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Home My WebLink About072-200-018" !L 72-20-18 554-91E 72-20-18 108-91 /:.' RTER, Richard CARTER.,. Richard:CA , ° � - � - � . - 28 Hurleton Rd, 0roville 28 Hurleton Rd;'Oroville -------- Contr: S.trang,Electric �%l Ag Exempti=on Permit ! (elec sery/ml')aY stg.) 72-20-18 2552791B CARTER Richard 28 Hurleton Rd, Oroville �U (carport) BO% -2077 072-200-018 RESIDENTIAL SFD-Custom/Model NSF (1699) GAR (330) COV (48) 28 HURLETON RD KOEHN, RUSSELL 072-200-018 j B08-0061 Demolition MISCELLANEOUS DEMO EX MH 28 HURLETON RD ERN, KO �N N D �� BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 28 HURLETON RD Owner: Permit No: B07-2077 APN: 072-200-018 KOEHN, RUSSELL Issued Date: 1/22/2008 By GLB Pertnit type: RESIDENTIAL 28 HURLETON RD Subtype: SFD-Custom/Model OROVILLE, CA 95966 Expiration Date: 1/21/2009 Description: NSF (1699) GAR (330) COV (48) -REI (530) 589-0767 Occupancy: R-3 Zoning: FRIO Contractor Applicant: Square Footage: KOEHN, RUSSELL KOEHN, RUSSELL Building Garage Remdl/Addn 28 HURLETON RD 28 HURLETON RD 1,699 330 OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch[Patio Total (530) 589-0767 (530) 589-0767 1 48 2,077 FEE INFORMATION DB R3 Dwelling -Custom, Model $1,685.89 DB R3 Dwelling -Custom, Model $1,123.93 DBEH Building Review Fee $75.70 DBFIRE Fire Inspection (SRA) $102.70 DBFIRE Fire Inspection (SRA) $102.70 DBFIRE SRA Fire Plan Review (S $102.70 DBOMSCF Fire Safe Standards Re $115.98 Total Charged: $3,321.51 Fees Paid: $3,321.51 DBSMIP Residential $11.91 Balance Due: $0.00 Receipt No: B6150 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Flass / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License KOEHN,RUSSELL OL:CRW00415492 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractoes License Law (Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 1/22/2008 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractors Signature Date 1, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL 00 THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS'COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements EII HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR. are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by 1. AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier Policy Number: Exp. Date: (This section need not be completed if the permit -is_Fo_rc_neTuFdred dollars ($100) Wor Fe—ss F__ I AM EXEMPT under Section B. & P.C. for this reason: :CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS /g SSUED, 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' X 1/22/N08 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisio Ow"Wignature Date X 1/22/2008 -7 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building SignatLr6- Date WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEYS FEES. use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the propertyr or am authorize alf. i. _019,act o h ;? 7rtywnees beh 19 1/22/2008 �AE a pr'; C.ON-SITRU,CTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for NallrdTlPermitt6e [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner 1:1 Contractor OR: E]Agent for Owner 0Agent for Contractor FILE COPY Lenders Address city State Zip `BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (5-10)5')8-7541 FAX #: (530) 538-2140 A FEE WILL BE REO_UIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name First Name Mailing Addre s 175- rd eN City z State Zip S9 Phone 7 Fax - 07 % E-mail CONTRACTOR Name Address City State Zip Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City C, Cz State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name G Vd Address City State 1 Zip Phone Fax E-mail APPLIqAN,Tj SIGNATURE 001,X2%e%04_ I UU PROJECT�,L/OCCATION Property Address1 1. Owv l?v City oY11le 4�_4t- 9s-� PERMIT NO. 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 Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Coy ❑ Structure Built without Permits ❑ Proposed Change of Occupancy . (Note previous use): 0 M For office use only: Zoning jj1 Flood Zone SRA No Occ. Type Const. C;i9 1 oo� 6yz, a_o_� �(Cp2 t5 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds PERMIT APPLICATION DATA SHEET Reference Number: B07-2077 Date: 10/05/2007 Location: 28 HURLETON RD By: KEJ Parcel Number: 072-200-018 Sub Type: SFD-Custom/Model Owner Name: KOEHN, RUSSELL Phone: (530) 589-0767 Description: NSF (1699) GAR (330) COV (48) The above permit application has the following Clearances required prior to permit issuance. Please contact each department indicated below regarding specific requirements pertaining to your permit application. Yes No DRAINAGE DISTRICTS Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740 LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000 VIEW* SCHOOL DISTRICTS Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281 Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723 Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000 Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext: 105 Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 Other: Other: Other: Signature of Property Owner: x4Date: 10/05/2007 FILE City of Chico, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 PARKS & RECREATION