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071-430-011
SPRINGS ROAD, BC CODE ENFORCEMENT 071-430-011 FERKOVICH,MARCIA TERRY CREEK Cont:OWNER NSF NOTES PERMIT NO. RESIDENTIAL 071-430-011 05-2154 FERKOVICH, MARCIA - -H4BHE S, PERK ,CREEK - I Cont: OWNERY�/iii i NSF t SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOB FINALED (Date) Signature 4 OK 0 = Not OK Not Appri able . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ r Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ r Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ r Fig. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped _ 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors • 23. Fire Sprinkler, Test 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. Date 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water' Date 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI Date 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or AI 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated Neutral O Yes 0 No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels -Motors -Meth. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector 69. Elec. Trim & Subpanel, Breaker Sizes & Labels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet a 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Botts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Duct in Garage -Damper a 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following InstldJDrive O Yes O No/Walks O Yes O No/Planters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: J=OK 0 = Not OK - = Not Applicable . = Not Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s Card B-1 Date 1. Zoning Requirements -Setbacks -Easements Date 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 1. Zoning Requirements -Setbacks -Easements 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ P L'ft. / P Nat. or/ /" L 'ftJ /LPG 3. Blocking 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 5. Electricity; MH Test 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water, MH Test-Regulator-Connectoe 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 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg- Frg- Bracing 1. Zoning Requirements -Setbacks -Easements 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 2. Footings; Size -Spacing -Marriage Line 7. Electric 3. Blocking 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 4. Gas; MH Test -Demand -Valve 10. Roof; Shthg-Roofing 5. Electricity; MH Test 11. Ext.; Steps -Doors -Landings 6. Water, MH Test 7. Water and Sewer Connected Card B-1 Date Card B-1 Date 8. Gas and Electricity Tagged Date POOLS (Plans) OK except #'s 9. Exits 1. Setbacks -Easements 10. License Decals 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 11. Verify #'s with Office 4. Eiec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 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. Eiec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 r BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT BP052154 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 02/16/2006 APN: 071-430-011-000 the Business and Professions Code, and my license is In full force and =it7 effect. License Class : License Number: Site Address: -*HORSESHOE TRAIL BCK Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NSF EFFICIENCY UNIT: LIV(560), GAR(1120) Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: FERKOVICH MARCIA to its issuance, also requires the applicant for such permit to file a 4717 JOHNSON DR signed statement that he or she is licensed pursuant to the provisions of the Contractor's Stale License Law (Chapter 9 commencing with Section FAIR OAKS, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95628 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 (916) 965-8501 applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and' the structure is not intended or offered for sale (Sec. 7044, Buslness and Professions Code: The Contractors' State License Law does not apply to an Applicant: FERKOVICH MARCIA owner of property who builds or improves thereon, and who does 4717 JOHNSON DR such work himself or herself or through his or her own employees, FAIR OAKS, CA provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 95628 year of completion, the owner -builder will have the burden of (916) 965-8501 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 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.