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Home My WebLink About069-250-021r 1 ftl rl s - �- O- ir w+pl',i iPtij 0144. f OS r' _ 069-250-021 -U99 MOL MIKE �i �i _ STREASURG HILL DR, OROVILLE ° ° r Cont: LEGACY CONSTAd NEW SINGLE FAMILY v` wt> r#�= o frcM a �r k ! if r 5 r= rt a l ry IZ ! Jk t I r K �' r> t' Psi .. t ilki j� F F+'_ _ , _ .. ., BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530)891-2834 (CHICO) OFFICE #: (530) 536-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. . BPO50993 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: 07/07/2005 APN: 069-250-021-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: 3302 O Site Address: 5323 TREASURE HILL DR ORO Date: �_ Contractor: Map Index: OPEN360COV653GAR NSF 1880 142 Description:. ( ) ( ) ( ) ( ) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: MOE, MIKE permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 500 SUNSET DR., signed statement that he or she is licensed pursuant to the provisions of PARADISE 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 95969 she is exempt therefrom and the basis for the alleged exemption. Any (530) 877-0209 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: MOE, MIKE Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does 500 SUNSET DR., such work himself or herself or through his or her own employees, PARADISE CA provided that such improvements are not intended or offered for 95969 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of (530) 877-0209 proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor:. 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: O 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. Engineer: FLT (� 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier:%Q%� /�rJHO Total Square Ft: 3035 S.F. Policy a: Valuation: $145,052.00 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, V M tVl and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith 1 1� r �i k9 comply with those provisions. e p) L (J — Date: d/ fi 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 eby issue un er f a plicable provisions of the Bufte County Cody+ 2nrvor I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolution o do we n i ed ab ve fo hich fees have been paid. Name: BY Date: PERMIT EXPIRES ON: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. O Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. 1 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 County to enter upon the above mentioned property for inspection purposes. Print Name: ,Oe�-,A- 0 ft�(' Signature: - Date: / 0 0 Owner 0 Contractor ❑ Agent for Owner 0 Agent for Contractor �14 �VBIJTTECOUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 BP OFFICE #: (530) 538-7541 /L A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION , `� • /j, O BIN # Website: www.buttecounty.net/dds "1 ✓✓ "PLEASE PRINT CLEARLY" OWNER Last Name First Name Address ,SOD Sc1.�.Se% City ®ZGr�i StateC� Zip Phon SAOe>>-020171 Fax E -mai CONTRACTOR Name Address SSD Q City e Stag, Zip'75z Pho Esem S/'y 201 Fax E-mail Lic. # 1 16 Class APPLICANT NAME ARCHITEC /ENGINEER Name City//7`� /fie Sta ff CSG`. Address 59 Ocl�`�r ate! City State Zip 9 Map Book Page Lot # Phone � � ^DZ Fax E-mail State License Numb APPLICANT NAME Name !�7, �i— D e Address SDD S City//7`� /fie Sta ff Zip y7S b Phon 5�o 02,9/0 Fax E-mail C-01 - APPLICANT SIGNATURE X c/ For office use only: Zoning Flood Zone I SRAes No Occ. Type Const. V Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 LOCATION AP#0A7 Property Address City z3TGe�s�ye h�'*/L OGo!/iGL Cross Street WORKER'S COMPENSATION Policy Number /3 OOSoz,7 - o3 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 Address F '8 537 0 Description or Scope of Work: S%ti Le �i�al Si�r✓tiG P ow Sq. Footage 1 ❑ Structure Built withou ermits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. (��iv7o Received by Amount: J �� 1. Bldg 3C4f_ - SRA Receipt #: 4 Itor! q �� 1011 Sheriff Other TTI I Date• otal _ REV 2-24-05 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 inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). 