DISTRICTS Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921 Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011 Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393 VIEW* SCHOOL DISTRICTS Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281 Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723 Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000 Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext: 105 Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 Other: Other: Other: Signature of Property Owner: x4Date: 10/05/2007 FILE Butte County Department of Public Works J. MICHAEL CRUMP, DIRECTOR LAND DEVELOPMENT DIVISION Storm Water Managment Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 Telephone (530) 538-7171 Fax www.buttecounty.net/dds O d 0 O O National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment [LESS THAN 1 ACRE 1 Reference Number: B07-2077 Date: 10/05/2007 Location: 28 HURLETON RD By: KEJ Parcel Number: 072-200-018 Sub Type: SFD-Custom/Model Owner Name: KOEHN, RUSSELL Phone: (530) 589-0767 Description: NSF (1699) GAR (330) COV (48) By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the state of California Regional Water Quality Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. Signed: 2l I FILE Date: 10/05/2007 BUTTE COUNTY FEE SUMMARY 7 County Center Drive Oroville, CA 95965 Permit Number: B07-2077 Department of Development Services Phone (530) 538-7541 Fax (530) 538-2140 Job Address: 28 HURLETON RD Contractor: KOEHN, RUSSELL 28 HURLETON RD OROVILLE, CA 95966 Printed: 10/05/2007 1:07 pm Fee Description Account Number Fee Amount Paid Date Pmt Amt DB R3 Dwelling -Custom, Model DBF DWLNG CSTM/MDL N Plan Rvv 0010-440001-4210500-1010 $1,123.93 10/05/2007 $1,123.93 DBF DWLNG CSTM/MDL N Permit Fi 0010-440001-4210500-1010 $1,685.89 DBEH Building Review Fee 0021-540013-4614901-1010 $75.70 10/05/2007 $75.70 DBFIRE Fire Inspection (SRA) 0100-450001-4617240-1010 $102.70 0100-450001-4617240-1010 $102.70 10/05/2007 $102.70 DBOMSCF Fire Safe Standards Re 0010-440001-4210500-1010 $115.98 DBFIRE SRA Fire Plan Review (S 0100-450001-4617240-1010 $102.70 10/05/2007 $102.70 DBSMIP Residential 1001-0-280-1011298 $11.91 Printed By: Karen Jones 39321.51 $19405.03 Balance Due: $1,916.48 At the time of permit application, I was advised the above fees are required prior to issuance of the permit. These fe ay change during the plan checking process. Signature: ` Date: 10/05/2007 Pursuant to Government code Section 66020, you are hereby notified those items listed above may have been imposed on your project. You have 90 days from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a protest are specified in Government Code Section 66020(a). California Department of Forestry and Fire Protection Butte County Fire Department Fire Prevention Bureau Reference Number: B07-2077 Location: 28 HURLETON RD Parcel Number: 072-200-018 Owner Name: KOEHN, RUSSELL 176 Nelson Avenue, Oroville CA 95965 (530) 538-7888 Office, (530) 538-2105 Fax Date: 10/05/2007 By: KEJ Sub Type: SFD-Custom/Model Phone: (530) 589-0767. Description: NSF (1699) GAR (330) COV (48) To meet the requirements of Government Code section 51182 and Public Resource Code 4291, Butte County requires a pre -construction inspection to pro -actively provide the below building and site requirements to the property owner. Your property is located within the State Responsibility Area (SRA) of Butte County SRA is required to meet the below requirements: ✓ Public Resources Code 4290 ✓ Public Resources Code 4291 ✓ California Building Code, Chapter 7A ✓ Butte County Improvement Standards Requirements prior to scheduling the pre -inspection: ✓ Full plan submittal to Butte County Development Services -Building Division ✓ Driveway and building pad must be identified on site Structure location must be staked out on the building site All development within the Requests for inspections shall be made a minimum of 72 hours in advance by calling the Fire Prevention Bureau's 24 hour inspection line at (530) 538-6837, ext. 169, (When the recording comes on, enter the extension number). For the pre -inspections, the property owner or authorized agent is required to meet the inspector at the construction site with two hard copies of the site plan. I have read and understand the above pre -inspection requirements. 10/05/2007 Date Signature All of the Fire Safe Requirements are posted on the Butte County Fire Department website at http://buttefire.org/Fireprevention/protplan/protplan.html Rev'd 5/7/07 FILE Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: D Make sure your application is complete. ftp Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at http://municipalcodes.lexisnexis.com/codes/butteco/ Reference Number: B07-2077 Location: 28 HURLETON RD Parcel Number: 072-200-018 Owner Name: KOEHN, RUSSELL Date: 10/05/2007 Phone: (530) 589-0767 Description: NSF (1699) GAR (330) COV (48) Signature of Applicant: Date: 10/05/2007 FILE Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not Iicensed as contractors or subcontractors, then you may be an employer. n 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 G income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. 1. I PERSONALLY P LTO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. (YES R NO) 2. 169FLAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 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 Description: NSF (1699) GAR (330) COV (48) Reference Number: B07-2077 Applicant Name: KOEHN, RUSSELL Owner's Name: KOEHN, RUSSELL AP h Signature of Property Owner: /' Date: 072-200-018 A'n 6,) C// /- Z-� v-1- 4w, Ze- e i BUTTE COUNTY DEVELOPMENT FEE,�vT tF� CERTIFICATION FORM ; Feather River Recreation & Park District • �covN�y� Assessor's. Parcel Number (s): 072-200-018 Building Permit Number: B07-2077 Property Owner (s): KOEHN, RUSSELL Project Location/Address: 28 HURLETON RD Project Description: NSF (1699) GAR (330) COV (48)-REPLA, OROVILLE Type of Residential Development Permit Type: RESIDENTIAL Permit Subtype: SFD-Custom/Model Building Type: New Single Family Dwelling New/Additional Sq Ftg: 1,699 Certificate of Existing Square Footage Existing Sq Ftg: 684 MH Replacement: Yes Existing Construction Type: Residential - Conventional Home Demo Permit Issued?: Yes Demo Permit Issued Date: 01/09/2008 Verified by Building Records: Yes Verified by Assessment Records: Yes Comments: Replacing mobile home with new single family dwelling. J -( OAAbLM Bu (ding Department Re r sentative 01/17/2008 Date ZFRRPD ❑ CARD ❑ PRPD ❑ DRPD certifies that: Applicant Name Phone Number 11's � DY v.e. Ord to Mailing Address City State Zip Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of: —ff5---- Dwelling Units @ $ per unit for a total of $ Square Feet @ $ per sq foot for a total of $ Remarks: Paid by Check No: Paid by Cash: Receipt No: Recreation and Park District Representative Date AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 COPY of Document Recorded 22 -Jan -2008 2008-0002347 Has not been compared with original BUTTE COUNTY RECORDER AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property 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 CI , - State of California County of On before me, personany appeared ersonally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature. A.P. # Seal: \p CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT File No: () STATE OF California )SS APN No: COUNTY OF Butte ) On January 22, 2008 before me, Mary A. Thompson , Notary Public, personally appeared Russell Koehn who 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. I certify under PENALTY OF PERJU�Y ur-Aer the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my,."f# 0nd offipial Signature y`� y MARY A. THOMPSON P Commission #11857914 n Notary Public-Calitomia -0 Butte County My Comm. Exp. APR. 15, 2010 This area for official notarial seal. OPTIONAL SECTION CAPACITY CLAIMED BY SIGNER Though statute does not require the Notary to fill in the data below, doing so may prove invaluable to persons relying on the documents. ❑X INDIVIDUAL ❑ CORPORATE OFFICERS) TITLE(S) ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER SIGNER IS REPRESENTING: Name of Person or Entity Name of Person or Entity OPTIONAL SECTION Though the data requested here is not required by law, it could prevent fraudulent reattachment of this form. THIS CERTIFICATE MUST BE ATTACHED TO THE DOCUMENT DESCRIBED BELOW TITLE OR TYPE OF DOCUMENT: Agrigultural statement NUMBER OF PAGES 2 SIGNERS) OTHER THAN NAMED ABOVE DATE OF DOCUMENT January 22, 2008 Reproduced by Mid Valley Title & Escrow Company 11/2007 Preliminary Report Description Order No. BU -1451169 AM The land referred to herein is situated in the State of California, County of Butte, and is described as follows: A PORTION OF THE EAST HALF OF SECTION 17, TOWNSHIP 19 NORTH, RANGE 5 EAST, M.D.B. & M., MORE PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCING AT A POINT ON THE EAST LINE OF SAID SECTION 17, FROM WHICH POINT THE NORTHEAST CORNER OF SAID SECTION 17 BEARS NORTH 0° 24' EAST, A DISTANCE OF 2503.20 FEET; THENCE LEAVING THE POINT OF COMA4ENCEMENTAND THE EAST LINE OF SAID SECTION 17., AND RUNNING SOUTH 78° 22' WEST, A DISTANCE OF 69.40 FEET TO THE BEGINNING OF A 95.49 FEET RADIUS CURVE CONCAVE TO THE SOUTHEAST; THENCE ALONG THE ARC OF SAID 95,49 FOOT RADIUS CURVE, AN ARC DISTANCE OF 55.0 FEET AND THROUGH A CENTRAL ANGLE OF .33° 00' TO THE END OF SAID ' CURVE; THENCE SOUTH 450 22' WEST, A DISTANCE OF 120.0 FEET TO THE BEGINNING OF A 159.15 FOOT RADIUS CURVE CONCAVE TO THE SOUTHEAST; THENCE ALONG THE ARC OF SAID 159.15 FOOT RADIUS CURVE, AN ARC DISTANCE OF 155.0 FEET AND THROUGH A CENTRAL ANGLE OF 550 48' TO THE END OF SAID CURVE; THENCE SOUTH 10° 26' EAST, A DISTANCE OF 70.0 FEET TO THE SOUTHEAST CORNER OF THE PARCEL OF LAND HERETOFORE RECORDED IN BOOK 1314, PAGE 65, OFFICIAL RECORDS; THENCE LEAVING SAID SOUTHEAST CORNER AND RUNNING SOUTH 820 21' 47" WEST, A DISTANCE OF 225.80 FEET ALONG THE SOUTHERLY LINE OF SAID PARCEL OF LAND RECORDED IN BOOK 1314, PAGE 65, OFFICIAL RECORDS TO THE TRUE POINT OF BEGINNING FOR THE PARCEL OF LAND HEREIN. DESCRIBED; THENCE LEAVING THE TRUE POINT OF BEGINNING, - AND CONTINUING SOUTH .82° 21' 47" WEST, A DISTANCE OF 371.20 FEET, ALONG THE SOUTHERLY LINE OF SAID PARCEL OF LAND RECORDED IN BOOK 1314, PAGE 65, OFFICIAL RECORDS, TO THE SOUTHWEST CORNER THEREOF; THENCE LEAVING SAID SOUTHWEST CORNER AND RUNNING NORTH 00° 24' EAST, A DISTANCE OF 223.09 FEET ALONG THE WESTERLY LINE OF SAID PARCEL OF LAND