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Dat21�Owner: License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit 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: 1680 S.F. Policy #: l Valuation: $63,280.00 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 provisions of Section 3700 of the Labor Code, I shall 0 forthwith comply with/ those provisions. Dale: V v� Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, Interest, and attorney's fees. CONSTRUCTION LENDING AGENCY nder t app is a provisions of the Butte County Code and/or This. permii is ra y isrdicated I hereby affirm that there is a construction lending agency for the the for this is issued (Sec 3097 Civ.) Resolutions do wo a ove for ich fees have been paid.`performance ^ 6 0 of work which permit B / Date: / y' Name: / 2—1 6 PERMIT EXPIRES ON: Address: (Date) ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it Is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to center upon the above mentioned property for inspection pu oses. Print Name: j /\_ r L.��tn�2 .��ii�\C l� Signature: Date: .. y(J Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 04/23/2008 18:44 9164238597 ADVANCED PROPERTY PAGE 01 .April 23, 2008 AT'1;TENT..ION — DEBORAH DE BRUN] RE; Permit. Refund. Permit No. BP -052154 P Hi Deborah, Attached is a copy of the "refund applicat. , request" thl the address on the application. On February 16 h, I had called and talked I rkh someone i and told me to go ahead and submit for a I d (since vN construction and the codes changed the fira. of the year), same day. 'At some point during the mon�hl of March, T was in process". In addition, we drove up (we live in. Sa and talked with Tammy, who again told the "permit i you had the request. I offered to leave a and again Here is a copy of the refund request (signi d by my .moth copy of the receipt that we were given wb Do we original i If you have any questions,1 can be reach Id on my cell a. actually be going t.hroughOroville on M �i dhy the 284. � , .Please let me know if you need anything ,lse. n' Thanks, Marcia & Shirley Ferkovich 5 1538-7785 b F3 s i sent on February 16ch to lirected me to the web site I been unable to start omitted the paperwork the I and was told the "refund 'nto) last Friday, 1 waited J" was in process and that old it was "in process". io wrote the check) and a d for the permit. '0215-8501. We will 04/23/2008 18:44 9164333597 ADVANCED PROPERTI' PAGE 02 oc6°l�� o�uTTFo Bette County Department of ,Devel ent Services O I Building Division I 7 County Center Drive ocOUR Oroville, CA 95965 (530) 538-7541 II REFUND R.EQUES APP Ll *TION REFUND POLICY - Butte County Code 3-41(t) I 1s on 1. Refunds can only be made upon written request by the 0eraon who pal sees, whose name the recelpt issued for the fees paid. Any refund chec 2. The request must be made within two years from the dat s will be made pe i of fee payments' I to the name on the receipt, ° rmits not Issued, and two years from the date of permit Issuance for permits Issue -If no construct n has been done. 3. Filing fees and plan check fees for work plans checked are a, Fees paid to other County Departments are not coveredliby not refundable,. this claim. �ork I INSTRUCTIONS: Submit this application to Development Services generated for any fees to be refunded and sent to the address bIlow for determinate for signature ' by refundable fees. A claim will'be e person whose name is on the receipt) and return CLAIMANT'S NAME: I L `l� MAILING ADDRESS:` �I (Wn�iW�� �- PHONE: ( CU (0 > t u L - 9 1 -1 �E f ASSESSOR'S PARCEL NO.: -!21 a I II (Please use one claim Form per permit.) BLDG PERMIT NO.: " �, n �`+ Receipt No. 1 I F'ecoi t' p. 1Z I ReC•ci t No. 3 ,1 ' -A RECEIPT NO- RECEIPT DATE;'44i RECEIPT AMOUNT: 5�c1 b 0�� l �aI . REASON FOR REFUND REQUE exBt CT's ` I l �.s- J + 00 Check those fees which you wish to have considered for refund-) ��(��_2 I ( d� 06uilding Permit Fees Sheriff Fees 111 I[A Fees (CDF Fire Planning) =Other (specify): Plans for cancelled permits will be disposed of within 10 workin �d#s upon submission of a Re uestfor Refund. If ou want the lans ou ma, ick them u i. or to that time. I Signature K:/Forms/Refund Application 082203 k6k 04/23/2008 12:44 9164838597 AUNTY SCHOOLS IMP (One form per AD'v'AI-ICED PROPERT'r FEE CERn N FORM PAGE 03 HZA [ 01 (I IT Build artt No. O 5 ) 1 4 ,II Jurisdiction: CRYL.. Courrty � I � ),Wk r ,1 ,.........................: ................. ............. � car I � 3 Home Additio 'Supplement ,kation Conversion Permit # II (No found3M De (Attach a signed copy of Deed Restric inion li I' �I I :hoof District certifies thilt r j: (State)il Ration No. presenting square feet. '' 1:112 8 i U�tIT1GA 0istrlC:.,Lr,. id by Check # Remarks: • • • -- ••+� r�^��,.�. �n�yrw�ocsn q vl• roes IO�ftttrt�Q above by 3UOrrtfltln9 # Wit— PF- "mant Cods SeCtion 6W20(a), ynAln 90 dsy* horn the deft f"a are PaW. F��`'+�� to aubwm ■ DM cttiltenptnp MCI ItnposlNon of V* fes In any court action. ,I 9 -WO rt to OW School Olatrlct Rewverrypr a49ntng &W, Butts County icy,aims Irnpe= Fee c C by th4 aWICabjs LOC61 Planning Agency that thk! project Is belnq -,,4— Ijunkia me Cartk '0 K Mev be sublect to addktonal scnoat t,p to retry M"j9S s Its Infix on the ad1►ooi c"tj I (schpol elsYellow (b�uilainq department), rink (aooii'tt) .............. 