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). E]7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 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 2-24-05 utte County Department of Development Services DNNE CHRISTOPHER, DIRECTOR co 7 County Center Drive Oroville, CA 95965 (530) 538.7601 Telephone (530) 538-7785 Facsimile O TO: ' W FROM: LO � 1 SUBJECT: O < DATE: WILLDAN Scott Rutherford (530) 538-7160 srutherford cDbuttecounty.net Plans Transmittal For Review Per Contract 4/19/2005 Applicant: IMoe, Mike Permit No: 05-0993 Project Type: NSF/Gar/Cov APN: 069-250-021 100% 70% Plan Check Fees $ 1,141.88 $ 799..32 $ 1,141.88 $ 799.32 WILLDAN Fee $ 799.32 Copies Attached: Qty Chk Application Site Plan Review FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other ss-.,..++q.+r.=..�..+r....."'a"""'.�;4i+W"�:.-.tv-,�,�,I•.r-+....'..-�..W-w'•... . _. r'-' ," "-%," ""J^"'�_. ; �+wr�...Rt.wi-sf.: COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER:%YII / 1 C. h' ASSESSOR PARCEL NUMBER Proposed Building Use: � S F Permit Technician:_ Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. Q 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. -B- 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form .P" 13. Acknowledgement of building permit application without required clearances. A PU p ❑ 14. Other 0ainin ' ems needed to issue the permit. (May require additional plan review upon receipt of the following items.) p -45. anitation and site plan approval from the E ertt-irrC3 Ehiev B 9rev+Ne as applicable ❑ 6. Fire Sprinklers............................................................................................ ❑ 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... O A Erosion Control Plan Required................:............................................. .......... 20. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 1. City of Chico Plumbing permit........................................................................ 0 22. Site plan and business license approval from the City of Biggs .............................. 23. California Department of Forestry plan approval 0-p'aid. Sent by: 24. Planning approval for (A) Use:(B)Parking: (C) Parcel Check:c7...... C _ ❑ 25. Contact Land Development abou _ Improvements, -Drainage ........................ 7 26. NPDES Form............................................................................................ � 27. Encroachment Permit for driveway from the Public Works Dept ........................... '(o ❑ 8. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... 3 Letter of Signature authorization..................................................................... 32. ecorded copy of Agricultural Acknowledgment Statement..-.C.!"r-!1.................. ❑ . Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone 60// and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. i Applicant: Date: /C - 1. Index permit application for the above items numbered: 6�K)99.Q Plan Check Letter 2. Additional items required Contractor, designer<E!!Pwas advised of the above data by Vphone, ❑ mail, ❑ counter, by Date: 5 = ojtt ( Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed b Date: Structural approved by: Date: A I it 85 Note transfer by: Date: Yellow: Building Division )Ef P=9-05 - 0 Wj COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE "(530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER PROPROSED BUILDING USE ��sf 1. BUILDING PERMIT FEES 6.� --- Balance Due ..................... $ --- FEMA Flood elevation review --- Additional plan checking Fee.... $ A. P. # () 7s -IY21 l DATE — RECEIPT # DATE REC. 2. SCHOOL DISTRICT FEES O iygI Q �l/evl � (paid at School District Office) (form available after Plan Check) _ SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$_ Units Commercial (sq. ftg.)..... X $0.03 = $_ -OS i 1 •' �iq.rtg. RECREATION DISTRICT FEES,/l0f ROCf'(�? (paid at Recreation District Office) (form available after Plan Check) RESIDENTIAL DEVELOPMENT IMPACT FE COUNTY WIDE (per dwelling) $44 0 q4z ax- E$, - CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per. dwelling) Zoning 6. SRA RE INSPECTION AND PLAN CHECK FEE 204.98 paid at Building Division) -my. "40- i 7. WATER TENDER FEES BATTALION # A�A$200.00 (paid at Building Division / -SMIP _ / lL7 ^ca 9. OTHER 10. OTHER 11. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checling process. APPLICANT G DATE 9 ��"U Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 3/05) 4 ' O!Q(T O 6UTTF Ac�UNI�S AUC Department .0 o u n t J. Michael Crump, Director of Public o f B u t `forks LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville, CA 95965 (530)538-7266 (FAX) 538-7171 National Pollutant Dischattrge Elimination System (NPDES) Phase ll Construction Storm dilater Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement FLESS THAN I ACRgJ Project Description: Project Location an WMI - , I -A.,,. ` 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:Q-�- Title: Date: Less than I Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program 12.-;. 4 C/7A/M AND WHEN RECORDED M:IL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2005-0022183 Recorded Official Records County Of BUTTE CANDACE J. GRUBBS Recorder. ROSEMARY DICKSON Assistant 02:26PM 19 -Apr -2005 REC FEE 10.00 CONFORM 1.00 COPIES 2.00 Kathy Page 1 of 2 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: ,SPP 4TTQ yyc11 Date PROPERTY OWNERS: yaeG State of California County of DAIr/ On M11 1611-VILb before me, a r-, PX1 M.OiC1'4i b JAII�lA.rl/ I?ublll personally app d K((YIp:Q,I M,O i 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 executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. I 4g8'pa 0, f KRISTEN MAGGITTI signature Seal: T- Q�R;-�� o Comm. #1472558 V NOTARY PUBLIC CALIFORNIA Q V BUTTE COUNTY A.P. # ° My Commission Expires Feb. 24, 2008 Escrow No.: 05407297 -TG Locate No.: CAFNT0958-0958-0001-0000107297 Title No.. 05 -107297 -BD S, r+ THE LAND REFERRED TO HEREIN BELOW IS SITUATEp IN THE UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF CALIFORNIA AND IS DESCRIBED AS FOLLOWS: Lot 193, as shown on that certain Map entitled, "Kelly Ridge Estaies Unit 4B", filed in the Office of the County Recorder of Butte County, California, on November 10, 1977, in Book 58: of ..Maps, at Pages) 73 thru 77. ENCROACHMENT PERMIT County of Butte Department of Public Works 7 Count Center Drive Oroville, CA 95965 Phone (530) 538-7157 Ext. 2016 Fax: (530) 538-4356 Download Forms: www.buttecounty.net/publicworks/forms.html NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE Phone (530) 538-7157 Ext. 2016 Permit Number District - APPLICATION I / WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the County roads and highways, all in accordance with County ordinances and general laws. (All information exce t signature must be typed or legibly rinted. I. Applicant's Name:. la. Company Name: . f a G Cav-S%`alp �a�.J 2. Address: D-Sv,/S. 7- 3. Phone: 3. 4. Assessor's Parcel Number: 5. Location of Work to be Done 6. Applicant's Signature C /7 /CO'NTRACTOR'S 7. Date: l%e _2 INFORMATION 8. Contractor's Name LOROSSIGNOI BRO 9. Address DOX 491 CA Paradise, CA 95969 10. Phone: 0•10 -cam 7- 7:3 11. Fax Odd 12. Contractor' umber: 13. Certificate of Insurance: Yes n No: ❑ 14. C ntractor's Sign j 14a. Date Signed: 15. Authorized Agent: TY`PE OF WORK TO BE DONE 16. Please Check:17. Curb: Gutter: El Sidewalk: 1:1 If Driveway List Type: 18. Other Work - De e: ' c�ae."'J f?3=-C�.�2-- 19. Plans Attached: ❑ Yes ❑ No PERMIT GRANTED In compliance with the above request, and subject to all terms, conditions (including those on page 2 of this permit form) and special conditions written below, permission is hereby ranted. 20. Conditions G'�� rl� Z `' ® " /4/C/moi As Underground Service Alert (U.S.A.) must be notified two working days prior to any excavation. 800-227-2600 21. JXAII work shall conform to accompanying: Detail Plans ❑ Special Conditions ❑ 22. Date issued C 23. Expiration Date: / / 24. Surety: S/ 25. Date Paid: 26. Amount Paid: u 27. 3z Paid ceipt No.6 Mike Crump, Director of Public Works By: ❑ Com I d - OK ❑ Completed - Not OK ❑ A itional Com ents Attached For County 29. Final Inspection Date: 30. Inspected By: use only:. 