARCEL NUMB R Proposed Building Use: Permit Technician: Date: Items required in order to apply or a permit All boxes MUST be checked OR marked NA id ord o apply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. 2. Complete plans, 3 or -4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. 1% 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 8.' Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. O 9. Metal bidgs: (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. Hazardous Material Form ❑ 12. Acknowledgement of building permit application without required clearances. 0 13. Other :+� U t R a'ning items needed to issue the permit (May require additional plan review upon receipt of the following items.) I-OA7 14. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicablelm ❑ 15. Fire Sprinklers............................................................................................ ❑ 16. Agricultural Buffer dr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... ❑j. 91fees rosion Control Plan Required........................................................................ l as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 20. City of Chico Plumbing permit........................................................................ ❑ 21. Site plan and business license approval from the Qyof Biggs..............4........... 22. California Department of Forestry plan approval ETpaid. Ser by.� r 23. Planning approval for (A) Use: OA—'.(B) Parking: (C) Pa I he :... ....... S 6 ❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 25. Fire Marshall Review (commercial projects only). Sent by: • ...................... 15 26. NPDES Form.....................................................".."....... 27 Encroachment Permit for driveway from the Public Works.........Dept......" ................. .................. ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... Cl 29. Worker's Compensation Carrier nd Policy Number .......................................... 30. Owner -Builder Verification (ve'h to owner, _Mailed to owner) ..................... etter of Signature authorization .......................................... F3Existing ecorded copy of Agricultural Acknowledgmdnt Statement...... �.. . 7 ;0t_ violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 3 Legal descriptio , ❑ .H. Title, title search, registration o MCO ........ ...... nther_m40� 'r C. U1 d� er. When issued Telephone I have been informed hold for pickup. Ing a building permit. Applicant Date: l/ 1. Index perm• pp of for the above items numbered: Ian Check e 2. Additional fife ifired Contractor, d i ; Owne as advised of the above data by . phone, ❑ mail, ❑ counter, Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner was advised of the above data by ❑ phone, ❑ mail, ❑ counter, b Date: Plans reviewed blir Date: 7 - Plans approved by: Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: L 2v Yellow: Building Division BUTTE COUNTY DEPAIRI MEN'll OF UEVtLUIJMtN i ,tKVlla, - t$UILUINU UtVIJtUN 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 www.buttecounty.net/dds PHONE (530) 538-7541 FAX 538-2140 RECEIPT OF FEES SCHEDULE - RESIDENTIAL Owner SMITH, SCOTT APN No: 69-240-042,Permit Type: Subtype: App Date: 6/8/2006 Permit No: BP 06-1370 Permit Desc: 1 BUILDING PERMIT FEES ESTIMATED AT APPLICATION $2,713.16 Plan Check portion of Permit Fee $1,085.26 $1,627.90 Balance of Building Permit Fee 2 FEMA Res Flood Elevation Review $109.98 0 3 SRA* Yes Fire Plan Check - Non -Refundable $95.00 $95.00$204.98 (State Responsibility Area) Building Inspection $109.98 $109.98 NON-REFUNDABLE portion of fees due at application $1,180.26 FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION $1,290.24 FEES (BELOW) DUE PRIOR TO ISSUANCE OF PERMIT $5,989.42 $1,627.90 g (5 $12.41 g RECEIPT DATE Tech/Asst 4 Balance of Building Permit Fees (from No. 1 above) 5 SMIP* - Strong Motion Instrumentation Program (Enter amount from permit system) 6 Additional Plan Check Fees (NON-REFUNDABLE) 7 Other*: 7a Other*: 8 IMPACT FEES - RESIDENTIAL* Per Dwelling I Per Dwelling Per Dwellinc Applications After 04115106 ,c SFD ,: MFD MH 9 County 1 4249.11 3183.54 Chico Urban Area 6146.23 4538.82 EI Medio Fire District 1 3249.971 2385.76 North Chico Specific Plan $7,211 $6,275 SR -1, SR -3, SR-1/PD 8801.091 7395.04 R-1 ° 8897.09 7491.04 R-2 8390.09L 6984.04 R-3 7604.091 6198.04 3rocessing Fee is automatically added to impact fee total TER TENDER FEE (Not collected when impact Fees Applicable) Enter Bat.# DRAINAGE FEES* 10 CHICO STORM DRAINAGE MASTER PLAN New construction, vacant land, on 1 acre or less - Enter 1 or less acre value 770 Butte Creek 771 Comanche Creek 772 Little Chico Creek 773 Big Chico Creek 774 Lindo Channel 775 SUDAD Ditch 776 Mud -Sycamore Creek PV Ditch 7289.40 RECEIPT DATE Tech/Asst $4,349.11 RECEIPT DATE Tech/Asst 1 $100.00 $200.00 7,997 $8,341 $9,088 $6,776 $8,267 $7,211 $6,275 $8,893 10a More than 1 acre, existing buildings - fees to be assessed by Public Works Fee Determination Sheet Needed - Enter amount determined by PW 11 THERMALITO DRAINAGE AREA 1 $684 Maximum Per each new living unit on existing lots where full drainage fees have not been paid 11a Temporary Dwelling $136 At time of building permit $136 annual renewal fee for first 4 renewals. Not to exceed $684. PROOF OF PAYMENT OF FEES (BELOW) MUST BE RECEIVED PRIOR TO E is completed for applicant to take to respective district office. 12 SCHOOL DISTRICT FEES* 12a RECREATION DISTRICT FEES* Forms will be prepared after plan check At the 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: 06 Pursuant to Governme cod S tion 66020, are ereby notified those Items followed by an ""' may have been impose on ur project. You have 90 days from the date of approval o porject or from the impostion of the above referenced items during which you may protest. he quire for a protest are specified in Goverment a Section 66020(a). K:/Building/Forms/Schedule of Receipt Fees esidential 041506 BUTTE COUNTY SCHOOLS IMPACT,FEE CERTIFICATION FORM N (One form per Building) School District 151-Z BuildlnEgDep7artment N el"' r-:�t>o 6 �;70 A.P. Numbei 0(/2—jurisdiction: city County /property Owner S—< Property Location/Address 1*4(1& /40. , Subdivision Lot No. :Sq. Footage ............ 7 Residential Development No of �V]ing Mobile Home Addition/ * USupplemental to (Group R) Units Installation Conversion Permit # No foundation inspection) ............................... ....................................................... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document), Commercial/industrial 0 0 Sq. Footage New Addition (Including Exterior Roofed Areas) Building Department Repr'Useative Date District Identification No. kke -School District certifies that (Applicant) (Street Address) (Phone Nurh ber) (V,," -ku— C.wA Ct so, (City) (State) (Zip Code) bt has complied with the requirements of Resolution No. 6 by payment of $ L( SQL representing 1—)+ —1 square feet. School District B 2926 ULL MITIGATION $ 'F. .:=j —0 to Date Paid by Check # Remarks: 0 (a A t,3 --a La .