5q. Footage L con (Group R) ctlon ) Itricted Sq. Footage d Notice of Limited Use Facility document) Sq. Footage (Including Exterior s Roofed Areas) Date (Applicant) - 9t,� �q- 6?� (Phone Number) (Zip Code) payment of S S S Date , to camotence wnn plohst .rel pm"btt Forr % zym 80►oat Dkvj= Is *mend Qual"y Alt (CECA), PI 311 � 7 BU TE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS -\\ W24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 /A A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" H �5 M, J ` CONTRACTOR OWNER Last Name r k Zip i lae t a1�1 Address 1 d o Zip City l Lot # Fax State Zip Ct Phone ��T � u Fax 2— E-mail E -mail esn C_ C,Q 00 APPLICANT NAME CONTRACTOR Name City Address Zip City Fax State Zip Phone Lot # Fax E-mail Date Approved: Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Lot # Fax E-mail Date Approved: State License Number APPLICANT NAME Name 'Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use only: AP# O� I _`-` 1 1 Zoning I U Flood Zone SRA I Yes DNo Occ. Type Const. Subdivision Name Carrier Map Book Page Lot # Planner Address Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc , Page 1 of 2 PERMIT NO. BP 0 S21Sy BIN # LOCATION AP# O� I _`-` 1 1 Property Addre �s Ci Cross S eet 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 U�_ Address i�S Description or Scope of Work: 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 REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: �� Amount: 9 9_ - m 19 Bldg F : 2024 22 sRA Receipt Sheriff SMIP Date: n ^� Other —1 a / 7 Total REV 7-27-04 CHRISTOPHER, DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538.7601 Telephone (530) 538-7785 Facsimile TO: FROM: d' SUBJECT: Q DATE: WILLDAN Scott Rutherford (530) 538-7160 srutherford (a)buttewunty.net Plans Transmittal For Review Per Contract 08/12/2005 -5-oo 1�1�cr� ►tee � 9//�os Applicant: Ferkovich, Marcia Permit No: 05-2154 Project Type: Nsf 071-430-011 100% Plan Check Fees $ � 14.46 �i $ 70 .126 $ 21 $ 150.1 WILLDAN Fee $ 150.12 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 0 ' t S COUNTY OF BUTTE -DEPARTMENT OF DE.OECOPMEl10 S[=RVICES-BUILDING DIVISION ��5��� .� •� I v < 7 County Center Drive, Oroville;JCA 95,965 Phone (530)538-7541 Fax (530)538-2140 r, _- PERMIT APPLICATION DATA SHEET OWNER: {- I� �O C 1�+ l Qr CI (� ASSESSOR PARCEL NUMBER O1 1 Proposed Building Use: \Gula ae A - C FI CO Pn w U n i+ Permit Technician: , �a ?t � , � �ate: Items required in order to apply for a permit. All boxes MUST be checked OR marked Nklr; order td ap'pty. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. �Al 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. �1IV 4. Engineered truss details and layouts in duplicate. No faxesl 0 5. Letter from Engineer or Architect for truss design review. A _ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Pian, (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 an 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 0 12. Hazardous Material Form N&N 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Rgmaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 16. Fire Sprinklers............................................................................................ 0 17. - Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by t ❑ 18. Soils Report and/or Engineered Foundation required ........................................... ❑� 1 Erosion Control Plan Required........................................................................ Fees as shown on the attached Schedule of Fees Due Sheet....,...... ............. _ ---- - ❑ City of Chico Plumbing permit.................................................I �1C. 22. Site plan and business license approval from the City of Biggs .............................. _ 23 California Department of Forestry Ian approva[Z paid. Sent by: Ct?� Ilanning approval for (A) Use(B)Parking: (C) Parcel Check: ...f .... I " ❑i4Contact Land Development about _ Improvements, _ Drainage ........................ 26. NPDES Form............................................................................................... ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... p 28. Contractor's license information. (Number, Name Style, Classification) ................... 0 29. Worker's Compensation Carrier and Policy Number ........................................... %AN 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) .:................... ' ,Letter of Signature authorization.................................................................... (32;Recorded copy of Agricultural Acknowledgment Statement ................................. O . 