RECORDED IN BOOK 1314, PAGE 65, OFFICIAL RECORDS TO A POINT IN THE OROVILLE-FORBESTOWN ROAD,AS SAID ROAD EXISTED ON MAY 1, 1969; THENCE LEAVING SAID WESTERLY LINE AND RUNNING NORTH 53° 56' 52" EAST, A DISTANCE OF 231.26 FEET ALONG SAID OROVILLE FORBESTOWN ROAD TO A POINT IN SAID ROAD; THENCE LEAVING SAID OROVILLE-FORBESTOWN ROAD AND RUNNING SOUTH 30`03' 43" EAST, A DISTANCE OF 342.45 FEET, TO THE TRUE POINT OF BEGINNING. EXCEPTING THEREFROM ALL THAT PORTION DESCRIBED IN THE DEED TO THE STATE OF CALIFORNIA, DATED DECEMBER 13, 1965, AND RECORDED MARCH 9, 1966, IN BOOK 1417, PAGE 429, OFFICIAL RECORDS. APN 072-200-018-000 BUTTE COUNTY SCHOOL FEE CERTIFICATION FORM ,wrrF0 (One form per Building) o 0 0 UN �y School District: Oroville Elementary School District Building Permit Number: B07-2077 Assessor's Parcel Number (s): 072-200-018 Tax Rate Area No: cu-(``j"`i Property Owner (s): KOEHN, RUSSELL Project Location/Address: 28 HURLETON RD OROVILLE Project Description: NSF (1699) GAR (330) COV (48)=REPLACED EX NIH Type of Development Building Type:New Single Family Dwelling New/Additional Sq Ftg: 1,699 Buil in Department Repr a tative District Indentification.No. 79 t/ Permit Type: SFD-Custom/Model Deed Restricted Sq Ftg: 01/17/2008 Date 01127 (�& apr-- School District certifies that ` (Payor) ez h+ (Street Address) (City) (State) (Zip Code) (Phone Number) has complied with the requirements .of Resolution No. (�5` Utv -- r by payment of $ 2 (0 representing /Q %5 square feet. AB 2926 $ FULL MITIGATION $ School District RepVesentative Date Paid by Check-# Remarks: -- Notice: You may protest the imposition of the fees identified above by sumitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing. this Butte County Schools Impact Fee Certification Form; the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. DDS—School Fee Form rev'd 12.12.07 ° � I 0 0 r a. • Ano ion of she Northeast Quarter of He Southeast f Quarter (NEof SE1) of Sec Lion Seventeen 2. Nineteen (•Z9) Nort a .,.. (' 7r), ownahip por :on being more par£ir'cuJ at y de�ecrFibeei Pas �o'llowpid P=r. SEOIIJIIING at a I -inch ron pipe with brass cap T marked FPR_5 from ohich the Southeast burner of eFig Secoicn 17 beaxs South 28° 5� O1" Eaat� 2X' �• C�i" THEtdCE txom said point of beq.tnning ,r�52•fi8 fee,. ccs Sou h 35° 17+ �° Eae$ $8.22 feet :o a paint on the ro SOath line of that certain parcel oP lsnddcco':�ve e*a Fed A. Bnner, e't x, by Died dated Ap'�1 2�7,y;,¢�4� and recorded Mey 15 964 , ?., in Boot Zj14 of Ggfic sl Re�arde if - utte Coz.nty, Califorrilu, at page E, fr_m khicti a SouY c run pipe with br�ss cap mar ed r boars 1?30" East 10,.8E3 feet• t:;ence a3cn said + SouB:� ltine West 102.87 2eet o t Muth�rest Corner of said pa: cel; th2ncEe along t_ a West ins thereof IJorth 00° !il' 1�3" Y;edt �k7, ; 0 res to the centerlTine of the Orov-mile-Forbee*own Road; :hence e�long snird ten erlTine Itorth� ssr-- y289 feet, i~orc or less, to J the o_th line of said NortT+ st Q�yrter of to a0u=hpaet I Quarter of Sect on i•7• thencA 2 i said . orth fine Sout�h'49° ��'< 2v✓�S said centerline anc� South 40° 06'+ 14" Test � ;• ast ?0.00 Peet; thence 227,$0 i`ee° .o ainch iron Pipe Yrit yeas ca. c�rke@ F: g_ �_. Socth 1`+3° 36'' 17" west 83 thence � faint o2 beginning, 93.10 fe t to the '� l Containing an area of 0•,5 acre, mare or Zeas, Beer ngs and di•tanc2s }he e abov? escr ption arbase on the Calif. r is Coordinate Syateh� Zone II and Zore �J 3C0ordinatea for the tint of Degin�`ning are ~6u9, 8,7 and X=2,�'61,152L�i9. j The date of Posasssion v 0rsrrt a of the herein deacribed I F�Perty is either Jul 22, 555! or t e ec relation date of this deed (whit lever occurs l+first), � - J t i -2- oRo_493 7/27 65 f Itryl y+ - �`F� J.MEH i 0 19W 20 10 40 t !4 SLC?C Of Gtih76NIA 1 • � TK nwQau✓C �iAT I 6EPART,MEy7 O� tFP RESOURCES i1F Py R�Qi1ES7' OF RECO°.D:NG R:QUESTED BY j._i polo,f r - i 1*7li3J ltKORDED MAlL_TOEU-M CMCLAL PUM; OF COUP AL W aM P.8%sQ,ZF�CRg P. O. BOA 3m Scjy `i.'p'�,ri-ryS...�r y ► ,_ * . S—,", CQ�iftJf j. c Qs ¢'I,So' *sit }AiER RESOURCES22,162 YJ oast CeurtLy ROad Relocation GRANT DEED Arorei.11e=geatner Fa11 s � (il1tQlViiCiylA1) Dora.Bragger.;a•widow). , I% r- CgA?if to tha TAYB flP CALIIrJRI�1IA, AU that rte: ---- •---- :-•-•-.-_.,.Cam `ri ? $ •..n, swenDsr.rti� i, t f. � • � � '� c �, 74 � •C L'dl�9sl.,4 .nitrvet etHOW- o ' psi• oil i bit tlM y� V. foist. 77771 FOIia OWA 641 tZY 11 ynicr* �:• ' ---•�. .,tr.^�-�ti.w� +wi <c -a a ,,,... '*'•'• e�i tx.x t��. •L. t) • `'.• w 4.r ": '''7 p., .'} Rp�l ^ 3 •..l.a{ ,`7.�,,, Lr'X. "r ' ty_ ,}..�.'S.. , ....�' `�,�,,1�.� S 1 y�..� x in? r r a ,Ct ,�sy`�i y" "e2e�. •a-a��'i!�`+�}�"^` ' S 4 30 00'8+ E ORO-494-A(D:E.D.)� 0.13 Ac. ORO -495 • FfR 3 0.46 Ac. 3 f' ORO -496 JA ORO -493 do / • f fR-� _ 0.01 Ac. R 035 Ac. 82P 3..x'47!'.E 410' :J ; R �� SSO'(.) ForDstoon 1O o • f'f:? Ofed11�'... .. ter• t 0 rorlla_porU�.b4q _ A4 s e2e lie, 47�_ — — L •� f N- °3Y47"'W _ •ffR VlaF. ffi. _ sls^19'43'w 2N.11' 204.46 ....� Ey4J 8. O M Zj. lsq,e4. a� � � ` �-M=:Ol R W O Cio Sto � 102.8 ��'7.• N90°j'3'S X39 rL E31fi. � �%fl0•-489 ..w _ W P08 TL ORO -494-8 / 512 43.94 E. :3 Ac, w >4'T..4-je w — — — — ORO -494 7! •• �_ / ORO-4.94-B(D.E.D.) / earn is w •• 3.80 Aa 0.03 Ac. /7 16 20 21 DETAIL A�� SCALE i" = 100 f y:rr -I ORO -49 A(D.E D ) 0.1313Aa � el e �- ORO -495 • SFR 3 \ 0.46 Ac. ! ORO -496 R ORO -493 // • FR-� - 1 0.01 Ac. •� • $ ? 