(43 Node@: You may protest the Imposition of the fees Identifted'above by submitting a written protest to the District, In cornptlance 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 Irnposition of the fen In any court action. N, Subsequent to On School District Representative signing this Butte County Schools Impact Fee Certification Form, the Sdwd matict is notified by the applictle Local Planning Agency that this project Is Ming reviewed under the California Environrnental Quality Act (CEQA), this project may be subject to addit!" school fen to ftft mitigate Its Impact thwachooll ftbWs schools. 'A 4 BUTTWE UNTY IDEVEI,OPNIENT FEE CERTIFICATION sTRICT (FRRPD) FORM HERRIV.ER RECREATIONACHICO AREA RECREATION AND PARK DISTRICT (CARD) 0 PARADISE RECREATION AND PARK DISTRICT (P.RPD) 0 DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) Property Owner (s) Project Location /Address Subdivision Name %7'-42, lCBuilding PermitNumber 50 Assessable Sq. Ftge_�_7�Z7_ Type of Residential Development (check one) New DevelopmentSingle Family -Detached Single Family -Attached Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling Mobile home Mobile home replacement verified by Assessor Department Demo Permit (date issued ) erified by Building Department Comments: D O CARD - O PRPD 0 DRPD certifies that: (n Applicant Name Phone Number State Zip Mailing Address City Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of: Dwelling Units @ $ Square Feet @ $ Remarks: per unit for a total of $ ' per sq foot for a total of $ Paid by Check No: � Paid by Cash: Receipt No: e, �0TT 0 D&part ent ®f Public Works o 0 C o u n t y o f B u t t e 0 0 7 County Center Drive ' Oroville, CA 95965 0 0 c�UN�y J. Michael Crump, Director. (530)538-7681 (FAX) 538-7171 pvecrc WoF�y Shawn H. O'Brien, Assistant Director Assessors Parcel Number: 2,(-10 -dqZ Building permit # Owners Name: Owners Mailing Address: Property Address: ENCROACHMENT PERNIIT ACCEPTED: PERMIT NUMBER: fI /I ENCROACHMENT PERMIT EXEMPTION: Reason for exemption: F] Not a County maintained road [J Existing driveway conforms to County S-31 standard (J Other Approved by Printed Name Title Date -1 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. RECORDING REQUESTED BY Bidwell Title & Escrow Compaov nraer Na 00227655-002 (Y -- 13? 0 2006-0031484 Recorded 1 REC FEE 18.88 Official Records I TAX 156.28 Countq of 1 t c mACE J. eBuss County Clerk-Recorderl t t SA 89:Bmm 21 -Jun -M 1 Page 1 of 2 ABOVE THIS LINE FOR Parcel No. 069-240-042 GRANT DEED THIS FORM FURNISHED BY BIDWELL TITLE & ESCROW COMPANY The undersigned Grantor(s) Declare(s) Docu [3 CitylTown of ® computed Transfer Tax is $156.20 conveyed, or ed on full value of interest or property Y [3 Unincorporated Area 0 full value less value of liens or encumbrances remaining at the time of sale D Monument FCC of $10.00 FOR A VALUABLE CONSIDERATION, receipr, of which is hereby acknowledged, Rosemarie Harder hereby GRANT(s) to Scott Smith, a single man, the following real property in the O City of ® Unincorporated Area County of Butte, State of California.- SEE alifornia: SEE EXHIBIT A. ATTACHED HERETO AND MADE A PART HEREOF osemarie Har er Document Date: June 15, 2006 State of California )SS. County of is i /y� O ,,, P ? Ao —F. before me, Ont L R� Notary public, personally appeared daeolae4e M4,"ke Rosemarie Harder ADV SEAL OR STAMP ftrsomd me (or proved to me on If►e basis of satisfactory evidence) to be the persoro whose name�dj is/ subscribed to the within instrument and acknowledged to me that 4he/tbef executed the same in jtt's/her/tb& authorized copaeity(iedj, and that by Xssllter/their signatureW on the instrument the personal; or the entity upon behalf of which the personf,ttj acted, executed the instrument..::- WITNESS my hand and offi�al seal. , Signature OOYY�1� NKARV we LUROIOM �11a1MtE000lwn �ol�tt.lfipirasoa. t1elOb9 MAIL TAX STATEMENTS TO: Same as Abcroe BTEClGRANTDEED AND WHEN RECORDED IIAILTO Scott Smith 6299 County Road 25 Orland, CA 95963 C9q. sure Mp nraer Na 00227655-002 (Y -- 13? 