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 q t& q 0� � Sb and hold for pickup. I have beenJ formed of the above items and requirements for obtaining a building permit. Applicant: itl� Dale: 1. Index permit to tion f r the above items numbered: �� Plan Check Letter 2. Additional items required Contractor, designe owne was advised of the above data by , phon mai , counter, by Dated;. I %(D S Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by =1-" Cate: ` Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: 111 11 9 Date: Structural reviewed y: Date: Structural approved by: _ t Date: Note transfer by: Date: Yellow: Building Division 1�. E.H. USE ONLY Slot Ran A"achod �— Row Ran Attachod �Saw to S.D. TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance 41:5,e5,5 n55 Y- e v Owner Location JPP—/�% AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well Clearance for ✓. dwelling. Other c Hold final for: Final clearance. O.K. for: NOTE: En 8/96 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE (530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER Ve p �W 1 Ch tAQ ri.Ia A.P. # PROP SED BUILDING USE _ S� - 6a1i�Qi $r ETTICI�P WCa/ DATE - RECEIPT # DATE REC. 1. BUILDING PERMIT FEES Q � 2,1b, --bb /� -- Balance Due ...................... $ I � O�_ jN ����/' V --- FEMA Flood elevation review ... $ --- Additional plan checking Fee.... $ i1 2. SCHOOL DISTRICT FEES ornull tyi1 b —1-IIu1� ION&C ?� 6—bL (paid at School District Office) (form available after Pl heck) cI ;O h5 3. SHERIFF FEES (paid at Building Division) Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. RECREATION DISTRICT FEES Fwther 'SRQ(paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPAC F ES COUNTY WIDE (per dwelling) $ q09_CQ e jo CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per dwelling) Zoning $ `V'^-'6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) L //� IS3&. SMIP coIe)3 IJI,IN /� D, V 9. DRAINAGE 10. OTHER 11. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be ch=Codu ng process. l APPLICADATE<41/ (7� Pursuant to 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. 7/05) zO v C : 3IO iE;b, fi.�.�yfrr..K:,,.�s...,.>.i�i. �.,,�� :tet=�c:x.�:._. �,;�.:. _.. ,a: �. .. •:;,�.t�r. 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 [%] NO [ ]. 2. 1 HAVE [)] HAVE NOT [ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: '. ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPE DATE: 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 t 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 thanyourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. tiV___1 Mic el C. Vieir4 C.B.O. Ma4ager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. x +fepartment of Public 'vUorks r�'���` Ilk%z;<-•��� B t t e t .0 o u n t y o U =J• e J. Michael Crump, Director LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive /114 5 / Oroville, CA 95965 �Clc \4q (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase ll Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement BLESS THAM 1 ACRE] Project Description: Project Location and/or Parcel Number: By signing below, I, the project ownerlowner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: Date: 1 1 I l V11 Butte County Dgpan6nent o.f'Developinent Sci vices °�'',El rF° 7 County Center Drive ° ° � Oroville, CA 959651� ° °�, .` may° (530) 538-7601 Telephone 00141 (530) 538-7785 Facsimile 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 and/or well to Butte County Environmental Health immediately. s 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:�i.�a �C&O Vtdl APN: r Building site address: 4' Permit No.: od and accept the terms rMftditions as•ex�e� herein as indicated by my I have read,understo pP submission of the above -referenced building permit application and my signature below: SIGNATURE OF APPLICANT DATE �WILLies Serving Publ,DA�N September 9, 2005 Scott Rutherford Butte County Building Department 7 County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX 117 C Street Marysville, California 95901 530/749.2373 fax 530/749.2199 www.willdan.com BUTTE COUNTY PLAN REVIEW REPORT Status: Approved Jurisdiction Job No: 05-2154 Assessor's Parcel No: 071-430-011 Description: Garage with Efficiency Dwelling Willdan Project No: 14353-1848 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, sheets S, 1 through 3 dated 8/1/05 by Mark Johnson * Truss Calculations: Two (2) copies dated 10/18/02 by Longfellow Lumber Co., Inc. * Energy Calculations: Two (2) copies dated 8/2/05 by Todd Ferris The plans have been stamped with the Willdan approval stamp and dated. According to our previous letters relating to