033 Ac. a e sx'RY ; I R'3 a we ffR' w az^azo.wa • �-A$ _ 1 M a3. alwe'.Y• zz.. u' _ ORO 489 risea�. tb •R� �� ``�`�=_R r ° ° ' am, _ T los.e� FFR'T• wemoa _ r roe .n. Mo -s.-• _ 0.33 AC. e • ` ��_—� - - a�// 61��b'li E 1` w Te -g rr �•. -- '' ORO -494 1.4e)e.' • `1 w eo 3.60 AA _ / ORO -494-8 (D. E.0.) /7 '16 20 2/ DETAIL ."A" SCALE i' = iod / / SCALE I" = Id / ORO-494-A(D.E.D.) 0.13 Ac. — To O. W. 1. D. I o^ �a — m1 r_ — � a7zao - Ro. r. a ao.1 ORO -373 M o 0.09 A. ORO -373-A E - 0.09 Ac. To County of Butte R i i j,"q C . :. I ctm., _ 9 Y S. 1 A� Si7 z ju,vp Ij S O� I 3�1 R i i j,"q . :. wn? ooN,.=gAp a A� Si7 z ju,vp Ij S O� wTioa' a S .5 0• 9 C of : aNI R i i j,"q . :. Ij S n{aa _I - it T i -1- F-. 4� I ..... -�:o_o. c .. V. j 7i7 �;�•- � � o ' i z li: o • �iu -iy. i a I -'T.. E.: r BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION . Site Address: 28 HURLETON RD Owner: Permit NO: B08-0061 APN: 072-200-018 KOEHN, RUSSELL Issued Date: 01/09/2008 By KCG Permit type: MISCELLANEOUS 28 HURLETON RD Subtype: Demolition OROVILLE, CA 95966 Expiration Date: 01/08/2009 Description: DEMO EX MH (530) 589-0767 Occupancy: Zoning: FR10 Contractor Applicant: Square Footage: KOEHN, RUSSELL KOEHN, RUSSELL Building Garage Remdl/Addn 28 HURLETON RD 28 HURLETON RD OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch/Patio Total (530) 589-0767 (530) 589-0767 FEE INFORMATION DBMSC Demolition $58.00 Total Charged: $58.00 Fees Paid: $58.00 Balance Due: $0.00 Receipt No: B6035 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License KOEHN, RUSSELL OL:CRW_00415492 / / Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, , also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 01/09/2008 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractor's Signature Date 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). ❑I, I HA�E AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). Carrier. - Policy Number: Exp. Dale: ple (This section need not be comted if the permit is or one hundred dollars ($100) or less.) I AM EXEMPT under Section B. & P.C. for this reason: I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X 01/09/2008 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those O ner's Signatu Date provisions. X 01/09/2008 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building / Signatur Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused arising out of, in any way connected with HUNDRED THOUSAND DOLLARS $100,000 , IN ADDITION TO THE COST OF COMPENSATION, ( ) the issuance of this permit. I hereby acknowledge thatt is issuance of this pea rmit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the pro owner or a thor' ed to act on the property owners behalf. 1 e. of 01/09/2008 CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for tWafne of Permittee [SI Print Date the performance of the work for which this permit is issued. (3097 civ. code) ® Owner 1:1 Contractor OR. E]Agent for Owner Agent for Contractor FILE COPY Lender's Address City State Zip Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY P�O PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IM0?L11VE PROVEMENT. YES R NO) I 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 CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 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 Description: DEMO EX MH Reference Number: B08-0061 Applicant Name: KOEHN, RUSSELL Owner's Name: KOEHN, RUSSELL AP # : 072-200-018 Signature of Property Owner: Date: 9— OPS DEMOLITJON PERMIT ASBESTOS NOTIFICATION STATEMENT Pursuant to section 19827.5 of the Califomia Health and Safety Code, all demolition permit applicants arc required to fill out this form_ 19927.5' A demolition permit shall not be issued by any city, county; city- and county, or state or local agency which is authorized to issue demolition permits as to any building or other structure except upon the receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both; pursuant to fart 61 of Title 40 of the Code of Federal Regulations, or the successor to that part. The permit may be issued without the applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project. The permitting agency may require the applicant to make the declaration in writing, or it may incorporate the applicants response on the demolition permit application. Compliance with this section shall not he deemed to supersede any requirement of federal law Attached is a copy of the Asbestos NESHAP Notification of Demolition and Renovation form for the project located at (Address) (City) (Zip Code) Assessor's Parcel Number Date Signature of Applicant I hereby declare that a written asbestos notification to the United States Environmental Agency is not applicable to this demolition project located at (Address) (City) (Zip Code) Date Signature of Applicant BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY PERMIT NO. gc& �� 1 srn a "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last Name t7 First Name ,,, ,,/ Mailing Address 17 P!ode_azA- Pk. City LA ///� State Zip Phone QA Fax E-mail PROJECT LOCATION AP# 07 Z 2 -co - pt F Property Address City ek WORKER'S