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069-370-006
is NOTES RESIDENTIAL /y d PERMIT NO. _"060--1707006 GS -02 _ SMITH, _1'O:VI/ I t al _ 0,\K. i:.l'.!=.S"1: 1:>R 1 VE, OROV iLLE Cont: OWNER NEW SINGLE I:nV1ILY r F� FFICE G COPY ^Q Address OA U GAS Meter By Date L�i ELECTRIC Meter By Dat&nn I SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER Ke (z [ 1y dg�z a&za-, 14q ly4q 1 t [� eAr S Oct?, eu/Tot— h JOB FINALED (Date) s Signature "M4 �n� = OK = Not OK a = NotReadyablet MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ P' L -ft. / P Nat. or/ P' L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing Date 11. Card B-1 Date Card B-1 Date 12. Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except Ws 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line Card B-1 Date Card B-1 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date 11. Card B-1 Date Card B-1 Date 12. Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line Card B-1 Date Card B-1 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance -GA 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panel boards -Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date ODERFLOOR (Pla ) OK except Ws r // 7:pning-Se cks-Easements-Flood-Slope . Dg., Main; Soils -Elea Grnd.-/ /" Ftg. Depth Date PLUING (Permit) O xcept Ws Ft Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth Water Htr.; V ess -Combustion Air Baffle Porches & Decks; Soils -Steel-/ /' Ftg. Depth Water P' ; TeST& Anchor -Nail Protection . Ste walls, Main; Steel-Blockouts-Wrapped DWT; Test Fittings & Anchor -Nail Protection temwalls, Garage; Steel- Blockouts-Wra ed i 6 old Downs and Special Anchors Test Tub & Shower, Second Floor -Tub Access 7. Slab. Steel-Wrawed 6 t? T .V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test 1 F, Gas Pipe; Size Anchors -Yard Gas Piping; Size -"-.nWater Pipe; Test -Anchors -Regulator -Service Test 4E—Electric Underground -13-Ple ms & Ducts; Clearance-Material-Support-Im 1 rs-Sills-Anchor Bolts-Joists-Vents-Crippies Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUING (Permit) O xcept Ws 58. Water Htr.; V ess -Combustion Air Baffle 18. Water P' ; TeST& Anchor -Nail Protection 19. DWT; Test Fittings & Anchor -Nail Protection 65. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchor Dat -/5 6S r; est Date — 5 Card B-1 Date Card B-1 Date Card g�4 Date Card B-1 Date ELEC,WAICAL (Permit) OK except Ws & Switches at Doors & No. of Conductors 27�m�x Installed Close to Edge of ids & C.J. /' / 2 ip, Ground made up w/Mech Fasteners -Bo d Gas & Volter 2 pliance Circuits in Kitchen &Conductor Size GEL 30/Su ed Wire SizeXfUga. Cur ''A.C. Wire e Yfa Cu or Al 1 an a Circle/ /ga Cu or AI-O"ven C /ga Cu or Al 7ulated Neutral 0 Yes @Tlo �rf.,Xrvi�e-Riser Conductors & Ground Main Disconnect 3S.' f4uie. Clearances Panels-Motors-Mech. Equip. C es Closet Light -Shower Light -Spa Light 3 Smoke Detector Date i���j�- Lr7%.' d B-1 V Date Card B-1 Date Card B-1 Date Card B-1 Date NtECUMICAL (Permit) OK except Ws Ducts Insulation & 3Y. Vent Fan, Exhaust above insulation 3 6n_4ehsate Drain & Overflow, Size & QvdGe 39..4"Grnace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40.-Aftic Access & Platform if Furnace in Attic Date -0,5 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRA GJPermit) OK except Ws W.. Si Proper Materials & Anchors 4 s Studs -Nailing Spacing & Braces -Plates -Sound 4 earing Walls over Girders & Floor Nailing ,44 Q—Stop in Wall (rat of) 45,"Fire,Stops, Furred Ceilings -Stairs -Ch rs- s 4 eaders & Beams-Siz&Artearina Date FRAMIIN ntinued) 4 an ers- Post Caps -Anchors -Connector 4g,fFri�Tist Rftr. Ties- Purl in -Roll .-Tr ti ng. 49 50. -ic Access: Size & Romex Protection -Draft StoD-Ins. Baffles 61fBd . Windows or -E± i ing Doma'Sill Ht. & ons 5 . Garage Fire Protection Framing -RC annel 4?-W-OS- &3-4115-eertv Line Firewall & ODeninas ,54' Ext. Doors -One T -Check Garage 3rd Story, 2 Exits 55 Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 6. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 51. zing Area -Glass PjDt fiaon-SkyIight4PtTs_fic 60. Shear Walls; Nailing -Bolts 65. Brace Interior/Exterior Wall Panels (j S 2. Insulation -Walls -Ceilings 3. Infiltration -Walls -Windows Dat -/5 6S Card B-.1 UP Date Card B-1 Date Card B-1 Date Card B-1 Date FIN (Plans) OK except Ws Ext. Steps -Door & Sidelight Protection -Landings 6—,Smoke Detector Furnace Vents -clearance -Comb, Air-Connector- lp arage; Above Floor-Ducts-Mech. Protection bedroom Exiting Q.F.I. & Bath Fixtures & Tub Access -Spa 9. Elec. Trim & Subpanel, Breaker Sizes & Labels 7 . Stairs & Rails 7 Fireplace or Stove, Clearance -Hearth 72. Flec. Outlets at Wood Panel, Int. & Ext. 797 . Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 7 ec. Outlets & Receptacles at Kit. Counter 7 . Garage Fire Door; Swing -Landing -Closure 76. jX_ Duct in Garage -Damper Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection Elec. & Mech. Equip. Listed for Location 7 Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. l9su lation- Foam- Looked in Attic 8 . Guard Rails & Deck Construction -Post Caps 82�dn. VBents & Crawl Hole Door Drainage & Wood -Earth Cle ance Looked under Floor ❑ Yes _ 83. FoGing Instld./Drive ❑ Yes D NoMalks O Yes D No/Planters O Yes O No 8 S cco Brown -Finish C. Unit Disconnect, Electrical -Plumbing Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing Be Exterior Elec. Trim, G.F.I. Receptacle -Underground ,Wntilation Throughout House Glass Protection Corrections from Previous Inspections 9 Gas Test -Meters Tagged, Gas -Electric 93..,Water & Sewer Connected -C/O to Grade -HD Approval energy Compliance Certificate -Other Certificates 96. Address Posted 96. Fire Sprinkler Date ai 9 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date! Card B-1 Date Card B-1 Comments at Final: S= BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING PERMIT ' 24 HOUR INSPECTION #: (630) 638-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 - PERIVIIT NO. BPO50288 8. C. bunomg rermn 0 i - 6-04 vu 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penally of perjury that i am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and Issued Date: 03/28/2005 APN: 069-370-006-000 effect License Class: License Number: Site Address: 28 OAKCREST DR ORO Date: �_ Contractor: Map Index: 'OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NSF(2282)GAR(1152)COV(622) Contractors' Stale License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior Owner: SMITH, TOM K. & PATRICIA A. to its Issuance, also requires the applicant for such permit to rile a signed statement that he or she is licensed pursuant to the provisions of 3643 PARK DRIVE the Contractor's State License Law (Chapter 9 commencing with Section ELDORADO HILLS, CA 7000) of Division 3 of the Business and Prolesgions Code) or that he or 95762 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 penally of not more than rive hundred dollars ($500).): I, as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' Stale License Law does not apply to an Applicant: SMITH, TOM K. & PATRICIA A. owner of property who builds or Improves thereon, and who does 3643 PARK DRIVE such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for EL DORADO HILLS, CA sale. If however, the building or improvements are sold within one 95762 year of completion, the owner -builder will have the burden of proving that he or she did not build or Improve for the purpose of sale.).. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. -The Contractors' Stale License Law does not apply to an owner of properly who builds or improves thereon, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' Slate License Law.). ❑ I am Exempt under Article f the Buejness and Professions Code *� Dale:_ Own". 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 Is issued. Architect: ❑ 1 have and will maintain workers' compensation Insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit Is issued. My Workers' compensation Insurance carrier and policy number are: Carrier: • Total Square Ft: 4056 S.F. Policy Valuation: $185,930.00 P/I certify that in the performance of the work for which this permit Is Census Code: Issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that If I should become subject to the workers' compensation provisidns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. zb Date: Applicant T_ WARNING; Fallure to secure workers' compensation coverage is /? 