31. Comments: Note: If permits are faxed to any number besides (530) 5384356, they can be delayed up to one week. Page I of 2 PERMIT NO.: 58-05 Lake Oroville Area Public Utility. District 1960 Elgin Street OROVILLE, CALIFORNIA 95966 533-2000 DISTRICT APPROVAL AND VERIFICATION OF INSPECTION BUILDING SEWERS This verification form must be submitted to the Butte County Department of Public Works Building Department prior to issuance of a building or occupancy permit, whichever is applicable. Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by Lake Oroville Area Public Utility District, must be submitted to Butte County. Date: June 2, 2005 Applicant: MICHAEL A MOE LEGACY CONSTRUCTION Applicant Address: 500 Sunset Dr., Paradise, CA 95969 Applicant Phone No.: 877-0209, Cell #514-020.1 Property Locations(s): 5323 Treasure Hill Drive Kelly Ridge Estates Unit #4B Lot #193 A.P. No.(s): 069-250-021 Fees due: All fees paid as of 6/2/2005 Application for service approved: LAKE OROVILLE AREA PUBLIC UTILITY DISTRICT Inspection(s) made and successful test(s) observed: Location: Lake Oroville Area Public Utility District release to close permit: Date: By: Date: m AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 COPY of Document Recorded 19 -Apr -2005 2005-0022183 Has not been compared vith 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 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: Date —/V CSS PROPERTY OWNERS: State of California ) County offC/ ) personally app6aWd K((AM)J Mhf,, 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 executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. e,.° .� KRISTEN MAGGITTI Signature Seal: r Comm. #1472558 NOTARY PUBLIC CALIFORNIA Q P BUTTE COUNTY 1 A.P. # My Commission Expires Feb. 24, 2008 Escrow No.: 05 -107297 -TG t ' Locate No.: CAFNT0958-0958-0001-0000107297 Title No.. 05 -107297 -BD .ax M tri •vl o J :.: r:. : s . . +,�::��.}•p.Jjf ��',{.Wryylyd-i4�� fi`�H�ar.,::6Ye�1: n': .i`, THE LAND REFERRED TO HEREIN BELOW IS SITUATEp IN THE UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF CALIFORNIA AND IS DESCRIBED AS FOLLOWS: Lot 193, as shown on that certain Map entitled, "Kelly Ridge Estates Unit 4B", filed in the Office of the County Recorder of Butte County, California, on November 10, 1977, in Book 58: of -Maps, at Pages) 73 thru 77. ;.• 5<: 1, w'+.. 'h�°j s+ga.•.i[� •?;Psr• ,0 -ry r.:5`�::rr e,.:. �. 4.1'::i>' , • � .��. - . gyp• .:d', ..y: . r. 1'i+:, �: �E1•"1,�{'::'i�i:F, :l.i:'{: :. t. ��Y:I.�f t i:� r :t r..'. I i" i,.�..,:..err,:......, ,-,•va ':;2 c is S':: ��, � , .',: • F ; .`'E�..,' '',�:�i.',ID' IJ. ,�L24�1�� I{a;�,' >7iSN[� r jf,.; ;I. •}'-P$'I�rA;:: �ij. :jR11f. '.e,_ ':3- �,. • �.`.�;'.':. _ 'duals•..... BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District lylom Building Department No. A.P..Numbertion: city County ;� 1%---A J-4,2 - /Jurisdic Property Owner Property Location/Address Subdivision Lot No. Residential Development Q Q 0 Q Sq. Footage w) No of Living Mobile Home Addition/ *Supplemental to (Group R) Units Installation Conversion Permit # ....................................................................... *(No foundation Inspection) ! ............... ..... . . ... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/industrial Sq. Footage New Addition (Including Exterior Roofed Areas) Building 'bepairtment Representative Date District Identification No. —10 6L, School District certifies that (Street Address) On, Ise 11� (Applicant) (Phone Number) (City) (State) (Zip Code) has compliid-with the requirements of Resolution No. 0 3 -014 --L4 by payment of $ Lk- k k .2—c'� representing k F'ff 0 9qUare feet. 2926 $ FULL MITIGATION $ Ci School District RevrWhentative Date Paid by Check # )— Remarks: 0 6 q- '3- 5 0 - C) I,- I . lgRO ._2-It- Notice:You may protest the Imposition of the fees Identified above by submktlng a written protest to the District, In compliance with Government Code Section 66020(a), within 90 days from the date fan are paid. Failure to submit a timely written protest will'prohlbft you from challenging the Impoeftlon of do less In any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School Die I trIct Is OR by'the applicable Local Planning Agency that this project Is being reviewed