this project, the superseded plans and documents will be discarded within 10 days unless we receive other instructions. On the pages to follow is the identification of the codes and standards applicable to the project, a code analysis, conditions -of -approval and identification of any deferred submittals. WILLDAN Serving Public Agencies APPLICABLE CODES Our review was 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 (CBC). • Part 6, known as the California Energy Code, and Energy Commission Standards (CECS). CODE ANALYSIS Specific Use. Type of Occupancy Type of Construction Sprinklers Stories 1" Floor Total Sq Ft S Ft EFF DWEL R-3 V -N N/A 1 560 560 GARAGE U-1 V -N N/A 1 1120 1120 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. 3. All plan sheets shall be signed by designer or person responsible for the plans as required by California Health & Safety Code Section 5536.1. 4. *Permit application building areas specified in the scope -of -work shall be reconciled with plans to Butte County's satisfaction. 5. Designer or person responsible for the plans shall provide name and signature on all plan sheets per California Health & Safety Code Section 5536.1. 6. Field inspector to verify installation of existing or new smoke detectors in all existing bedrooms and hallways leading to bedrooms (may be either battery operated or 110 volt with battery backup) as required when the valuation of any addition made to a Group R - occupancy exceeds $1000 per CBC 310.9.1.2 through CBC 310.9.1.5 7. Gable -End Truss calculation submittal is deferred to Butte Co.'s review at their discretion. SPECIAL INSPECTION NEEDS Our plan review reveals no special inspection needs pursuant to CBC 1701. DEFERRED SUBMITTALS Our plan review reveals no deferred submittals. Sincerely, Tom Trueb Plans Examiner Thank you Cc: Alice Mefford, amefford@buttecounty.net Marcia Ferkovich, marcia@sidesacountancy.com Page 2 of'2 County of Butte Willdan 1.4;53- 1848PC1 F ,;7 * %, - ..:.i'. -z1-' WA 101 BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District Oi nv 111 e • NA Building Depart ent No. 0 521 5 1 J A.P. Number 0-71450-011 Jurisdiction: City County Property Owner Fer k ov i C 1 l , N! Qr c i A Property Location/Address Subdivision Lot No. ......................................................................... ...... Residential Development Q . Q Q :Sq. Footage 86 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 0 New Addition District Identification No. 0 b. 1 6 Z w 1� brou"hy, U h 1 D 11 i Q)L, School District certifies that Sq. Footage (Including Exterior Roofed Areas) 2-1(6-0ro. Date pv-�V - q -144 (Street Address) J (Phone Nu�) (City) (State) (Zip Code) p q ( by payment of $ has complied with the requirements of Resolution No. (� V representing J to square feet. District Paid by Check # Remarks: B 2926 $ 'VB MITIGATION $ Date � Notice: You may protest the Imposition of the fees Identified above by submitting a written protest.to the District, In compliance with Government Code Section 66020(x), within 90 days from the date fees are paid. Failure to submit a timely writbn protest will prohibit you from challenging the Imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee CertMcation Form, the School Diablo Is notified by the applicable Local Planning Agency that this project Is being reviewed under the California Envlramwntal Quality Act (CEQA), this project may be subject to additional school fen to fully mitigate Its impact on the school distrlcYs'sdrools. White (school district), Yellow (building department), Pink (applicant) feeform.xls (3i05)dr= BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) 0 CHICO AREA RECREATION AND PARK DISTRICT (CARD) 4 0 PARADISE RECREATION AND PARK DISTRICT (PRPD) ❑ DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) Q `� �y �b I Building Permit NumbeQ 2—IS 1 Property Owner (s) Fe r k nV l Ch � M nr c a Project. Location/Address Hi'ddth �(Dpwos �&rru ft�-tk , CA Subdivision Name Assessable Sq. Ftge Type of 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: Department 2` Date 0 FRRPD 0 CARD ❑.PRPD 0 DRPD certifies that: Applicant Name_ Phone Number n 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: Recreation and Park District - 11—T -11—T r nnI, _ rnn\/c,--A,-e......,...4_4 44__ —, 1 dnr. per unit for a total of $ 40'. per sq foot for a total of $ Receipt No: / 8-6 S- AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 COPY of Document Recorded 16 -Feb -2006 2006-0008307 Has not been compared with original BUTTE COUNTY 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_OWNERS: mayclm COUR qA :. C?r�M543538 z W C Nola: ublic • California m State of California ) z .i aciamento County County of 5 A C rG /r] a r) �� ) Comm. Expires Jan. 10, 2009 P On /`P