1 1�� 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 fees. code, interest,and attorney's CONSTRUCTION LENDING AGENCY This genmit Is h9feby Issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there Is a construction lending agency for the Resolullo o work ndlcated above for vyhich fees have been pal performance of the work for which this permit Is Issued (Sec 3097 Civ.) BY:qa : Name: / PERMIT EXP ON: Address: (Date) O 1 hereby certify that the use of this facility shall comply with Sections 25505; 25633, and 25534 of the California Heailh and Safety Code, which regulate the storage, handling and use of hazardous materials. O Notification In accordance with Section 19827.5 of California Health & Safely Code is not applicable to the scheduled construction of this project. ❑ Allached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information Is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and slate laws relating to building construction. 1 acknowledge It Is unlawful to alter the substance of any official form or docum 1 of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned properly for inspection purposes. c Print Name:�t it f�` DyI C �� Signature: �/c=` Date: Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor 8. C. bunomg rermn 0 i - 6-04 vu 1 APA icrry Certificate .of Conformance certnicate 054-09 2 coll"tive mark of THIS IS TO CERTIFY that the glued laminated ti rod er rroductsdanciIdOn with th• applicable standards Engineensd Wood Systems (EWS) were ma nufaand associated specifications indicated below: ANSI Standard A190.1-1992, For Wood Products - Structural Glued Laminated Timber NER-486 Glued Laminate a mb rCombinationmining n SsAn "GAP" Computer Program For RITC 117.93 - Manufacturing - Standard Spedfications For Structural Glued Laminated Timber of Softwood Species linated Umber members t the APA EWs trademarked structuralglued accordance with the Engln+� IT IS HEREBY CERTIFIED that facility subject to regular audits were produced in a manufacturing As Program. Routine auk adequate inspection to verify Wood Systems (EWS) Quality slant QA program w manufacturing Process and .evaluation °f me � e and glueline bond quality, conformance to industry standards for lumber 9 �Gf F ,/k' 5 $� 56S.� Wk ic.�►�c�o� O rE' �Sd' io ? m: Z Go y � SH M 4 ���`��' by Thomas G. WM18mso ExeMWe Yoe President a ��-n+E Enrsau� wuoD►�'' SWNEERED WOOD srsrEWS b Mated X,paaoo" WA 04t14700 7011South t tth gtraet • P.O. soot F ' teNplaM: �t,3) 6E60600 i u�agcalei�=tt SO 6Z 'q��� i+Z T i E1►EOES •. �o t.a dm3 spooM , ' ,.,-s *.r, Fy Y¢�, •qtr +s7 ""T���t�a-� fin} ��fi3 1`•�'. ... �`r r r � Vit! 'f ^:., :iieiir�•4'� li..t d+i�:.; 09/12/2006 TUB 19:43 FAX ,5 INSULATION CERTIFICATE 2001/001 Job Number: 6112 CUSTOM CONSTRUCTION 28 OAKCREST DR., 0110VILLF; CA Contractor/Owner Nance Job Address (street, city, state) BUTTE County Subdivision Name Lot Number 1 � DESCRIPTION OF INSTALLATION 1. ROOF Material: Brand Name: Thickness (inches): Thermal Resistance (R -Value): 2. CEILING , Batt or Blanket Type: Ftibcrglass Brand Name: Knauf Thickness (inches): 12 Thermal Resistance (11 -Value): 38 Loose Fill Type: _ Fiber��lass Brand Name: Knauf Minimum Installed Weight/ft .569 lb Minimum Thickness: 13 inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R -Value): 38 3. EXTERIOR WALL , _ T _ Frame Type: A. Cavity Insulation Material: Fiberglass Brand Name: Khalif Thickness (inches): 61/4 Thermal Resistance (R -Value): 19 B. Exterior Foam Sheathing Material: Brand Name: Thickness (inches): Thermal Resistance (R -Value); 4. RAISED FLOOR Material: Fiberglass Brand Name: Knauf Thickness (inches): 61/4 Thermal Resistance (R -Value): 19 S. SLAB FLOOWPERIM_ETER Material: Brand Name: Thickness (inches): Thermal Resistance (R -Value): Perimeter Insulation Depth Inches: 6. - . FOUNDATION WALT. Material: Brand Name: Thickness (inches): Thermal Resistance (R -Value): DECI.ARATIO I hereby certify that the above insulation was installed in the building at the above location in conformance will) the current EnergyEfficiency Standards for residential buildings (Title 24, Part 6, California Code of Regulations) as indicated on the Certificate of Compliance, where applicable. 2,.3 & 4 Chico Insulation & Fireplaces Item Number's (rgnaturc and Vale Installing Subcontractor (Co. Nance) or General Contractor (Co. Name) or Owner Item Number's Signature and Date Installing Subcontractor (Co. Name) or . General Contractor (Co. Name) or Owner f' Butte County Department of Development Services. oe?re, aaea NOTES(� 7 County Center Drive, Oroville, CA 95965 (530) 538-7601 www.buttecounty neVdds aeOUNty. RESIDENTIAL APN: Permit No. 069-370-006 05-2352 Owner. SMITH; - Site Address: 28 OAK CREST DR, OROV_ ILLE j Cont: BI COUNTY POOL Contractor. ! POOL (MSTR 01520) Type of Permit: { irk 0 `f OF - �1�✓G' t� SPECIAL CONDITIONS { CHECKED BY ;? 0 SRA 0 FLOOD CERTIFICATE EQUIRED 0 FIRE SPRINKLERS REQUIRED 0 SPECIAL INSPECTION ITEMS Q VERIFY Q USE PERMIT CONDITIONS Q SUB -STANDARD HOUSING LETTER Q ENCROACHMENT PERMIT Q REINSPECTION FEE PAID Q ENV HLTH CLEARANCE 0 �1 DATE JOB FINALED: SIGNATURE: L ,1 +=OK 0 = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION SOFT -SET DATE ID E C K S'C O V E R S'C A R P O R T S GARAGES 1 Zoning -Setbacks -Easements 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 2 Ftgs; Soils-Sz-Dpth-Spacing-CnnctrsSteel 3 Sewer; Loctn-Test; Fall/C/O-Concrete 3 Decks, Girders/Joists-Dcking-Brcing 4 Wtr; Loctn-Test-Easement Needed -Regulator Stairs-Guard/Handrails 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat 0 or LPQ 4 Wood Awn; Posts -Beams -Rftrs-Cnnctrs-Shthg Frmg-Brcng . Inch Sz Ft Lngth 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 7 Blckng; Sz-Spacing-Marriage Line 6 Carports; Wndws-Doors 8 Gas; MH Test-Demand-Valve-Cnnctr 7 Electric 9 Elec MH Cntnty Test-Crossovers-Breakers-Cirncs 8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses 10 Drain; MH Test -Fall -Flex Cnnctr 9 Siding; Nailing -Veneer -Stucco -Lath 11 Wtr & Sewer Connected -C/O to Grade 1.0 Roof;-Shthg-Roofing 12 Gas and Electricity Tagged 13 Tie Downs Q Foundation Q 11 Ext; Steps -Doors -Landings . 12 Braced Wall pnls 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers °� 48,�c DATE ,- P O , S ` S2tbayks-Easements ' -kVr its; CompactionStructure Stability %Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI °° 5- E'l.e%c ool Lting; 15 volts-GFl c clsrs; Conduit Entries -Terminals -Listed Bonding; Metal w/5'-Crcltng Eqp-Htr lec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Bdxes-Enclsrs-pniboards-Insultn to Main Conduit 9 Heal Dept Apprvl Cir Test-Wtr Supply Test 2! p 1 iche 1 sr; Fencing -Alarms 13 Bonding, Diving board or Slide f � Pool Drawing J� f ��'ri �•��:/A 5A IkS7 J t s = OK 0 = Not OK RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR DATE IPLUMBING 1 ZoningSetbacks-Easements-FloodSlope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth. 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First flr-Tub Acc 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwr, 2nd fir - Tub. Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test �� a s 10 UF, Gas Pipe; Sz Anchrs-Sz Test 1.1 Wtr Pipe; Test-Anchrs-Rgltr-Service Test DATE IMECHANICAL 12 Elec Undrgrnd 61 AC Ducts Insultn & Support 13 Plenums & Ducts; Clrnc-MaterialSupport-Insultn 14 Girders-Sills-Anchr Bolts-Joists-Vnts -Cripples 62 Vent Fan, Exhaust abv Insultn 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16 Insulation 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic a� a` O° 0 O'er 0` O DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE IFINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & flr Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage; abv-flr-Ducts-Mech Prtctn 22 Headers & Beams-Sz & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns 70 GFI & Bath Fxtrs & Tub Acc-Spa 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 71 GFI Arc Fault 25 Frplc Ties or Type A Flue-Frplc Throat Clrnc 72 Elec Trim & Subpnl, Breaker Szs & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frplc or Stove, Clrnc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 30 Ext Doors -One X -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm-Rise-Run-landing-Fire Prtctn 78 Garage Fire Door; Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtri Vnts-Undrflr Acc Mech Prtctn; LPG Appince Undr House 3' drain 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 81 Plmb; Elec & Mech Eqp Listed for Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnls 83 Insultn-Foam -Looked in Attic 38 Insultn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters DYes [:]No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Clrnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous Inspctns 44 Eqp Grnd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec 45 Grndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz 9a ❑ CU or DAL 98 Address Posted AC Wire Sz ga D CU or DAL 99 Fire Sprinkler 48 Range Circ ga DCU or DAL Oven Circ ga D CU or D AL Insulated Neutral D Yes D No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnis-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector s. 090 m o'`0 0` 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.neAdds _1 t+.5• LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 10/27/2005 APN: 069-370-006-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license. is in full force and Site Address' • 28 OAKCREST DR ORO effect. .� 3 License Class: rT5 License Num Z 5Z Map Index: Date: �OSIIO Contractor. 01 Description: POOL MASTER 01-520 OWNER -BUILDER DEC ON 1 hereby affirm under penalty of perjury at I m exempt from the "reason Contractors' State License Law for the folio g (Sec. 7031.5 Owner: SMITH, TOM K. & PATRICIA A. Business and Professions Code: Any city or county which requires a 3643 PARK DRIVE permit to construct• alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a ELDORADO HILLS, CA signed statement that he or she is licensed pursuant to the provisions of 95762 the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit_ subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not Applicant: BI -COUNTY POOL CONSTRUCTION']NC intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 871 VON GELDERN WAY provided that such improvements are not intended or offered for YUBA CITY, CA 95991 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of (530)673-3786 (530)673-4079 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: BI -COUNTY POOL CONSTRUCTION INC not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code 871 VON GELDERN WAY YUBA CITY, CA 95991 Date: Owner: (530)673-3786 (530)673-4079 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: 720512 ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Architect: ❑ 1 have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of g the work for which this permit is issued. My workers' compensation insurance♦ carrier and policy numb are: -err Carrier:��l Policy #: ��� O 6 0 0,1 Total Square Ft: 0 S. F. r ' Valuation: $0.00 ❑ 1 certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to Census Code: 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 provi Lons. Date: Applicant: WARNING: Failure atoecure workers' compensati verage is unlawful, and shall sun employer to criminal pena ties and one hundred thousand d($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' ereby issued d the app ..able ovisions of the Butte County CodA anrVc,r I hereby affirm that there is a construction lending agency for the Resolutio to do workJrtd at above f whit s have been paid. performance of the work for which this.permit is. issued (Sec 3097 Civ.) Name: BY Date: (v PERMIT EXPIRES N: Address: Date O 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. O Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled Construction of this project. O Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application• that the above information is correct, and that I am the owner or the duly aut zed a ni 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 offici orm or doc ment of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: Signature: Date:���0 r 0 Owner Contractor 0 Agent for 0 er ❑ Agent for Contractor �L BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds * *PLEASE` PRINT CLEARLY* * OWNER Last Name 77`¢ First Name Address jj�.a' le CityA 12//,f Stateo Zip Phone Fax E-mail ARCHITECT/ENGINEER CONTRACTOR Address g0 Z cZ�f�GY �/Z �•¢- c.cJ Name 0 Zip f-; Address 621 0 •t o !'�.f.¢,v w E-mail City Qd State a ip P fie Page Fax 34,3 #,--7,9 E-mailLic. `13. � �� # zzos�z Class c -sem ARCHITECT/ENGINEER Name Address g0 Z cZ�f�GY �/Z �•¢- c.cJ City Ga "� State,� Zip f-; Phoao9) x67- . o/ Fa S7 3 33 3 -&3.0 E-mail State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail A ANT SIGNATURE X For office y6e onl AP# ,. 0-(O Zoning I C r Flood Zone WORKER'S COMPENSATION SRA Yes No Occ. LENDING AGENCY Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS KAFORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. 0S--zg BIN # LOCATION AP# ,. 0-(O Property Addressv ;MQnpS �- C r Cross Street WORKER'S COMPENSATION Policy Number gOI�O�OO$— 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 Page 1 of 2 Description or Scope of Work: t.. Sq. Footage ❑ 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. Rece' e by: Amount: (!� . Bldg r/ SRA Receipt #: Sheriff ov /N_l SMIP (J� � Total 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). ❑ 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 �1 morew.5 m. Received:/##aa � �JV� 'v ` `C/ Received y CASH Title CHECK / By v oaiamcw rvnrvia • �ou�� iyo•oo i i rarm ov�z COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVIS►ON 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax•(530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: ��� / �� ' ( �llN�lC ASSESSOR PARCEL NUMBER (lam / G �4P Proposed Building Use: � - ��i S % &�� 6e. rmit Technician: Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. P1. 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. 45- 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. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form ' 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remain 'ems needed to issue the permit. (May require additional plan review upon receipt of the following items.) 15 anitation and site plan approval from the Environmental Health Department in O Chico �Oroville, as applicable ❑ 6. Fire Sprinklers............................................................................................ 0 17. Agricultural Buffer cir and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... ❑ 19. Erosion Control Plan Required........................................................................ ❑ 20. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 21. City of Chico Plumbing permit........................................................................ ❑ 22. Site plan and business license approval from the City of Biggs .............................. ❑ 23. California Department of Forestry Ian approval ❑ paid. Sent by: ............ 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ............ L0 'd --I, o f o. Contact Land Development about _ Improvements,._ Drainage ........................ 26 NPDES Form............................................................................................... ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. 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 0,*(Nr.;i17L ig 1, 0 c.0 and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Qc %�� Date:-(/(-/)-/ / [� 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required ontrac , designer, owner, was advised of the above data by phone, ❑ mail, ❑ counter, by Date: �5 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 by: Date: I Plans approved by: Date: Structural reviewed ral approved b Date: Note transfer by: Date: 1/3 Yellow: Building Division A r:• E.H. USE ONLY Dios Plan Attached Floor Plan Attached Sam to S.D. / TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal----, Water Supply: Public Private Well . Clearance for dwelling. Other r1� Hold final for: Final clearance O.K. for: NOTE: Environmental Health 8/96 c list kt)j( IL� 71 -6 -- Date Department r n it n t - Michael Crump, Director of Public f B U t Works LAND DEVELOPMEIQT DIVISION S:orn Water Management Program 7 County Center Drive Oroviiie, CA 95965 (530) 538-7266 (FAX) 538-7171 LL National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement (LESS THA11! 