under the Calftrnla Environments! Quality Act (CEQA). this project may be subject to additional school fen to fully m1thiate. He Impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xis 110/031dmm BUTTE C9UNTY DEVELOPMENT FEE CERTIFICATION FORM PTEATHER RIVER RECREATION AND PARK DISTRICT FRRPD 0 CHICO AREA RECREATION AND PARK DISTRICT (CARD) ❑ PARADISE RECREATION AND PARK DISTRICT (PRPD) 0 DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) Property Owner (s) Project Location /A Subdivision Name PermitNumber Assessable Sq. Ftge� Type of Residential Development (check one) New Development Single Family -Detached Single Family -Attached Alteration/Addition(s) _ Mobile home Demo Permil,(date issued Comments: ve Non -Residential to Residential Mobile home replacement Date Multi -Family Dwelling verified by Assessor Department tverified by Building Department V(RRPD 0 CARD 0 PRPD ❑ DRPD certifies that: Applicant Name Phone Number Mailing Address City State Zip Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of: Dwelling Units @ $ 0 per unit for a total of $ % 0 00 Square Feet @ $ Remarks: Paid by Check No: Paid by Cash: Recreation and Park District KAFORMS\BUILDING FORMS\park-rec standard form rev Ldoc per sq foot for a total of $ Receipt No:/ '7153 6/.2 9/0 Date {1 M SITE PLAN REVIEW APPLICATION Date: AN e!�q- 0(5-zl` Permit Number (if applicable) OSS - D ��.� Bin Number APPLICANT INFORMATION Parcel Size: Owners Name:` �e Owners Address: Telephone No.: Email: Situs Address: 5-32-3 7—,^e41611,e =41Z A- zle Proposed Use: Residential New Single Family Residential ❑ Single Family Addition ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other ❑ Septic ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Zan Stamped Approved By Date Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) Expansive Soils (Test for expansive soils and if verified proper foundation design required) SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: X • 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 (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) ❑ Oroville Enterprise Zone Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance . ---------------------------------------------------- ----------------------------------------------------------- ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: P i-- / ('&OR) Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. Is CDF approval needed for encroachments into SRA setbacks. Page 2of5 I Zoning Code Streets & Highways Fire Prevention Subdivision Map Front 20 Side Side Street Rear / �0 Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. Is CDF approval needed for encroachments into SRA setbacks. Page 2of5 I V Applicable Development Fees: Standard Fees ❑ Fife., ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other -------------------------------------- Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) Amount Formula * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By ❑ Deeds: Date of Creation: Legal Access Provided: Deed of Reference: Legal Access Required Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: II . ❑ No ❑ Yes ❑ No ❑ Yes ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance/Notice of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: . ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 I" - Subdivision ME/Parcel Map: �Jy P+ Map Date of Recording: Lot: da 14 ❑ Use Permit/Minor Use Permit Permit Number: C1I M • Date of Approval: Page:7-3-77 Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Attached ❑ None ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. X ❑■ Page 4 of 5 PLAN REVISION/RETURN Owner's Name: j oLffv)c-. AoqAP#: - 2S50 L d BP#: r (5 !Z !?