0 2006-0031484 Recorded 1 REC FEE 18.88 Official Records I TAX 156.28 Countq of 1 t c mACE J. eBuss County Clerk-Recorderl t t SA 89:Bmm 21 -Jun -M 1 Page 1 of 2 ABOVE THIS LINE FOR Parcel No. 069-240-042 GRANT DEED THIS FORM FURNISHED BY BIDWELL TITLE & ESCROW COMPANY The undersigned Grantor(s) Declare(s) Docu [3 CitylTown of ® computed Transfer Tax is $156.20 conveyed, or ed on full value of interest or property Y [3 Unincorporated Area 0 full value less value of liens or encumbrances remaining at the time of sale D Monument FCC of $10.00 FOR A VALUABLE CONSIDERATION, receipr, of which is hereby acknowledged, Rosemarie Harder hereby GRANT(s) to Scott Smith, a single man, the following real property in the O City of ® Unincorporated Area County of Butte, State of California.- SEE alifornia: SEE EXHIBIT A. ATTACHED HERETO AND MADE A PART HEREOF osemarie Har er Document Date: June 15, 2006 State of California )SS. County of is i /y� O ,,, P ? Ao —F. before me, Ont L R� Notary public, personally appeared daeolae4e M4,"ke Rosemarie Harder ADV SEAL OR STAMP ftrsomd me (or proved to me on If►e basis of satisfactory evidence) to be the persoro whose name�dj is/ subscribed to the within instrument and acknowledged to me that 4he/tbef executed the same in jtt's/her/tb& authorized copaeity(iedj, and that by Xssllter/their signatureW on the instrument the personal; or the entity upon behalf of which the personf,ttj acted, executed the instrument..::- WITNESS my hand and offi�al seal. , Signature OOYY�1� NKARV we LUROIOM �11a1MtE000lwn �ol�tt.lfipirasoa. t1elOb9 MAIL TAX STATEMENTS TO: Same as Abcroe BTEClGRANTDEED ,o ti Order No. 00227655-002 EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: PARCEL I: LOT 113, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "KELLY RIDGE ESTATES UNIT 4B", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA.. ON NOVEMBER 10, 1977, IN BOOK 58 OF MAPS, AT PAGE(S) 73, 74, 75, 76, 77. AP NO. 069-240-042 PARCEL Il: AN EASEMENT FOR INGRESS AND EGRESS OVER, ACROSS AND OF, ADJACENT TO NDER A STRIP OF D THE UNIFORM WIDTH OF TWENTY FEET LYING NORTHWESTERLY AND PARALLEL WITH THE SOUTHEASTERLY BOUNDARY LINE OF LOT 114, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "KELLY RIDGE BUTTE, WHICH UTTES ATE OF WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF CALIFORNIA, ON NOVEMBER 10, 1977, IN BOOK 58 OF MAPS, AT PAGE(S) 72, 74, 75, 76, 77. OWNER -BUILDER VERIFICATION 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 th major labor and material for construction of this proposed property improvement: YES PK -4 NO [ ]. 2. I HAVE [ Q 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 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 TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone . (530) 538-7785 Facsimile www.buttecounty.net/dds OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 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 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-CSLB (2752) or by accessing their website at www.CSLB.ca.gov. 