1,QCRE1 Project Description: 6C Project Location andlor ParcelNumber: L�. By signing below, L the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that L 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 W ater Quality Control Board I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project.* that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: Date: dt 0 Butte County Department ol'Developznellt Se,�vzces °�`'T rF° 7 County Center Drive ° _ . �:.: ° ° ° Oroville, CA 95965 aG (530) 538-7601 Telephone (530) 538-7785 Facsimile DUNI BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building pen -nit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: I need to submit applications for septic andlor well to Butte County Environmental Health immediately. I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. ' Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not limited to, verification the parcel was legally created, adherence to. all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: p Applicant Name: APN: Building site address: c8' Permit No.: I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of th eve -referenced building permit application and my signature below: !/ fid. •/, 'o�� OF APPLICANT DAT K:Firms/B1dQPermitwithoutClearances 020705 BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District 0 r V Ui 16 , Glo'� Building Department No. osoa� A.P. Number �(�'( — �r% �— O 0(O Jurisdiction: / City County Property Owner � ! r 1r, ✓ "\ Property Location/Address� n,(_�t�r c�� T d /✓i O� uv) lam( Subdivision Lot No. ........_..........._..._...._._....:....................:..._................................. Residential Development Q Q Q Sq. Footage No of Living Mobile Home Addition/ 'Supplemental to (Group R) Units Installation Conversion Permit # *(No foundation inspection) .......................................... _....... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial Q Q Sq. Footage New Addition (Including Exterior t w Roofed Areas) Building Departmentve RepresentatiDate f t District i ritecation No. [o %'% 9 i 1 , School District certifies that (Applicant) (Phone Number) (City) ; (State) (Zip Code) has complied with the requirements of Resolution No. representing .:2a'8 -)— square feet. C School District Representative Paid by Check #r Remarks: by payment of $ 2926 $ FULL MITIGATION $ Date Notin:s: You may protest the Imposition of the fess identified above by submitting a written protest to the District. In compliance with Gowmmnt Code Section 66020(a), within 90 days from the date fess are paid. Failure to submit a firmly written protest wlll'prohibit you from chat nging the Imposition of tit fees In any cant action. if, subsequent to the School District Representative signing this Butte County Schools Impact Fes Certification Form, the School District Is notified by the applicable Local Planning Agency that this project Is being reviewed under the CalUomle Envlmimental Quality Act (CEOAh thisproject may be subject to additional school fess to fully mitigate, fit Impact on the school aisMd's schools. White (applicant), Yellow (building department), Pink (school district) feefwm.xte I10/03)dmm Nj�Serving WI LLDA�N Public March 11, 2005 Scott Rutherford Butte County Building Department 7 County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX SUBJECT: COUNTY OF BUTTE PLAN REVIEW APPROVAL 117 C Street Marysville, California 95901 530/749.2373 fax 530/749.2199 www.willdan.com Willdan Project No: 14353-1381 Jurisdiction Job No: 05-0288 Assessor's Parcel No: 067-370-006 Applicant: Tom Smith Description: NSFD Dear Mr. Rutherford: Willdan has completed a plan review of submitted plans and documents for the above referenced project and recommends your approval with the conditions noted on the 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 (9 sheets) dated between 01/07/05 and 02/16/05 by Tom Smith. • Structural Calculations: Two (2) copies of Beam/Post/Footing Calculations not dated by Tom Smith. • Energy Calculations: Two (2) copies dated 01/29/05 for slab floor and Two (2) copies dated 02/18/05 for raised floor by California Energy Design. • Truss Calculations: Two (2) copies dated 02/02/05 by Charles C. Truax, P.E. The plans have been stamped with the Willdan approval stamp and dated the date of this letter. 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. rte. Y 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" 4 Part 4, known as the California Mechanical Code and abbreviated herein as "CMC" • Part 5, known as the California Plumbing Code and abbreviated herein as `CPC" • Part 6, known as the California Energy Code, and.Energy Commission Standards, and abbreviated herein as "CECS" f CODE ANALYSIS , 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.. y DEFERRED SUBMITTALS Our plan review reveals no deferred submittals noted at this time: SPECIAL INSPECTION NEEDS Our plan review reveals no special inspection needs pursuant to CBC 1701. Sincerely, Michael LeBeau Ricardo Guzman, S.E. Plans Examiner Structural Plan Check Engineer Cc: Alice Mefford, E-mail: amefford@buttecounty.net Patricia & Tom Smith 3643 Park Drive, El Dorado Hills, CA 95762 Fax: (9;16) 933-0599 Page 2 oft - C ourtt} of Butte Permit N�au�her 05-028$ . illdan..Pro ect Number 14353-1381 PCH" SITE PLAN REVIEW APPLICATION Date: �: �02�/0 s AP# �3 7a 'o06, Permit Number (if applicable) 05-1021? APPLICANT INFORMATION Owners Name: Owners Address: �� `� 3 r" Telephone No.,:',, 53r :- 0 Situs Address: 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 FT Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): Parcel Sizer S ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) J� Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Site Plan Stamped Appr'ov'ed' _ By YDate �� 0 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 az</ ® SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attac�ied) • Flood Zone: x • Flood Panel No.: (%00 7 Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the C�bmiaReclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit El Minor Variance ❑Administrative Permit ❑ Variance - --------------------------------------------------------------------------- ❑ Detached Building Use Form ❑ Encroachment -Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: (fop Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 W OA Zoning Code Streets & Highways Fire Prevention Subdivision Map Front C2Q Side Side Street Rear f Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 W OA el Applicable Development Fees: '� � ��+� �.: ; !`: •,� Standard Fees ❑`Fire'r`�, ` , ❑School*{ ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ Other Subdivision Map Special Fees Amount C ` Formula ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By L1 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: E] No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel '❑ Verify Legal Access ❑Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑. Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 10 Subdivision Map/Parcel Map: 5vr 4 (:t Map Date of Recording: Lot: 6 Book: 02/ ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Page: Parcel Map/Subdivision Map[Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 RJ ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development.. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for roa EJ INN Page 4 of 5 ❑ u n Summary of Specific Requirements: This information provided in this summary is based on the application information and on the best available data at the time of review. C:1Larrys\Building Permit Site Plan Reviewl.doc Nft— Page 5 of 5 OWNERS We •GNARLGS F. REAMS and ANNA LpJISE ReAVI$ a OW.LRS or fke land inel,.ded ithin SUNSET TERRACE as shown on the a++ached mop, also SAMUEL. EVERETT KINNEAR,GERTRUDE J. KINNEAR,EARLJ. rerand CLARA MABEL OWE—EENEFICIAI n 14heagCNILL? TITLE co.