a40-rd/,�. a6tj before me, personally appeared �p personally known to me (or proved to me on the basis atisfactory evidence) to be the erso� s) whose am s s re subscribed to the within instrument and ackno >Sedtop me that hehey executed the same in is/ er heir authorized Capacit ies), and that by his er r ig) on the instrument, the erso s) or the entity upon behalf of which erson s) acted, executed a instru WIT S my hand ficial seal. Signatu A.P. #� Escrow No.: 05 -107331 -CC Locate No.: CAFNT0958-0958-0001-0000107331 TiUe No.: 05 -107331 -BD EXHIBIT "A" THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF CALIFORNIA, AND IS DESCRIBED AS FOLLOWS: Parcel I: A portion of Section 2, Township 20 North, Range 5 East, M.D.B. & M., and more particularly described as follows: Beginning at the Northeast corner of Lot 3 in Section 2, Township 20 North, Range 5 East, M.D.B. & M.; thence South 891D 50' 18" West along the Northerly line of Lot 3, a distance of 449.44 feet; thence South a distance of 522.64 feet; thence South 890 52' 30" East, a distance of 446.60 feet to the Easterly line of Lot 3; thence Northerly along the Easterly line of said Lot 3, a distance'of 524.89 feet to the point of beginning. Parcel II: a non-exclusive right of way for road and utility purposes over a strip of land 60 feet in width, the centerline of which is described as follows: Commencing at the Northeast corner of Lot 3 In Section 2, Township 20 North, Range 5 East, M.D.B. & M.; thence South 890 50' 18" West along the Northerly line of Lot 3, a distance of 449.44 feet to the point of beginning of the following described centerline; thence from said point of beginning, South a distance of 522.64 feet to the end of said description. Excepting therefrom all that portion lying within the bounds of Parcel I; described herein. Parcel III: A right of way for road and utility purposes over a strip of land 60 feet in width, the centerline of which is described as follows: Commencing at the Northwest corner of the Southeast quarter of the Southeast quarter of Section 35, Township 21 North, Range 5 East, M.D.B. & M.; thence South 000 35' 10" West, a distance of 29.47 feet along the West line of the Southeast quarter of the. Southeast quarter of said Section 35 to a point on the centerline of Canyon Creek Road, also known as Rockefeller Road; thence leaving the West fine of the Southeast quarter of the Southeast quarter of said Section 35, and running along the centerline of said Canyon Creek Road, North 710 06' 05" West, 52.99 feet and North 530 19' 05" West, 143.94 feet; thence South 440 55' 05" East, 30 feet to the true point of beginning for the following described centerline; thence from said true point of beginning, South 450 04' 55" West, 272.58 feet; thence South and parallel with the North and South centerline of said Section 35, to a point which bears North and perpendicularly distant 30 feet from the Southerly line of said Section 35; thence Westerly and parallel with the Southerly line of said Section 35, a distance of 980 feet, more or.less, to the North and South centerline of said Section 35 and the end of said centerline. Initials: CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ���c�..�cGrce�;cu�.�'--,�.ocA,�cl•�e�c�.�c'.,��c-r�.er..cr..�.���=���u-�o,�..e�:ccc�.c�.c•c..cccrcr�,.c�:�,�-r,��,cc.,c�c� .,c•e.�.�—>s State of California } ss. County of On / (��� before me, Date• A , Name personally appeared ��%!`t' / /7 ANN P. MENANG # 1590350 ?q:;;P;,.�CommlW1on Notary Pubnc = CaDforMa Butte County My Comm. Expires Jun 26, 2009 Place Notary Seal Above 7%4pj;761A�114 4 of Officer (e.g.,,Jan Doe, Notary P ' ') of Signer(s) ❑ personally known to me proved to me on the basis of satisfactory evidence o be the personfs) whose name( (s re subscribed to the within instrument and acknowledged to me that he�&they executed the same in hiseir authorized capacity(ies), and that by hi a heir signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITN my ha d an off, r lure AW Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Title or Type of C Document Date: Signer(s) Other l Capacity(ies) Cl ' ed by ig¢ Signer's Name: Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: & Individual ❑ Cb9ZQorate Officer — Title(s): ❑ Partner Limited ❑ General ❑ Attorney in Fa ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: © 2004 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313.2402 V Item No. 5907 Reorder: Call Toll -Free 1-800-876-6827 i SITE PLAN REVIEW APPLICATION Date: o o Q 5_� AP# 071-4-130-011 Permit Number (if applicable) APPLICANT INFORMATION Parcel Size: Owners Name: &A CCA, Ot/L (' 7 Owners Address: Telephone No.: 916 — 9 6-- ?so Situs Address: 0"Lt Proposed Use: Residential W New Single Family Residential ❑ Single Family Addition ❑ Single Family Remodel ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ )Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ Commercial Remodel ❑ New Industrial. ❑ Industrial Addition ❑ Industrial Remodel Other ❑ Septic ❑ Well ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) M Approved . ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Site Plan Stamped Approved By Date Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: Snow Load Area: �2-6vO f) a o© Land Conservation Act Minimum Acreage: ❑ Verify residence can be builter contract ❑ Nitrate Action Plan (See Environmental Health for standards) p ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) SRA - (CDF to determine specific requirements) 100 -Year Flood Plain: (See attached) • Flood Zone: X • Flood Panel No.: • ,Q('.000 Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ❑ Detached Building Use Form ❑ Encroachment -Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: a Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front CIO Side Side Street /01 Rear 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 . `" , t? ❑ Subdivision Map/Parcel Map: Map Date of Recording: Lot: Book: Page: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land 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 Page 4 of 5 Applicable Development Fees: �r 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 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: nc, — 6_) WOs S(1--G� G C — 0' 9 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 n n Summary of Specific Requirements: This information provided in this summary is based on the application information and on the best available data at the time of review. CALarrys\Buildina Permit Site Plan Reviewl.doc Page 5 of 5 A F-1 n n Summary of Specific Requirements: This information provided in this summary is based on the application information and on the best available data at the time of review. CALarrys\Buildina Permit Site Plan Reviewl.doc Page 5 of 5 ' $U'T C�C�JJli'iY-t�;;IIF 1 ` AUG 1 12 59 N 1374 RETURN TO: Planning Dept. CERTIFICATE OF _C01'flFLIAP,rCE L0111aE X1 LIU@1-R t H Issued to: WALTER & ROSEIfilh NTAT A` OEall 7ided 1/3 interest; and GARY Y. & DOR L E. Kms` N, an undivided 1/3 interest, and WILLIAM H. & GLORIA A PERKINS, an undivided 1/3 interest. c/o Walter Halus 5510 Bobbywood Ave. 3393 San Jose, CA 9512.4 This Certificate of Compliance is hereby issued by the County of Butte to certify that the land division which created the parcel of property identified belo'ri complies with applicable provisions of the Subdivision iftp Act and of Chapter 20 of the Butte County Code. 1. Property Location: Sec 2, T20N, R5E, I:IiDB&X 2. Assessor's Parcel Number: 71-35-09 3. Description: All that certain property located in the County of Butte, State of California, more particularly described as follows: A portion of Sec 2, T20N, R5E, 1tiDB&.I'=(, and more particularly described as follows: Beginning atd the P4E corner of Lot 3 of Sec 2, T20N, R5E, PiiDB&P,1; thence S 89 50' 18" along the Northerly line'of Lot 3, a distance of 449.44 ft.; thence South a distance of 522.64 ft.; thence S 89 52' 30" E a distance of 446.60 ft. to the Easterly line of Lot 3; thence Northerly along the.Easterly line of said Lot 3, a distance of 524.89 ft. to the point of beginning, and all easements as granted in Deed recorded November 22, 1971, in Book 1714 at Pages 432 and 433 Records of Butte County, California. Issuance of this certificate is conditional upon the following conditions which have been imposed pursuant to Butte County Code Chapter 20-48 and Business and Professions Code Section'115832.(b) to protect the public health and public safety. w 0 0 County of Butte Subdivision Committee t� _D By — _ m Cn CD CJO END OF DOCUMENT LAND DEVELOPMENT BUILDINGI ENVIRONMEN�'I�ALfE�A�TH =. PERMIT CLEARANCE Building Permit Na. OWNERS L r,J�P�M�S � �jh�13A-�1h PRINT LAST NAME FIRST A.P. NUMBER: l J� COUNTY DESIG ATONING U FLOOD ZONE: 1, X, r• FLOOD MAP: -950 6 APPROVED: CONDITIONALLY APPROVED: �/ 9 nrq'ESOLVE PROBLEMS PRIOR TO APPROVAL: PARCEL CREATION BY DEEDS OR MAP S. So i}C T 4 lea DEED INFORMATION: /L'-M'9r pRorr 7/-35- 09 DATE OF CREATION: Z ?' ' DEED REFERENCE: LEGAL ACCESS PROVIDED: YES NO LEGAL ACCESS REQUIRED: YES NO COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: YES NO COMMENTS/CONDITIONS: f i�� ✓ ! ►'� �� Cf�-'1—I o l�( �EEI� 1/ -cr=y LCGl9L R ft-8EFss 6W dOe- iss(IEV 5// /74 MAP INFORMATION: DATE OF RECORDING LOT BOOK PAGE COMPLIANCE WITH OLD SUBDIVISION LOT ORDINANCE REQUIRED?. (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT PAGE 23): YES NO . IF YES, MARK APPROPRIATE ITEM(S) BELOW: A. Construct road to B. Meet parcel size required by zone. C. Meet current E.H.D. requirements. CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BE PAID TO THE BU/LD/NG DIVISION UNLESS OTHERWISE NOTED. 