COMPENSATION Policy Number Carrier Nhiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: CONTRACTOR Name Ko eAy uSsr� Address SRA City No State Z Phone Fax E-mail Lic. # Class PROJECT LOCATION AP# 07 Z 2 -co - pt F Property Address City ek WORKER'S COMPENSATION Policy Number Carrier Nhiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: ARCHITECT/ENGINEER Name Ko eAy uSsr� Address SRA City No State Zip Phone Fax E-mail State License Number PROJECT LOCATION AP# 07 Z 2 -co - pt F Property Address City ek WORKER'S COMPENSATION Policy Number Carrier Nhiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: APPLICANT INFORMATION Name Ko eAy uSsr� Address SRA City No State Zip Phone Fax E-mail PROJECT LOCATION AP# 07 Z 2 -co - pt F Property Address City ek WORKER'S COMPENSATION Policy Number Carrier Nhiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA Yes No Occ. Type Const. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE - OROVILLE, IFORNIA 95965 - TELEPHONE: (916) 538-7541 AGRICULTURAL BUItNO EXEMPTION PERMIT PERMIT N0. 4 Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. _�� ® ! �J ZONING F P i D OWNER PHONE NO� �Z—_ / •I / OWNER'S ADDRESS 2 LJ LOCATION OF BUILDING //V) Q_ —7 USE OF BUILDING -4 �•—T-�-,� A�� SIZE OF STRUCTURE X SQ. FT. — TYPE OF CONSTRUCTIOI�V. WOOD FRAME STEEL CONCRETE OTHER (Specify) TYPE SIDING COST ROOF COVERING � FLO�� ESTIMATED OF CONSTRUCTION AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as follows: r ( FRONT -fb-`'^^ �- SIDES REAR AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated above and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Department of Public Works and will obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and beforeoccupan 7/ Date Signature of Owner Permit Fee - $25.00 The above described AG Building is exempt from a building permit. Receipt No. c%7%27,-1 Director of Public Works By Date 7 _32 White - DPW, Yellow - Assessor, Pink - B.I., Goldenrod - Applicant FLOOD PARCEL P.D. ROOFING ISSUE C� I i1 Director of Public Works By Date 7 _32 White - DPW, Yellow - Assessor, Pink - B.I., Goldenrod - Applicant COUNTY OF BUTTE - DEPARTI ENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROV�tLLE,"GALJF;QRNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET OWNER_ Proposed Building Use Permit No. Building Inspector 2- -,2,9C - Date At time of pef it application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED s6y 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. — 5. Hazardous Material Form ........................................... — 6. Energy Design Compliance and supporting documentation ......... — 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions........................................................ 10. Fees of $ — 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. — 14. Sanitation approval from Health Department _ 15. City of Chico plumbing permit ..................................... — 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... _ 18. Improvements may be required. Contact Land Development Section DPW _ 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required ... Pre-Inspec. request to Building Inspector (Date) _ 21. Contractor's license information (No., Name Style, Classifications ... —22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ............. ' ..................... 26. 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone_maiI—counter by .date Contractor, designer, owner, was advised of above required data by—phone —mai I—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 RRECTION NOTICE Dr T) INER PERMIT N, A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify� this office when correction of work is completed. If you have any question pertaining to this maVeT-.Rr need additional explanation, please contact this office immediately. / —/I 4?74 �-)-T-ov AILL 00e, Date Inspector [' COMPLAINANT ADDRESS: PHONE NUMBER: OTHER COMMENTS: ��`N�!'c'.ti�� f,4'�`.�'6L'4�'^!•1Y'�PY'" l,K±q.ry±Ff-}^�„ �r.&��T...D��:.G �M�T�' i'�s�'_": �T �r',Fj.M'�'!_.,�_. r.1 �•.,{ �'.a4r•K.�.e�,Kr.'a'�{j%'�. ; e�3+'F.x9.,r77.'�.; 4k 11-11z i COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7,County Center Drive - Oroville, Californla 95965'= Telephone: 916/538-7541 f APPLICATION AND,PERMIT ASSESSOR F&A CEL NUMBER 72-20-18 i ZONING' !FR1 3 BUILDING PERMIT OWNER Richard Carter TELEPHONE `� R SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 28 Hurleton Rd., Oroville 95966 C ONTRACTOR'S NAME Stran Electric TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS F i l i n Fee g $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER None LICENSE NO. Plan Checking Fee $ Ener Plan Checking Fee Energy g ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 28 Hurleton Rd., Oroville Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping - 5.00 .0a Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehomep Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 ea TYPE OF WORK New❑ Addition❑ Remodel❑ UtilitiesJ5 Installation❑ Other ❑ Describe work: electric service ungrade Permit Fee t $(� Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 1 017) Main Service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code" and my license is in full force and effect. License No. /�� rQ 3 ' Classification. a� / U ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ontract- ors.