- nderadecAol trust e,corded May 10.19:4 underReco de 3Serial .417782 do hereby certify thou we ore the only persons whose consent 15 necessary }o pass a alcor tl tie to said lana and we consent to the prep., and recordation of Sold mop,os shown within ihe colored Sines. OAKCREST DRIVE .hereby ofr.l.d for ded'ico+ion to+he public Far County Road purposes. we offer for dedication for specific purposes +he following: (o) - Rights airway and easements for wafer, gas, ana sewer p pas, and rorpoles and overhead and underground wires for electric and telephone service, fogeTFier with any and all appurtenances appertaining iherefo on,over,and under those strips of land lying between the rear and/or side lines Of 10 -9 and the lines designated Pyblit, Utill}y Easernii =r• (b) Eosements for guy wires and anchorages extendin 20 Teti from the centerline easements referred to in (a) above, and 2 fed in widfh, of ihe location shown thereon w.:• . f ..1 b9 symbols. NOTARY Vbr�GQ STATE OF CALIFORNIA COUNTY OF BUTTE on this2/?"4ay of APRIL1955, before me , LORAN R. SMITH 0 Notary Public :ianfar the Said County Of BU}+e, personally appeared CHARLeS F. REAYIS, ANNA LOUISE ','AF -AVIS, EARL J. DOVE, CLARA MAGE.l,, DOVE, SAMUEL EVERETT KINNEAR and GE TL2V,DE J. KINNM9 , known to me to be ihe persons Wh se names are subscribed tb'X Foregoing cert iflcale and acknowledged to me +ha++ ee h 5a NOV Public My mmM)On expires May n, Isle SURvEYOR 1,K.G Soule, hereby certify that I am a Licensed Surveyor of the 5faie of California, that the attached mop of . SONSET 'TPRRAI;P correctly represents a Survey made under my supervision in APRIL 1955, that the survey is true and complete as show"} indicated nand are 5uiffic ant to enable and sure yhtoebe retraced. aeeuyy ihe positions ,,� K.E. Soule L. S. 2.513 COUNTY PLANNING COMMISSION ' 1, (he undersigned sere eforyy��of The Planning Com?iseion of the Count of Butte, State of California, do hereby cer+ii"y that the attached,f"fnol map of SUNS T TEF'fEtACE conforms syybsfanfiaily with the subdivision design shown on a tentative map w ch was approved bg this commission on the 231- day of February ,1955. .h Sec , tar RECORDER Recorded in the office of the Recorder of the Couniy or Butte, State or California at the request of OAa FIAit IdIs Cre 40his ))fl day of May ,1965, of3o minutes past f o'elockp M, In Map Book 21 . pogo 2 q nd ,L S 20904 ^fid «I Recording number County Recorder by Deputy X-;� COUNTY ENGINEER I,MARSHALL JON!$ Oi,CCi• of Public. Woks qr the County of Buffe,51afe or California, do hereby cert ifyy that (have exCmlflca F1e attached final map of N5ET TERRACE ,that if is substantially the sane as appmred on ihe, tenlative map on File and any appnOv�add changes the roof that o l the provisions or >he Subdivision Map Act of the Statuttes of Callfarnla and on focal ordinances applicable at the firne or approval of said fen+oF ive map have been mmpl ed with, and I am satisfied that the map 1s technically correct. w Direcfrar of Pu61i ork5 Reg • Engr. NP TO AUDITOR L F•H.?FFLY JR. Aud,fcr of thq County of Butte, State of Colifornia, do hereby Cerfi C'y, fhat the[e ere no liens against 5UNsE7 TE,��tt RACE p�• as herein set forth, or unpaid S}ale,Counfy Municipal, p"local taxes, of:'9pccla4:pssessmenfp collected as foxes, exceyt taxes or special ;,5-5,ner, not yet payablex 'as'sir, assessments which are a lien, but not yet. Payable, I e f mafs to be in The, ,a1+'TgW! ;q, n626.12 Coun 41idi F _.I. J!29 Deputy BOARD OF SUPERVISORS I do hereby cerfify that on the 9Pday ofnf , 1955 the Buf+e Counfy Board of Supervisors offleiolly approved ,+hemapp of SUNS T TEF{RACE The receipt of sofisfocfCry se4uri+y in fhe Audifor'S es mated aro✓nf of#24.12 to insure a men+ of taxes w ch are o lien buf not + oyable, was acknowledged. p y Ookere. ti Dr's a as sfi on said r5�op. and offered for Eledica+ion for public use, was aceapfad on behalf of +he public %r rood pu .psses. .0 erFc NOTARY STAT` of CALIFORNIA 55 COVNTY OF BUTTE On +h Ls2>•�da of APRIL.1955, befOM me . VIOLET M.CLARKE, a notary in and for said COUNTY OF BUTTE, pPer.onolly ppd.r.d L.R. SMITH kown tome to be 4-h.VICE PREgIOENT of file o1'porafion -+got executad +he Oby��Ye cC,r+W; ci+a and acknowledged tome +fiof such corporation executed ++1e same.. , NOTARY iPUBLIe. "- My rOmm 99ian GxpifeG Au9.9.,,5G"I �•;t SUNSET TERRACE BEING A SUBDIVISION OF A PORTION OF THE EAST VI OF THE SE '/d. OF THE SW I/A OF SECT. 12-T IBN-R4.E-M.D.M.ANDA PART OF LOTS 10 F_ 11 OF GLENDALE RIDGE.TRACT UNIT Na 1 OWNER CHAS. F. REAVIS SUBDIVIDER OROVILLE CALIF. BY K. E. sou LE. L. S. 251a APRIL 1955 SCALE 1'•100' Shee+ 1 of a)-ay�; tu I)c OROVILL.E-WYANDOTYE FQUITLANDS q (r v - UNIT Lu z U) 0� — (D m z Ir ti 4'Pipeline RIW oI.z pogo 329 LOf 588.OR-73 10i --A-,07 i. OR 20 13 0 ins @ r if 1.44IA�.t "-4 'X y ri &9.2G,- -2m.odl t X/ LOCATION DIAGRAM _ • SCALD 0 ? I ry 1.09 A..! d �O 1-In +r . ll�N—r a�, , ,� -"� ' 11 > ,o // qk� //� © �sao3r / / / �y�ci ` or G c—J —p I—d.l. �idg. Tr-4 . U�*,+ Ne 1. T.4-1 Acres - 18.47-5 Ac. Rood - 2.000 Ac. 1.35 Ac. tron Pentp eI ofa// /0/corners excai where concrete 589*27'W- 219.71' 1,0. ry 5,29-.z for �4 bl-1-4 .- 5.9-9, .,) r�—r OrO-1.11W. Is d "s-R. Dis+-!-.. 's 90.27' ci 0 c 4 ."'d Vol-210of re.0-1.0 Vol. 2015 D 0 of I.G.5 Ac.! q, LOT .`.i Q' —OX 2Z4 v SUNSET TERRACE 6ac. I-z BEING A SUBDIVISION OF A PORTION OF THE aA57 Vz OF THE S.E.V� OF THE S.W !, OF SEC. Z -T 19N - RA I- - M.D.M. AND A PART OF 1-075 SEC. 13 �Oe–ll OF GLENDALE RIDGE- TRACT UNIT NS I OWNER CHAS. F. REAVIS SUBDIVIDER OROVILLE CALF. BY K.E.SOULE L.S. 2513 APRIL 1955 SCALE. I*- I00' RECORDED APRIL, 1555 500K 21 OF MAPS AT PAGES AND SHEET 'Z OF 2 SHEETS BUTTE COUNTY DEPARTMENT OF PUBLIC HEALTH DIVISION OF ENVIRONMENTAL HEALTH SEWAGE DISPOSAL PERMIT 411 MAIN STREET • P. O. BOX 5364 7 COUNTY CENTER DRIVE CHICO, CALIFORNIA 95927 OROVILLE, CALIFORNIA 95965 TEL:(916 891-2727 TEL: (916) 538-7281 FAX: (916; 895-6512 FAX: (916) 538-2140 Date Issued ��'� '- 00 EXPIRES ONE YEAA FROM DATE OF ISSUANCE Permit Issued to ��/''� J �' 7--;�t e . To construct a sewage disposal system for: 0 • .c,) EZ -t_ -/.L3 Located at: A.P. # ®Cc>. 9 - 3 70 -9 O 4�' SEWAGE DISPOSAL SYSTEM REQUIREMENTS SEPTIC TANK LEACHING FIELD Liquid capacity: 411"(31-<') gallons Total length: 6-14, feet r Material Trench width: 31P inches�1 Minimum No. of lines: �3 3 Rock under pipe /off- inches 4- / B RO G i UNn e -i Special c nditions: 'TJX I,,r-- Cox--.) 7-0-o/t dF Pipe F_ C 44426 . 7%'c. 7,UC ,� -� jeV ""A& 0. In4lu7`.4iA-) SLG Additional leaching field will be required if experience shows it to be necessary. No part of the system may be located within 50 feet of the center line of any County Road. NOTE: Satisfactory inspection by the Health Department is required before backfilling or putting the system into use. Occupancy of a new building is not permitted until the system is approved. Permit Fee $S2 Penalty Fee $ Additional Fee $ Rereint Nn. `/`'/1J i Issued Bv: T- ; 2 OT FEE $-' z 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.butter-ounty.net/publicworks/forms.htmi NOTIFY COUNTY 24 HOUFUS t3brL)Kz wvM w i !c'1m S'lR-71 S7 Rxt 2016 Agent APPLICATION PnNTR At )K'S 11NJ' VJ:c-1vJ1kJ_tvJ.-c TYPE OF WORK TO BE DONE 17. If Driveway Check Curb: ❑ Gutter: ❑ Sidewalk-, ❑ g. Other Work - List 1 ype. S ) 1 CV N 19. Plans Attached: D Yes PERMIT GRANTED i compliance with the above r>;quest; and subjerx to all terms, conditions (mcluding those on page 2 of this permit form) and special conditions wrinen below, omission is berc ted. . 0. Conditions Ind and Service Alert (U -SA) must be notified two °+°skin da rior to any excavation. 800-127-2600 1_ D All Work shall conform to accompanying- Detail D Plans D Special Conditions D _ 23. Expiration Datc 24.5urety M,t. Irm-,t Z -'1A 5. Date Paid: 7 26. Amount Mike Crump, Director of Public Works la C:,.et i.,enrr-hnn We 30. IIISpe� nor Counir us-oniy: 31. Comments: oto 27. Paid B 28. ReceiptNo.: D Completed - OK \A Completed —Not OK O Additional Comments Attached AND WHEN RECORDED MAIL TO: 1 BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 A ' 1111 III III I Lill I IIII I Iill II II III II 2005—®007442 Recorded I REC FEE 10.00 Official Records I CONFORM 1.00 County Of 1 BUtiE I CANDACE J. GRUBBS I Recorder I ROSEMARY DICKSON 1 Assistant I Andrew 01:2013M 07 -Feb -2005 1 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 2g 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_ PROPERTY OWNERS: b _4 'Sk&L State of California County of �9 On o5 " ? -U S/ before me, personally appeared 'J4)%"�'I ,t✓ . 