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. Sincerely, Scott Rutherford Manager, Building Divi ion NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. vetrc rwOV0i45 Department of Public Works J. Michael Crump, Director LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville, CA 95965 (530)538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE1 Project Description: C4 (oma Project Location and/or Parcel Number: 61P — Z, L/0 - 0 1 -2 t -C L (- 11( P -.C- 61 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: ��— 0 13 v Title: ben IA AAA yck' Date: S= Z3-oA Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 SITE PLAN REVIEW APPLICATION Date: /rZo AP# O 4/0 — ayZ Permit Number (if applicable) 06-1370 Bin Number i APPLICANT INFORMATION Parcel Size: ©% 9^a2gO -O `� 2 -- Owners Name:��--5��� Owners Address: to Z� 9 /:O► • -2 t%/l.�I / sig% .3 Telephone No.: Site Address: ei C% I-etp t/l a Q/7 M/Zj-,4 Proposed Use: Zone: �T— Residential New Single Family Residential ❑ Single Family Addition ❑ Single Family Remodel ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial . ❑ Industrial Addition Other ❑ Septic ❑ Agricultural Exempt Building ❑ Other: Brief Explanation/Issue: ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well ❑ Agricultural Buffer Form DEVELOPMENT SERVICES INFORMATION (For Staff Use GP: L -D k- Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval ❑ Resolved By Date Z 1 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Williamson Act Minimum Acreage: ❑ Residence can be built per contract ❑ Watershed Protection Overlay Zone ® SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: • Flood Zone: • Flood Panel No.: 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 ❑ Chapman/Mulberry ❑ Cohasset Area Use Requires: ❑ . Use Permit ❑ Variance ❑ Agricultural Worker Affidavit ❑ Administrative Permit ❑ Minor Use Permit ❑ Minor Variance Zoning: & — i Applicable Building Setbacks: General Plan: L1)°IL ❑ Setbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: 2 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side Side Street Rear 5 Height Waterway N/A N/A N/A ❑ Setbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: 2 7) Parcel Created By: ❑ Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements IN Subdivision Map/Parcel Map: Map Date of Recording: I //0 7 7 Lot: Book: J Page: 73177 3 MER'S CERTIFICATE N A WE; SOUTHERN CALIFORNIA FINANCIAL CORPORATI 0 S OWNER OF THE LANOS INCLUDED WITHIN "'KELLY RIDGE ESTATES UNIT AS" AS 'SHOWN WITHIN THE COLORED BORDER LINES ON THE ANNEXED MAP..DO 'HEREBY CERTIFY THAI' WE ARE -THE ONLY PERSONS WHOSE CONSENT I'S NECESSARY TO PASS CLEAR TITLE TO 'S A'10 LAND AND WE CON SENT TO THE PREPARA- TION AND RECORDATIONOF-SAID MAP A'S -SHOWN WITHIN THE COLORED BORDERLINES. THAT PORTION OF ROYAL OAKS DRIVE, WOODMAN DRIVE, DILLARD COURT, JACK HILL DRIVE , TREASURE HILL DRIVE, KANAKA AVENUE, ST. ELMO COURT, AND BLINIIG COURT AS 'SHOWN WITHIN THE COLORED BORDER LINES ON SAID MAP, IS 'HEREBY OFFERED FOR DEDICATION FOR PU BL IC USE FOR COUNTY ROAD PURPOSES. WE. ALSO OFFER FOR DEDICATION; AND DO HEREBY DEDICATE'FOR SPECIFIC PURPOSES, THE FOLLOWING: (1) 'EASEMENTS FOR LIGHT AND KIR OVERTHOSE STRIPS OF LAND LYING BETWEEN THE FRONT AND/OR 'S IDELA NES OF LOTS AND THE LI NES 'SHOWN HEREON AND DESIGNATED "SETBACK LINE" l"S.B.L 'SATE 'STRIPS TO BE 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 SERV.I CES. TOGETHER WITH ANY AND ALL APPURTENANCES APPERTA'IN- 'ING THERETO ON, OVER, UNDER AND TOGETHER WITH THE RIGHT To TRIM OR REMOVE THE NECESSARY TREES. TREE LIMBS OR BRUSH ON (HOSE PORTIONS OF LAND MORE PARTICULARLY DESCRIBED A5 FOLLOWS: (0 A °TRIP OF LANG FIGHT (B) FEET IN WIDTH WITHIN THE LOTS AN. CONTIC '^US TO ANY STREETOR OT14ER PUBLIC .WAY (B) A STRIP OF LAND SIX (6) FEET' IN WIDTH WITHIN THE LOTS AND CONTIGUOUS TO ALL SIDE AND REAR LOT LINES. (C) T40CL' STRIPS OF -LAND DESIGNATED AS PUBLIC UTILITY EASEMENT (P.U.E.) IN THo LOCATION AND OF THE WIDTH SHOWN HEREON. (3) RESERVATION PROHIBITING VE HICUL4R INGRESS AND/OR EGRESS OVER AND ACROSS THOSE STRIPS OF LAND ABUTTING ARROYO DRIVE AND DESIGNATED "NO ACCESS STRIP." 