(Sec. 7044) ors. ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. I DWELLING OCCUP.Ik OR ACDNS. (ACC. BLDGS. , /z¢sgft NEWCONST FL U NON•RESID BRANCNCHH CCIRRCCU ITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20@50t DAL@ 30 Ex. Occup. OUTLETS iRESID )ED APPLNS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Iyirin g 15.00 Permit Fee $ 90,00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's. Compensation Insurance or a Certificate of Consent to Self -Insure. ! I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 1,0.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree t saVe indemnify and keep harmless the County of Butte against all liabilities, 'udgments, costs, and expenses which may in any way accrue against said Cou consequence of the granting of this per it. X ll Date ,� Signature of Applicant - 0 n g pp q ❑ Contractor ❑ Agent An OSHA permit is required f r excavations over 5'0" deep and demolition or construct. ion of structures over 3 storie height. i Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE - TOTAL FEE $� HAz. can PARK SCHL FLO cOF PAR PD I Ho. Issu This permit is hereby issued unser the sions of the Butte County. Code and/or work in ' ated above for which fees DIR OF PUB61 By PERMIT EXPIRES Date applicable provi- resolutions to do have been aid. P WORKS Date ' Receipt No.0083521— WHITE-D.P.W.• YELLOW-A38ESSOR. PINK-INSP TOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Cellfornle 95965 - Tolephono: 918/638-7541 APPLICATION AND PERMIT PERMIT NO. ; 72-20-18 FR1D BUILDING PERMIT N R Richard Carter YMLIKPHCNM SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 28 Hurleton Rd., Oroville 95966 CONTRACTOR'S NAME Strana Electric TELEPHONE CONTRAC OR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation Is FilingFee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER None LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 28 Hurleton Rd., Oroville Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 /%✓� Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome(X( Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilitiesa Installation❑ Other ❑ Describe work: electric service uTgrade _ Permit Fee $ (' Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6OOV OR LESS 100 AMP OR LESS 10.00 Main service ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Cop -and my license is in full force and effect. License No. '��S e�d� f Classification.. �• % C.) F] 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason /EA. NR ADDNST C DWEACCLLIN GSCCUP &) '/22sgft NEW CONSTR ULTI.OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS e (SINGLE OUTLET CIR. ) Ex. OCcup(OUTLETS OR FIXTURES t 5ALOeAL0So FIXED APLNS. Ex. DCCUp. OUTLETS PR (RESID IEA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 _is on ermit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed,revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree t e,T- n ify and keep harmless the County of Butte against all liabilities, 'udgmen , co ,s, and expenses which may in any way accrue against said Cou consequ nce of the granting of this per it. Signature of Applicant — #On ❑ Contractor ❑ Agent An OSHA permit is required ava'ions over S'0" deep and demolition or construct- ion of structures over 3 stoneight. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ HAz. CUA- PARK SCHL FLD cDF PAR PD l HD. Issu This permit is hereby issued unser the applicable provi- sions of the Butte County. Code and/or resolutions to do work i ' ated above for which fees have been paid. DI ROF PUB I ORKS BY Date PERMIT EXPIRES Date Receipt No. 83521—,25.00 25,531-1,15-,490 WHITE-D.P.W., YELLOW -ASSESSOR, PINK-INSP TOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovlller California 95965 - Telephone: 916/538-7541 APPLIMTIaN AND PERMIT A58ss R PARCEL —7 zo)--NJUZL BUILDING PERMIT OW�� Q TELEPH NE SO. FT. OCC. BUILDING VALUATION OWSS NER'S g, I L i� l l- D! OE(�% l I O kl CO TRACTOR'S NAME r J 'c_ TELEPHONE CONTRACTOR MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN c Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BU L ING AD RESS r � D� ✓ I Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping ' 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome� Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is 10.00 ea TYPE OF WORK New ❑ Addition ❑ lemo/dIel ❑ Utilit' Installation❑ Other ❑ Describe work. T r" I C— f^ U f C'- r a C9 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 610V OR LESS 100 AMP OR LESS 10.00 /Q Q Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): E]I am licensed under provisions of Chapt. 9, Div. 3 of the Business(POWER and Professions Code and my license is in full force and effect. License No. Classification. ElI, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.e OR ACDNS. (ACC. BLDGS. ,/z¢sgft NEW CONSTROUTLET NON•R ESID BRANCH CIRCUITS) 2,50 ea APPARATUS e) _ SINGLE OUTLET CIR. Ex. Occu P(ouTLETs OR FIXTURES SALO 30 eAL0 FIXED APLNS. Ex. OCCUp. OUTLETS PIRESID 1REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 / D Mis . Wiring g 15.00 Vie- r 7, 0 S Permit Fee $ 0, WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you becomesubject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit isrequired for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE _ TOTAL FEE $ qqZ CUA PARK scHL rLD coF PAR PD I Ho. IssuE This permit is hereby issued unser the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. WHITE-D.P.W.. YELLOW-ASeES30M. PINK -INSPECTOR, GOLDENROD -APPLICANT PRE -INSPECTION / _� OWNER: �! Q !"