13M r7l-7 a, k {!r h, /'� �/7 . J/n � 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 m and and offi ' seal. Signature Seal: IMIAM. Rel Comp ttlon • 146760 V Notary_ NM - COWN A.P. #_6(e q - 3 70 -000D " Butte county E Comm.Explr rMoV .2008 Exhibit "A" Title Order Number: File Number: 0403-1741493 Real property in the unincorporated area of the County of Butte, State of California, described as follows: LOT 6, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "SUNSET TERRACE", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MAY 11, 1955, IN BOOK 21 OF MAPS, AT PAGE(S) 24 AND 25. APN: 069-370-006-000 6 SITE PIAN REVIEW APPLICATION Date: / / U C> �5' AP# Permit Number (if applicable) APPLICANT INFORMATION Owners Name: Owners Address: Telephone No.: Situs Address: Proposed Use: C/'/6 -e133 --6s Parcel Size: Residential ❑ New Single Family Residential ❑ Single Family Addition ❑ Mobile Home - ;_❑- Residential. Amessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie, ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other im Septic ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES WFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Site Plan Stampe pproved' By (/)– 0-1—VO4 Date ALL ITEMS CHECKED APPLY To THE PROPERTY Parcel Is In: Snow Load Area: 2 s' Land Conservation Act Minimum Acreage: El 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: • Flood Panel No.: 1 D `_ O L Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit E] Minor Variance ❑ Variance El Administrative Permit _ .-. ❑ Detached Building Use Form ❑ Encroachment.Permit ❑ Agricultural Worker Affidavit _ ❑ Agricultural Aclmowledgement. Statement_ Zoning: — `-j Applicable Building Setbacks: Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side Side Street nDj Rear Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan, Iff CDF approval needed for encroachments into SRA setbacks. Applicable Development Fees: Standard Fees Amount Formula ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ Other ---------------------------------------------------------------------------------------------------------- Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) # Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of—. the building permit Parcel Created By ❑ Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: --El Meet Parcel size required by zone F]Meet current Environmental Health Department requirements Subdivision Man/Parcel Man: Map Date of Recording: Lot: ❑ Use Permit/Minor Use Permit Permit Number: Book: Z' page; 2q -2j Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.RC. 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'shallbe 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 ma *1 Summary of Speck Requirements: This information provided in this summary is based on the application information and on the best available data at the time of review. CM,arrys\Building Permit Site Plan 77icuTdoe BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM ,FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) ❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD) 0 PARADISE RECREATION AND PARK DISTRICT (PRPD) ❑ DURHAM RECREATION AND PARK DISTRICT (DRPD) ffiD-00(�' Assessor Parcel Number (s) DLo � Building ermit Number C-�!-'0 Property Owner (s) Project Location /Address Subdivision Name )r, 0 , b -e Assessable Sq. Ftge p2pk� Type o Residential Development (check one) New Development Single 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 ) verified by Building Department Comments: KFRRPD ❑ CARD ❑ PRPD ❑ DRPD certifies that: G - Applicant Name Phone Number 3(,A!) ng, __L9g&p2o 14(LLs f!5 126 2 Mailing Address City State Zip Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of: Dwelling Units @ $ Square Feet @ $ _ Remarks: Paid by Check No: Paid by Cash: District Representative K:\FORMS\BUILDING FORMS\park-rec standard form rev Ldoc per unit for a total of $ �dj� , Cx) per sq foot for a total of $ Receipt No: /63617-) I (. TM� BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891--2834 (CHICO) BP050288 OFFICE #: (530) 538-7541 - B. C. Building Permit 01-16-04 pp 1 LICENSED CONTRACTORS DECLARATION 1 hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and Issued Date: 03/28/2005 APN: 069-370-006-000 effect License Class : License Number: Site Address: 28 OAKCREST DR ORO Dale: Contractor: Map Index: 'OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NSF(2282)GAR(1152)COV(622) Contractors' Slate 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, TOM K. & PATRICIA A. 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 3643 PARK DRIVE the Contractor's State License Law (Chapter 9 commencing with Section ELDORADO HILLS, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95762 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 penally of not more than five hundred dollars ($500).): ,tK I, as owner of the property, or my employees•with wages as their sole compensation, will do the work, and the structure Is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' Slate License Law does not apply to an Applicant: SMITH, TOM K. & PATRICIA A. owner of property who builds or improves thereon, and who does 3643 PARK DRIVE such work himself or herself or through his or her own employees, provided that such Improvements are not Intended or offered for ELDORADO HILLS, CA sale. If however, the building or improvements are sold within one 95762 year of completion, the owner -builder will have the burden of proving that he or she did not build or Improve for the purpose of Cl I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Pfofessions Code. The Contractors' Slate License Law does not apply to an owner of property who builds or Improves thereon, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Q 1 am Exempt under Article Uf the B:uWnne¢�sssaanndd Professions Code Date ow ^' License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penally of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided lot by Section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. Architect: ❑ I 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: 4056 S.F. Total Square Ft: , Policy fl: Valuation: $185,930.00 V/1 certify that In the performance of the work for which this permit Is Census Code: issued, I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Zb. Date: Applicant: WARNING: Fallure 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 Thls p it Is h eby Issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there Is a construction lending agency for the Reso ullo o wor ndlcated above for vyhich fees have been pal //\\ performance of the work for which this permit Is Issued (Sec 3097 Clv.) ' V Da Name: BY /\ �� U PERMIT EXP ON: Address: (Date) Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, ❑ 1 hereby certify that the use of this facility shall comply with handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safely Code is not applicable to the scheduled construction of this project. O Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above Information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or do cum t of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: I�� �'%%7 r! Signature: —e Dale: Owner ❑ Contractor Q Agent for Owner ❑ Agent.for Contractor B. C. Building Permit 01-16-04 pp 1 -04 V 8t BUTTE COUNT DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS (�/� 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 —6. O' A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** �� q 1� CONTRACTOR OWNER Last Name Address 3 First Name NA Ic I er Address Stat CA Cit tEt_ State Zip Phon f Class I Fax 3 _a E-mail , MuMM70e ifir—&I-06AL. KE T CONTRACTOR Nameo 111+ 7tc Address 3 Address City Stat CA I Zi'15 GZ Phon 3 _ D Fax (�-133-65f E-mf� Lic. #- . r Class I APPLICANT NAME ARCHITECT/ENGINEER Name U 1 — i5 t7t�c7c� Address Zip 7576P City Fa'y_l,.