14) RIGHTS OF WAY AND EASEMENTS FOR DRAINAGE PIPES AND OTHER DRAINAGE WAYS TOGETHER WIT" 'ANY AND ALL APPURTENANCES APPERTAINING THERETO ON, OVER AND UNDER THOSE'STRIPS OF LAND DESIGNATED "DRAINAGE EASEMENT ("D.E.") IN THE LOCATION AND OF THE WI DTH'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 PRI VATF. DRIVEWAY EASEMENT ("C.D.E.") AN THE LOCATIONS AND OF THE WI'DTHS_SHOWN HEREON. 'SOUTH CALIFORNIA FINANCIAL CORPORATION 'Z_ ASSISTANT VICE PRESIDENT 'STATE OF CALIFORNIA 1 COUNTY OFLP,S�L}>�4S 155 ON AWAY 31 1977, BEFORE ME Po�LiBIa/�MPf�ytR A NOTARY PUBLIC. :IN AND FOR Lof Aa -&(a* COUNTY. STATE OF CRIIF�lJ,4 PERSONALLY APPEARED � �- KNOWN TO ME TO BE THE AMf -w �" r ^F THE H ON .THAT EXE CUtED THE WITHIN 'INSTRUMENT AND ALSO KNOWN TO ME TO BE 'THE PERSON WHO EXECUTED -ST ON BEHALF OF SUCH CORPORATION AND ACKNOWLEDGED TO ME THAT SUCH CORPORATION EXECUTED THE 'SAME. &CO.AiStFION EXPIRES m NOTAR 'PUBL'IC SURVEYOR'S CERTIFICATE .I . RICHARD W. MORTONHEREBY CERTIFY THAT :I AM A REGISTERED CIVIL ENGINEER OF THE .;TATE OF CALIFORNIA:' THAT THE .ANNEXED MAP OF KELLY RIDGE ESTATES UNIT 48 CORRECTLY REPRESENTS A'SURVEY MADE UNDER MY SUPERVISION 'IN SEPT. 1976 ;'THAT THE SURVEY 'IS COMPLETE AS SHOWN: THAT THE MONUMENTS WILL BE OF THE CHARACTER AND WILL OCCUPY THE POSI'T.IONS A NOI CATED AND WILL BE 'SET BY SE PT. . 1977, AND THAT 'SAID MONUMENTS WILL BE 'SUFFICIENT TO ENABLE THE 'SURVEY TO BE RETRACED. 7I• y f � ' .DATE OEC. '[8,797Cw 0, a $ , RICHARD W. MORTON R.G.E. 145 ONL fig'- 73 �6 AU)ITOR'S CERTIFICATE I, W. L. LAWRENCE. AUDITOR OF THE COUNTY OF BUTTE. STATE OF CALIFORNIA, DO HEREBY CERT.I FY THAT THERE ARE NO TAX LIENS AGKINST KELLY RIDGE ESTATES UNIT AB AS HEREON 'SET.FORTH OR UNPAID -STATE, COUNTY, MUNICIPAL OR LOC AL"TAXES OR SPECIAL AS S ESSMENTS"NOT YET PAYABLE: 'TAXES OR ASSESSMENTS WHICH ARE LIEN BUT NOT YET PAYABLE 'I ESTIMATE TO BE -IN TH AMOUNT OF �.9iP..� TOR wi/ er55 / COU N'fY DOR COUNTY SURVEYOR'S CERTIFICATE :1, CLAY CASTLEBERRY, COUNTY SURVEYOR OF THE COUNTY OF BUTT F., 'STATE OF CALIFORNIA. 00 HEREBY CERTIFY -THAT -I HAVE EXAMINED"THE FINAL MAP OF KELLY RIDGE ESTATES UNIT 40AND THAT 'IT 'IS 'SUBSTAN- T,IALLY THE ' SAME 'AS WHAT APPEARS ON THE TENTATIVE MAP ON FILE AND ANY APPROVED ALTERATIONS;,, THAT ALL THE PROVISIONS OF THE 'SUBDIVISION MAP ACT OF THE 'STATE OF CALIFORNIA, AND ANY LOCAL ORDINANCES APPLICABLE AT THE TIME OFAPPROVAL OF SAID TENTATIVE MAP HA'S BEEN COMPLIED WITH ANDA AM SATISFIED THAT THE MAP :IS TECHNICALLY .F� , CORRECT. DATE .(f -a -77 CSL/A�Y/CASTLEBERRY, RCE 14224 COON TY' SURVEYOR COUNTY CLERK'S CERTIFICATE :I 00 HEREBY CERTIFY THAT ON THE 3Q DAY OF V N , 'THE BUTTE COUNTY BOARD OF 'SUPERVI'SORS OFFICIALLY APPROVED 'THE 'SUBDIVISION MAP OF KELLY RIDGE ESTATES UNIT 48,THE RECEIPT OF 'SATISF ACTORY 'SECURI'TY'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 'SKID MAP AND OFFERED FOR DEDICATION ARE ACCEPTED ON BEHALF OF THE PUBLIC FOR ROAD PURPOSES. COUNTY CLERK BY RECORDER'S CERTIFICATE REG RDED:IN 'THE OFFICE OF THE RECORDER BUTTE CO�jYTY, 'STATE OF CALIFORNIA. AT THE REQUEST OF -'� N.Lt4� �.w. 