_2 Received By: 7P ' Date: b - so :7� Contact Person & Phone Number: PURPOSE OF RE -SUBMITTAL OR REVISION ❑ Permit Application Data Sheet Item 2- *Engineering 1_ ` IM' *Plan Revision ❑ *Requested by Building Inspector's Correction Notice - Inspector's Name: ❑ Requested by Plan's Examiner - Plan Examiner's Name: ❑ Other: *If revising a plan which has already been issued, submit two (2) drawings reflecting the revision for plan review along with your approved plans. If engineering is involved in this revision, the engineer must put his requirements on these drawings and wet stamp and sign two sets of engineered drawings. Revised drawings must clearly show changes proposed and locations involved. WHEN APPROVED, PROCESS AS FOLLOWS: ❑ Mail to Owner/Contractor at this address: ❑ Call ❑ Deliver with next inspection. and hold for pick-up. Minimum revised plan check fee to be collected at time of submission of revision, plans examiner will determine if additional plan checking fees are needed: ❑ Minimum $54.99 Receipt #: ❑ Fee not required for revisions requested by plans examiner prior to issuance of permit. ❑ Additional Fee Amount: Receipt #: Revised 2/04 W I LLDAN Serving Public Agencies June 17, 2005 Scott Rutherford Butte County Building Department 7 County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX SUBJECT: COUNTY OF BUTTE PLAN REVIEW APPROVAL Willdan Project No: 14353-1566-M Jurisdiction Job No: 05-0993 Assessor's Parcel No: 069-250-021 Description: Moe-NSF/Gar/Cov Dear Mr. Rutherford: 117 C Street Marysville, California 95901 530/749.2373 fax 530/749.2199 www.willdan.com Willdan has completed a plan review of submitted plans and documents for the above referenced project and recommends your approval with the conditions noted on the 2"d page of this letter. The plans and documents provided for this review that have been found in compliance with the applicable codes are: ➢ Plans: Two (2) copies, sheets 1 through 4, not dated by Legacy Construction ➢ Structural Calculations: Two (2) copies dated 4/05 by FLT Engineering ➢ Energy Calculations: Two (2) copies dated 4/6/05 by Robert Mangrum The plans have been stamped with the Willdan approval stamp and dated the date of this letter. According to our previous letters relating to this project, the superseded plans and documents will be discarded within 10 days unless we receive other instructions. On the pages to follow is the identification of the codes and standards applicable to the project, a code analysis, conditions -of -approval and identification of any deferred submittals. APPLICABLE CODES Unless noted otherwise, all. comments, are based on requirements of the 2001 California Building Standards Code found in the' California Code of Regulations, Title 24: • , Part 2, known as the California Building Code and abbreviated herein as CBC •''. Part 3, known as the'California Electrical Code and abbreviated herein as'CEC Part 4, known as the Calif6thi echanical Code and abbreviated. herein as CMC • Part 5, known as the California Plumbing Code and abbreviated herein as CPC • Part 6; known as the, California Energy Code; and Energy Commission Standards; and abbreviated herein as CECS CODE ANALYSIS Our plan -review revealed the following information regarding the occupancy designation, type of construction, and 'other pertinent features. This information is not consistent with that- shown on the permit documentation. The square footage of the porch and deck areas differ. frorn..that listed on the permit, application. Butte County may recalculate the fee based on this new information. Specific Use.' Type of ant Type of Construction Sprinklers Sprinklers Stories 1" Floor Sq Ft 2" Floor Sq Ft. Total . . ;Sij Ft .._ .. `1',_. Dwelling.... - R-3 . V=N No' 1880 NA. ' 1880 Garage U-1 V -N No 1 653, NA 653 Porch. R-3 V-N_No 1 360 NA 360'. Deck R=3 V -N 1. No 1 142 NA 142 CONDITIONS OF APPROVAL 1. Approval is contingent upon the review, requirements and approval of other departments and/or agencies that have ,jurisdiction over this project. 2. Revisions and/or notes as red-lined.on the plans. DEFERRED SUBMITTALS.,l Our plan review. reveals no deferred submittals noted at tliis?time. 'SPECIAL INSPECTION NEEDS Ouublannreview, reveals'no special inspection needs pursuant to CBC 1701. Sinter Fo (Z - Isaac Isaac Kuster. Michael Ng, P.E. Plans Examiner Plan Check Engineer Cc: Alice'Mefford, E-mail: amefford@butiecounty.net Mike Moe, Legacy Construction, 506 Sunset'Drive, Paradise, CA 95969 FLT Engineering, Fax: (530) 872-9331 Page 2 of County of Butte.Permit-Number 05-0993 W illdan Project Number. 14353-1566