-rf 3�,3-0G,-7 State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name tCA A A. 5,rt — Address3.43 _ Cit!/ I I StateC Zip 7576P Phon b$ ?A Fa'y_l,.-rf 3�,3-0G,-7 E-mailCeL077 6 � APPLICANT SIGNATURE For office use only: Zoning Property A dr s 8 D Pe, Flood Zone X SRA e f No .Occ. _Type Const: Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. ()S ozg S' BP BIN H_ - J7 LOCATION AP#04---3 / �7 0 o 00 Co Property A dr s 8 D Pe, City _ CLLR Cross Street WORKER'S COMPENSATION Policy Number Carrier if hiring.anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name 069-370-006 05-0288 A , SMITH, TOM Address J2_ OAK CREST DRIVE, OROVILLE cont: OWNER t rtr_177 cIrXrn.. OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 - rpt v"l_. I -- Description or Scope of Work: 51H6,LE_rPt+fuw DwcL�LtAlG ark • Structure Built withoOf 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..—f Amount: �S Bldg S,e _ eoQ — --- - R`S� SRA Receipt #: Sheriff 0/0 /' `� SMIP Dater _ 17 c �j Other Total REV 7-27-04 r"I r 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. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). ❑ 13. Sanitation and site plan approval from the Environmental Health Department. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or Mould like additional information regarding this process, contact a Permit Application Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits, refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KIFORMSWILDING F0RMS\81dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 00 00 N O I L0 O utte County Department of Development Services )NNE CHRISTOPHER, DIRECTOR County Center Drive roville, CA 95965 30) 538.7601 Telephone 30) 538.7785 Facsimile TO: FROM SUBJECT: DATE: WILLDAN �UTr J i O O O cOUR Scott Rutherford (530) 538-7160 srutherfordCo)buttecounty.nei Plans Transmittal For Review Per Contract 2/9/2005 Applicant: Smith, Tom & Patricia Permit No: 05-0288 Project Type: NSF/Gar/Cov APN: 1 069-370-006 100% '70% Plan Check Fees $ 1,285.94. $ 900.16 $ 1,285.94 $ 900.16 WILLDAN Fee $ 900.16 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 _. - i ..�. -..� .. . ,. .__.� -. -. r'.- ... rte- / •.v _. -._ v � � v .. _ 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 / % 1 ASSESSOR PARCEL NUMBER ��%J Proposed Building Use: APS Counter Technician: / Date: Items required in order Coapply for a permit. All boxes MUST be checked OR marked NA in order to apply. UZ 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. .p4. Engineered truss details and layouts in duplicate. No faxes! 0 5. Letter from Engineer or Architect for truss design review. 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or find plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner 14. 15. Hazardous Material Form Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ....... OErosion Control Plan Required.................................................................... 3 ... + Fees as shown on the attached Schedule of Fees Due Sheet ......................... ❑ _ t42.. City of Chico Plumbing permit ....................................... ............................... ;z N 23. California Department of Forestry plan approval PInid. Sent by: ............. -CEJ 24. Planning approval (A) Use: -Of- (B)Parking: (C) Parcel Check: 1z OS ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 7 . tNPDES Form.................................................................................. . croachment Permit for driveway from the Public Works Dept ................ `� 28. Pre -Inspection for require ..... . ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... 31. Owner -Builder Verification en to owner, _Mailed to owner) ..................... 0 32. Letter of Signature authorization......................................:............................. 33. Recorded copy of Agricultural Acknowledgment Statement........................I........ ❑ 34. Manufactured home utility clearance......................................................... :.... . ❑ 35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, O'Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone �/�/ _ ��T� viii and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant:: -f, Date: 2 -2 d s 1. Index permit application for the abovetems numbered: Plan Check Letter 2. Additional items re ' - ✓ Contractor, designe , owne , was advised of the above data by phone, ❑ mail, ❑ counter, by Date: bJ Contractor, designer. er, was advised of the above data by• ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: 11. Date Structural reviewed y: Date: Structural approved by: I Date: Note transfer by. Date: Yellow: Building Division TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance E.H.USE ONLY 'riot Plan Attechod ^7 floor Man Anachod Sam to ®.D. %T 90s, Owner / Location AP# Plan Approved for: Sewage Disposal ✓ Water Supply: Public Private Well Clearance for )C dwelling. Other A346:, -d (j 5-�% /�,-3 7 Hold final for: Final clearance O.K. for: NOTE: Environmental Health 8/96 cialist Date COUNTY OF BUTTE r,3�� DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER Sim 1 h) PROPROSED BUILDING USE USE _e LB DING PERMIT FEES Z -- alance Due......... .. $� am OV --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ '42. SCHOOL DISTRICT FEES (2011 lk ll )n l 5 i") (paid at School District Office) (form available after Plan Check) SHERIFF FEES (paid at Building Division) Residential............ X Units Commercial (sq. ftg.)..... Sq.Ftg. 4. URBAN AREA FEES X $0.03 = $ A.P. # DATE - QS qR � BC (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Ftg. Amt. <� 5. RECREATION DISTRICT FEES I;U, Ix Re'( (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 21J//1 7. SRA FIRE INSPECTION AND PL CHECK FEE l�' $ -(paid at Building Division),;) U�, qT 8. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... X = $ Sq. Fig. Amt. 0. OTHER Aftime 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 2 — 7 '-0 S Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) Butte County Department ofDevelopment Services 7 County Center Drive ° Oroville, CA 95965 (530) 538-7601 Telephone o `"'_ o (530) 538-7785 Facsimile BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: • I need to submit applications for septic and/or well to Butte County Environmental Health immediately. • I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained • I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building_ permit or require submission of amended building plans to the Building Division. Once the plans examination .process begins, there will be no refund of plans examination fees.. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for'the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not limited to, verification the parcel was. legally created, adherence to all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: Applicant Name: %~. ate. 45 f1 (7 If APN: 70 _00G Building site address: 2$ QAcK_ C-p—e5j ID I2 Permit No.: IN465 - bZ%& I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: SIGNATURE OF APPLICANT DATE Copy to Applicant/EH/File K:Fonns/B1dgPennitwithoutClearances 020705 p�QPgTMENT (),o �vTTF o J C \� 0 , 0 `isC WORD g AU Department J. Michael Crump, Public Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 9 ACRE 1 - Project Description: Project Location" and/or Parcel Number: �� /;, // f/ - By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB acre or more of'1'aiid ;and.that.I; therefore, do`not:rieed Co apply for a Construction Storm Water Pemut _'from theState of Callfomia Regional-Vilater Quality "Control Board. Phased projects that contain multiple site build -outs of less thaiiorie-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: nn Title: V!� Date: Z-7-- �S Less than I Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 t.�•'•e •� •`.i.a :.c _�ry :i c_ •tPs,i,"�i ;.r ' il1, '�_•_: :'Y •.::K ADDIO :: Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: YES[ k J NO[ ]. 