'TH IS 1, OA OF 11— , 19791 . AT 34 MINUTES PAST -L— O'CLOCKA- .M., 'IN MAP BOOK AT PAGE5„Z4 9f 7�^ 76 t 9'T RECORDER NUMBER 11c12 LOUI'SE KLUENDER, COUNTY RECORDER 14, SUBDIVISION NO. h�6 KELLY RIDGE ESTATES UNIT 413 A PORTION. OF THE W. 1/2 OF SECTION 6 ,TIM. R.5 E.. M.D.M. AND A PORTION OF SE 1/4 SECTION I, T. 19 N, R.4E.,M.D•M. COUNTY OF BUTTE , CALIFORNIA OCTOBER , 1976 OWNER B SUBDIVIDER: SOUTHERN CALIFORNIA FINANCIAL CORPORATION ENGINEERS: MURRAY McCORMICK INC.. SHEET I OF 3 SHEETS- 17n / - - " ,d?/ SEE SHEET 5 :I• 208 a / t ^ POt Coy P/0 —eR� I67 2 /J4 _ ,A �•' N -•g q u /90 /l h' /.P 1AOGE0 BASIS OF BEARINGS - 4- y KELLY RIDGE ESTATES UNIT eA BOOK N M.0 R 405 I N w U PAGES 11, 10, H /r ?Q% �_t- \ w te' ''1 :; •--N' 6tWtR lA6tu1Nr - / /. 6. .. 1611. �:�. O roq • a •y 8 Ib9 �yi,,. q 8 oF, 406 8. s "' ; u ��� A+R._RR, tv. tea ~ x ,✓,fir'. W ?/b St WtR PA6PMtN1 ut 0 ,x.q/u� �• r "� 108 LEl21m �d ; C xRI• .p.p `Z I/ ' � 4R ". 14• i P/7< .4i' � tIN < - Tp = " FOUND MONUMENT AS 'SHOWN ..................................... All �' i •$ l09 !�'ayP, '9 /94 SET 2" K 3' IRON PIPE TAGGED RCE /4e17 .......... 185 q. ZY vl <^a.4ir g to 0b0-e5/A, ///P" CPOUND, i NOTHING P , N07N/NO Str. ........................... .....0 l95 ♦ 4 s Yb :> - • •.'. 'b ' „ ll7 >r r g6.6R' ..W/n/ AW.R. OR455 CAP q•46c �,�/59 •�c : r�_r .� !`• a GSA 5 L7' SET CENTERLINE MONUMENT, 81 'f,E CO. 'STD S-17•„--,-,® C Y. S a /f0 <.i 8... r• wyp 8 Q• Z i .. �i �� RADIAL LINE-- .......... .............................. 1.1 r 1"A PH i $.• •Y j ? «,ti _� '•.:v0' �/' •V - Y fewe, 'AltuNT BUI LCING SETBACK LINTIS 0 .............. OR:_RR. PG_ a:a � : ,.m•c.e $. ?PO<' �.` /b7 �✓i_�. •t �,q1�M ^ ^ I/S 8 ` � COMMON PRI/ATC C.:I VEWAV EASEMENT ............ 6.,�a:r :” eAf, •`TG G i• a. /a,a / Ib) / DRAIIrAGE CASEMENTID I. 1 ...................... +� \ 221 '�S •:t<ai pT W 't.m�a. [[� a o \ 111 - M�N^ 1/4 lfry a/ � .� PURI.: f, !,TILITY EASEMENT 1- Il E 1 ............... !bb R e` DEPAle I': '.' 1-F WATER Rf.SOUR:.ES........................ O. W.A. 173YlpMdp'p• i ^@ ' he, STAT! ,. Ai IFORNIA a4 b:•.am'n/v. :-scb` @ ' 77b �e A11 ' gatr m' �G� rA PA ALL LOT CORNERS NOTANDICAT'ED BY THE ABOVE 'SYMBOLS \ f4/ Bid o- w' �P,/b� ! AflE TO RE MARKED BY 3/4" IRON PIPE WITH 'TAG RCE HSM In _ .N• drebva. l40 / v q 4: n/5b a c ^� �193 .. 276 Lg :�� �•��a�crP, gyp/ Y44 3 �� .. An: b' rs• ,.' 89�o'i Y l" t <`- •xv""r 7amQ -' .:Pga°D.-- - N fSI .1W4 c /� k 8 1144 14S ' 8 147 !I - ACREAGES 7914 .w , 4 245 I o d 1— / � /G � 1O °' .•ml.w• � ,wb• 3 tors ................ ee./51 Ac. Z � Na 4619 ';� v p off`� 6rRPtlS........... IP.Ol1 AC. DOUNOARY..._.. 60714 AC. at9T, LAID C IV I247 ` W � �.ae. N• I _. In 248 / - . 49 �a.. � o•m'aua• J( " s"M aur ro' aroiu fa./NAGt lAerurxr ARROYO OR/VE \ T KELLY T;IUGE ES19T E5 1 �' :1( UNIT 5 apax 45 KAAP3 PAG 9 M. I Qi V 45, 46, 47, 4e, Jr9'- % SUBDIVISION NO.1,t� KELLY RIDGE ESTATES UNIT 4B A PORTION OF THE W.1/2 OF SECTION 6 JIM, R.5 E., M.D.M. AND A PORTION OF S.E. 1/4 SECTION I, T. 19 N., R.4E.,M.D.M. COUNTY OF BUTTE ,CALIFORNIA SCALE : IK= 100' OCTOBER , 1976 OWNER 8 SUBDIVIDER: SOUTHERN CALIFORNIA FINANCIAL CORPORATION ENGINEERS: MURRAY Mc CORMICK INC. SHEET 3 -0F. 5 SHEETS PERMIT NO.: 52-06 Lake Oroville Area Public Utility District 1960 Elgin Street OROVILLE, CALIFORNIA • 95966 (530) 533-2000 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: June 23, 2006 Applicant: SCOTT SMITH Applicant Address: 6299 County Rd 25, Orland, CA 95963 Applicant Phone No., 530-865-3000. Property Locations(s): 6585 Jack Hill Drive Kelly Ridge Estates Unit 4B Lot 113 A. P. No.