1. Maintain a 50 ft. building setback from centerline of road. 2. Maintain a ft.building setback from right-of-way/centerline of _ 3. Comply with Zoning code for building setback from road. 4. Maintain a 100 ft. leachfield setback from all existing wells. 5. Maintain a ft. leachfield setback from 6. Pay water tender fees in the amount of $ to Battalion Number 7. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290. _ 8. Connect to a public water supply. _ 9. Connect to a public sewer system. of the Butte County Fire Department. _ 10. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National Fire Protection Association Standard for the 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 Fire Department specifications, serves the parcel. _ 11. Pay T.O.D. (Thermalito Drainage District) fee in the amount of $ _ 12. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See phone number below) 13. Obtain approval from the Department of Fish and Game for vegetation removal. Contact Fish & Game at 916-355-7010. _ 14. A traffic mitigation fee for each new or additional living unit shall be paid. Pay the amount of $ as stated in the Oroville Area Traffic Mitigation Fee Agreement. Payment to be euaare to Lhe P11""k'9 Dhds+'an- _ 15. All new residential buildings shall be constructed to comply with the requirements of the Uniform Building Code for seismic safety. Mobile homes shall be constructed on a permanent foundation system which complies with the Seismic Zone 3 requirements of the Uniform Building Code. 16. Deer Mitigation fees are to be paid, if such fees have been adopted by the Butte County Board of Supervisors. X .17. Pay school impact mitigation fees. X 18. A development impact fee for sheriff facilities shall be paid pursuant to the provisions of Chapter 3, Article II of the Butte County Code. _ 19. 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. _ 20. If any cultural resources are encountered during ground disturbing activities, all work shall cease in the area of the find pending examination of the site by a professional archaeologist. This person would then be able to assess the site significance and suggest appropriate mitigation measures. 21 22. 23. 24 25 26. wa INVU013A30 QNV" MIN 10 AjNr0^ 1661 9 0 033 a3ni333a LD 7196 C:\wP51 TORMS.K\BLDGPERM.CLR BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP052154 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 02/16/2006 APN: 071-430-011-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number:, Site Address: 78 HORSESHOE TRAIL BCK Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NSF EFFICIENCY UNIT: LIV(560), GAR(1120) Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: FERKOVICH MARCIA to its issuance, also requires the applicant for such permit to rile a 4717 JOHNSON DR signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section FAIR OAKS, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95628 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 (916) 965-8501 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 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: FERKOVICH MARCIA owner of property who builds or improves thereon, and who does 4717 JOHNSON DR such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for FAIR OAKS, CA sale. If however, the building or improvements are sold within one 95628 year of completion, the owner -builder will have the burden of (916 ) 965-8501 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' Stale 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.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Datea� /A 10 Owner: License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit 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: Total Square Ft: 1680 S.F. Policy fr. Valuation: $63,280.00 I certify that in the performance of the work for which this permit is Census Code: I 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' v' compensation provisions of Section 3700 of the Labor Code, I shall o forthwith comply withthose provisions. Date: b r l/ Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This. permit is su undert app is a provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the of the work for which this is issued (Sec 3097 Civ.)B dicated a ove for ich fees have been paid.performance Resolution do�by' permit Name: Date: y: / �-16 ^'O7 Address: PERMIT EXPIRES ON: (Date) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte Countyto center upon the above mentioned property for inspection oses. TCounty Print Name:y lf/k-LJ� �f1_irVii 1! ( ��► ` Signature: Print Date: `y] Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1