2. I HAVE [v 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 TVPP C)F wnRu SIGNED: PROPERTY 0 DATE: 2 -- `7 p 5 NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department of Development Services ADMINISTRATION' BUILDING' GIS `PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538.7541 Telephone (530) 538.2140 Facsimile Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Intemal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents.. If the structure,is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally 'or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is retumed. ON -1 Mic el C. Vieir4 C.B.O. M ager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. ,RDING REQUESTED BY -lid Valley Title & Escrow Company AND WHEN RECORDED MAIL TO: Tom K. Smith and Patricia A. Smith 3643 Park Drive EI Dorado Hills, CA 95762 20Ila 5-010&039 1 C3 Recorded Official Records County Of BUTTE CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 09:00AM 21 -Jan -2005 REC FEE 10.00 TAX 106.70 Travis Page 1 of 2 Above This Line for Recorder's Use Only A.P.N.: 069-370-006-000 File No.: 0403-1741493 (AM) GRANT DEED , �4- The Undersigned Grantor(s) Declare(s): DOCUMENTARY TRANSFER TAX $106.70; CITY TRANSFER TAX $0.00;/� SURVEY MONUMENT FEE $ computed on the consideration or full value of property conveyed, OR computed on the consideration or full value less value of liens and/or encumbrances remaining at time of sale, x unincorporated area; [ ] City of , and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Gary Elliott and Debbie Elliott, husband and wife as joint tenants hereby GRANTS to Tom K. Smith and Patricia A. Smith, husband and wife as joint tenants the following described property in the unincorporated area of , County of Butte, State of California: LOT 6, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "SUNSET TERRACE", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MAY 11, 1955, IN BOOK 21 OF MAPS, AT PAGE(S) 24 AND 25. Dated: 01/13/2005 4al ott Deb ie Elliott Mail Tax Statements To: SAME AS ABOVE AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 0 COFsY of Document Recorded 07 -Feb -2005 2005-0007442 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 _-Z-7- %- A)os.-' PROPERTY OWNERS: ri (7t( l State of California ) County of �� ) On _U S/ beforeme, personally appeared �I nPI r— . 3/27 r&-7 Cd4 j f � /'� fid fJ _ J /yf ��4/ 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 In andand offs ' seal. Signature Seal: y0SKA M. RYWL Ccln on # 1487649 �. Notory_ PubNc - Cdfoml© L,AO A.P. # q - 3 7 a ~ oo CD " Butte County My Comm. EA*es May 4.2008 Exhibit "A" Title Order Number: File Number: 0403-1741493 Real property in the unincorporated area of the County of Butte, State of California, described as follows: LOT 6, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "SUNSET TERRACE", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MAY 11, 1955, IN BOOK 21 OF MAPS, AT PAGE(S) 24 AND 25. APN: 069-370-006-000 ------------ .......... -7 . ............ ..................... 013 c1l, )V37 IS ci 40 AO vQ co ---------- P, tqaq) 027 14 DV31 51 ray .mw -i-vg 0001. , t6 abs A Ll 6" iso -aE- Oki bbl —8 —6+11 1 It LLI, �. a cm L N Q 0 3 1 q q C4 N� oil 20 NA heU U m r"UM CALII-URNIA 5UMVEYING & DRAFTING SUPPLY 1400.247.1414 P\A A5 ' ow -i C-4-1 f k C-3 d, eY + Taco( 6a ?(-' v-AeJ(x' { �_. APPROVED B °Environmeun3n�I � aita Dat Signature BI -COUNTY POOLS CONSTRUCTION, INC. 871 GARDEN HWY YUBA CITY, CA 95991 530-673-3786 Contractors License 720512 POOL SPECIFICATIONS -y•� SIZE 3Ss PERIMETER 1.�) A EA sq. {(. DEPTH 3�T0 VOLUME 1GALS. CONSTRUCTION SPECIFICATIONS RAMP SHALLOW/DEEP SWIMOUT Z x LOVESEAT _ x _ Wx EXCAVATION (COPING/�ANTILEVER , FENCE: DOWN BY 1UP BY HOURS OF GRADING AL LOADS TO DUMP STUMPS LEAVE/HAUL CONCRETE: REMOVE sq. it. STEEL/GUNITE/TILE/PLASTER (VORTEX/ANTI-VORTEX) RAISED BOND BEAM ��T. x height RAISED BOND BEAM -at --ft �eig DECK TIES TIL U--4- .1 �� . �� ; COLOR Of PLASTER 1/-/� CAP FOR BOND BEAM'06-A 4-s-1' CAP FOR RAISED BOND BEAM SPA _ x _ LENGTH OF DAMS—� CAP FOR DAM fes- SPILLWAY PLUMBING SPECIFICATIONS POOL: NO. OF RETURNS _MAIN DRAIN SIZE _ SIZE OF SUCTION LINE FROM SKIMMER SLIDE FILL LINE _ FOUNTAIN LINE _ (1. SOLAR HEAT `T's _ POOL CLEANER REVERSE FLOW'PLMG. _ DIV. BRD. _ PRONG JIG SPA MAIN DRAIN SIZE _ NO. OF JETS LIGHT, 4 RETURN _ VALVE TYPE NOTE: ALL AIR LINES PLUMBED BACK TO EQUIP. ( 1") UTILITIES ELECTRIC BY GAS BY s q�M POOL DECKING (C NTILEVER �'/ lSQ. FT. TYPE FINISH i.: FOOTINGS_ x _ x �A14AST C� DIVIDERS: TYPE �a DRAINS 01 1J1 RISERS _ (1. 104 THE UNDERSIGNED APPROVES THIS WORKING AND ACKNOWLEDGES RECEIPT, OF A COPY: A BI -COUNTY OQL DESIGNED ESPECIALLY FOR r VY� 3 �Gl'1 -: IWoWN CloiLYe.Sk-• n r . e SALESMAN HOME � '�a'=�IBUSINESCTW:Z7 zal-S- DRAWN BY QP CHECKED BY POOL EgU-I,P�M. ENNT 1� FILTER: TYPE) e VV SIZE PUMP: TYPE SIZE HP HEATER: TYPE SIZ — 000 BTU BLOWER: TYPE ----SIZE--- — SI E—AMPS POOL CLEANER TYPE ( �r,. SEPARATION TANK POOL AC�CgESSORIES LIGHTS: P005PA NSE KIT BOARD _ BOARD STANDARDS —� SLIDE STRT./L 9COR GRAB RAIL hAD4ER HANDRAIL POO LEANER TYPE j VACUUM HEAD AND _ FEET OF HO E MAINTENANCE KIT AND POLE MAP BOOK PAGE: TRACT NUMBER: LOT NUMBER: � QiJ c� LU J .Z � 9= as'9 C=3 N a p Q= w U W V m 110-06 14914' 1 /485 i_ _ 3-70'&34 X LFAcm -T RF-ur-IJES S/r 4! V� WAY LEptc4 I rl� 5: 10 (40 fo N ui I LAP -Q -p Vz-m AFAL.,.-c. 3? -OA I tt ZO-C) to -4 p :F!LL 1 FA I E- by -rrA/q,8FC) APN t 66 - CD Z Z Z O 33 N ui I LAP -Q -p Vz-m AFAL.,.-c. 3? -OA I tt ZO-C) to -4 p :F!LL 1 FA I E- by -rrA/q,8FC) APN t 66 - J -75p54- -P)QY-- CT - I— �1..N 0=15)V-VXL- 10.4K 172 Qr L17Z O T )V37 -AV A -t4lW '-7V9 0001 I bpl 50 -0 I N 04120 Q/ ELt, 11�50`, it le/ 4d� .0o 01✓ L c�L fq:1 vct HtL V rnVM L.ALIFUHNIA 5UHVt TING & UHAFIING SUPPLY 1 00.249.1414 FM Soo-- e" p►,umb+ vk5 'note S . oi-s-i 0 ,10 a VXA C- 0- .s .' Cw (.a ov'.A.6..o0'f qa"W) . 1 A -Is a it nCD kin T OFC PCI NS I RIF FO mmur P. SHR B. THE UNDERSIGNED APPROVES THIS WORKING AND ACKNOWLEDGES RECEIPT OF A COPY: A BI -COUNTY OOL DESIGNED ESPECIALLY FOR 7QVh 3 �G11" JVWTIV 245 8Q.S�` C C. 1tiR-�Qp�SALESMAN HOME,11 BUSINES(gI�r?�7 DRAWN BY ' IV� CHECKED BY BI -COUNTY POOLS CONSTRUCTION, INC. 871 GARDEN HWY YUBA CITY, CA 95991 530-673-3786 Contractors License 720512 POOL SPECIFICATIONS SIZE 3Sx ` PERIMETER LO-) A EA' 'J' -sq, ft. DEPTH3' 2TO VOLUME I'L GALS. CONSTRUCTION SPECIFICATIONS RAMP SHALLOW/DEEP SWIMOUT Z x -Sft LOVESEAT _ x _ W x _ EXCAVATION (COPIN / ANTILEVER FENCE: DOWN BY UP BY HOURS OF GRADING AL LOADS TO DUMP STUMPS LEAVE/HAUL CONCRETE: REMOVE sq. ft. STEEL/GUNITE/TILE/PLASTER (VORTEX/ANTI-VORTEX) RAISED BOND BEAM ----IT. x / height RAISED BOND BEAM _,_-__P.'7�� 'eig DECK TIES _ TIL COLOR OF PLASTER CAP FOR BOND BEAM CAP FOR RAISED BOND BEAM _ SPA _ x _ LENGTH OF D M -_- CAP FOR DAM SPILLWAY PLUMBING SPECIFICATIONS �u POOL: NO. OF RETURNS _MAIN DRAIN SIZE SIZE OF SUCTION LINE FROM SKIMMER SLIDE FILL LINE _ FOUNTAIN LINE _ fl. SOLAR HEAT `T's POOL CLEANER REVERSE FLOW PLMG. _ DIV. BRD. _ PRONG JIG SPA MAIN DRAIN SIZE _ NO. OF JETS LIGHT � 4 RETURN _ VALVE TYPE NOTE: ALL AIR LINES PLUMBED BACK TO EQUIP. ( 1") UTILITIES Rlce ELECTRIC BY GAS BY 1 q�P�O�OL DECKING (C NTILEVER J (' � SQ. FT. TYPE FINISH �` 3 FOOTINGS _ x _ x _`M�ASTC DIVIDERS: TYPE DRAINS 1 1 RISERS _ fl. POOL EQUIPMENT FILTER: :TYPE r SIZE 2, SIZE PUMP: TYPE SIZE HP HEATER:TYPE SIZE OOOBTU BLOWER: TYPE SliiE —�-- AMPS POOL CLEANER TYPE A- n 1 SEPARATION TANK l__ POOL ACCESSORIES LIGHTS: POOU1_ SPA _�NSE KIT BOARD _ BOARD STANDARDS SLIDE STRT./L OL GRAB RAILSLIS ADDER ._HANDRAIL _ POOL'CLEANER TYPE LX --+t I U -1- VACUUM HEAD AND _ FEET OF HOSE MAINTENANCE KIT AND POLE MAP BOOK PAGE: TRACT NUMBER: LOT NUMBER Cl 121 r ,z -4 —foe i LAI \P ����1 ./ LLJ -z -J CY qjC TIN J v va a Cj C) ul) 00 1 a - BUILDING PLAN APPRO DoLAm 4G DIVISION — -1 - Use: Date: t,\ Parking: Landscaping: •C Signaiure: . . . . . . . . . . . ... Awl H11WS H' H3W10H NOSHmNl :S321f11VNDI 3unIVNJIS 3f118 DNIMV38 SS3INn a a 010 90/E 'dx W W1717,0 z At 3000 ONI(IIne VINM041"NO 100Z N11M 30NVIIdM00 NI NV'Id-ZZ; 01.103) paU!D1U!DUJ sl aouDJoalo you! TL So wnw!u!w D pap!AoJd woaq puoq •6uipaaooid aJolaq ay} So Jawoo ap!slno Jamol ay} u! paoold aq Aow sad!d J919LUDIP you! 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