(s): 069-240-042-0 Fees due: $1,790.00 Capacity Charge paid as of 6/23/2006, Application for service approved: LAKE OROVILLE AREA PUBLIC UTILITY DISTRICT Inspection(s) made and successful test(s) observed: Location: By: Lake Oroville Area Public Utility District release to close permit: Date: By: - In Service J - Locked Out White - Customer Green - Office Final Yellow - CustomerFinal Date: Pink - FOS Fina/ Gold -FOS 4b. REQUEST FOR CONNECTION PERMIT Q - APPLICATION FOR SEWER CONNECTION AND SERVICE FROM LAKE OROVILLE AREA.PUBLIC UTILITY DISTRICT f/AC��l I hereinafter referred to as "Applicant", 'being the property owner or owner's agent desiring sewer service, hereby requests Lake Oroville Area Public Utility District, hereinafter referred to as "District", to connect Applicant's sewage disposal line to District's sanitary sewer system and to provide//sewerage service. / Location of property: to S�� �QA- l4�c�/li �_ A.P.#: (o — -2!:;( — Subdivision: ,c� Lot#:/. Block#: Property Annexed I No. of E.D.U.'s this permit: ❑ Property Not Annexed ❑ Property Annexation in Progress Multiplication Factor: Kind of Service: -/ I Residential Residence of Owner Rental (single family) ❑ Rental.(duplex) Industrial *Monthly Charges: V Capacity Charge: ,o Connection Fee: ❑ Apartment SC -OR Facility Charge:::z y Ov Commercial Total Amount Payable This Permit: % Site plan reviewed ® Jobsite reviewed,/�r 1�l 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 Applicant Name of Owner if not Applicant Olt 9syr Maili g Address of-Aipplidant Mailing Address of Owner OV Phone # of Applicant: X30-- d oO 00 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. 3 All structures fencing spoil materials engineered fill and retaining walls shall be placed on the property so their gravity loading is outside of the sanitary sewer easement. 4. Applicant shall secure permit(s) 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 line shall be at the sole cost and expense of Applicant. 6. Actual connection of the subject sewer service line to District's sewer mainline shall be accomplished by District staff. - 7._Al! York shsll 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/Charges required prior to final inspect .o Pay ent received by: Date Receipt # LAKE ORO LE AREA P.U.D. By: CASH [-]CHECK # Date*— $ `7 Permit #: So -O *Monthly charge payable at the current rate at time of connection. 0i AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING. DIVISION- 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 COPY of Document Recorded 2 -Aug -2006 2006-0039482 Has not been compared with original BUTTE COUNTY RECORDER 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.pay. be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides;•pestioides,,and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plow, in,&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: 11-,4 /13,,4 o,- 77�A7 , �C E,Q 7-4 /-J .1-7e o E17'l T[- 45 /9� �C�L /2/ 2) C L- tS7;R-7?-r-S Gtr /T', /{6 /�/C//'Mf+0" /N ?4�6 7.z,/c 1267(e,12-VC/2- o F 7V C- Goa-^ 77, '. � F % "71Z,- S-74 TE 0,F e4 GN ND ✓, /v� / /i 7 7 �,✓ vle- rd or Psj.4T �,qcr S i3�7s;7� 76/%.6 Date 0hV ' % PROPERTY OWNERS: S-�o fT S�w /4 State of California '' ) County of 6 1,C ! 1 h personally appeared S e n A+ personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged_ to me that he/she/they executedthe same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the persons) or the entity upon behalf of which the person(s) acted, executed the i ent. WITNESS my hand and o eal. , Signature Seal:' SHAWN FELIX �.. COMM. # 1632420 tp NOTARY PUBLIC -CALIFORNIA J0 ���- Z'7U UJ7 •� GLENN COUNTY A.P. # �'� , ^ , _ �,. .• My CommCmm Expkes JAN 18, 2010 SHAWN.`FELIX:.- Comm .,#::1632420 ' NOTARY PUB I:IC•CALIFORNIA •. GLENN 'COUNTY,