�'' (26L P` DATE LOCATION: To lel �d , �✓0 V A.P. CONTRACTOR: Y`V, ri /c_ C-1 i' 1 C_ ZONING 4w PRE -INSPECTION FOR : [ C� ►^ C_ /' / / Y DATE TO INSPECTOR ------------------------ PERMIT HISTORY: NONE AS FOLLOWS: TYPE OF OCCUPANCY ----------------- ----------------- FIELD - INFORMATION BUILDING USAGE: CIO TENNANT: " Eg-,,(!rC'CUPIED �S ELECTRICS"GAS S SANITATION FACILITIES [TED -COOLED OTHER COMMENTS: ACTION COMMENDED: ISSUE Etl OTHER: BY F -I PERSON CONTACTED HOLD FOR DATE wtvvm* Ail COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION s 7 COUNTY CENTER DRIVE - OROVItLE* CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET .�.-. Permit No. OWNER I 0 Ce �0 r }� A. P. No, Proposed Building Use C Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW Driveway permit (const r ctlon approval required prior to occupancy) 0. Pre -Inspection for . / C C t C t C — required Pre-Inspec. request Building Inspector a 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process s follows: Mail o owner. Mail to contractor. _ Telephone d hold for pickup at office. Deliver w/inspector. Other Applicant Date z7Z� Copy of Haz-Mat form sent Health Dept. Fire Dept. Ir oIIution Date Copy of plans sent Health Dept. _Fire Dept. Other Date By. The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone—nail counter by ..date Contractor, designer, owner, was advised ised of above required data by—phone —ma II—counter by date Plans checked byO":5,1=��e Plans approved by Date Sets of plans on hold in Copy—DPW File cabinet AP folder -111111 FAk Xuttz OROVILLE CALI ORNIA GENERAL CLAIM CLAIMANT: Melvin Taber ADDRESS: 28 Hurleton Rd. CITY & STATE: Oroville, CA 95966 IMPORTANT: August 6, 1991 SEE INSTRUCTIONS DATE OF CLAIM: ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) ; AMOUNT Owner has decided not to do work. Permit #2552-91B, AP#72-20-18, Receipt #96828, dated 7/24/91. I � Total Permit Fees Paid ---------- ------------------------- $85.75 Retain Building Permit Filing Fee------------- $10.00 j Total Permit Fees Retained------------------------------- 10.00 TOTAL REFUND DUE ----------------------------------------- $75.75 j i TOTAL $75!75 I. the undersigned, declare under penalty of perjury that the services or articles claim d h ve been performed or delivered, and that this lim is true and correct as stated. q / ,,, Xca Dated this .....1 Q..r......... day of ,�T 19./.J• at ................................. Calif./.L..! L�� ....��CCiC/.L.V............. .. .... . . . ... .... Signature of Claim ant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above h e been performed or de- livered and that there is a Budget Appropriation ❑ or Specific Board Approval J (Check oneVthe , Dated this 6th de of AllguSt 19 91 at groville Cellf. ' .................................... Y ......... ..............., ....... .............................. ... .... ........ ........................ . ........nt Head or Authorize uty Dept. Con Permits Code 44Q-QQ Code 4210500 PAYABLE FROM FUND ' j DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY �I DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. Liza �i�� r COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Or5;yf<fle, Ogalifornia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT T� ASSESSOR PARCEL NUMBER 072-200-010 ZONIN G BUILDING PERMIT OWNER RICHARDCARTER TELEPHONE 589-2201 SQ. FT. OCC. BUILDING VALUATION 312 C 4056 OWNER'S MAILING ADDRESS 28 HURLETON ROAD OROVILLE CONTRACTOR'S NAME NONE TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation $ 4056 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 50.50 ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ 25.25 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 28 HURLETON ROAD OROVILLE Permit fee $ 85.75 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping , 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other CARPORT SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G JW I 10-00ea r� TYPE OF WORK vvi_I NeAddition [1Remodel ❑ Utilities ❑ Installation❑ Other ❑ D cribe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 800V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification. IN I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ontract- ors.(Sec. 7044) ors. ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. / DWELLING OCCUP.a+\ OR ADDNS. \ ACC. BLDGS. I , /20sgft NEW CONSTR. ULTI.OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e SINGLE OUTLET CIR. Ex. Occu p OUTLETS OR FIXTURES BALC30 200030 EX. OCCUp. FIXED P OUTLETS (RESID )REA.; 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: if after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. � xn2,zf r� &I.J Datee—2!%— /p / 'd, Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home installation Fee $ Energy Inspection Fee $ occ CONST TYPE 5 .75 TOTAL FEE E $ 85 HALcuA PARK scHL FLD PAR ) HD. ISSUE This permit is hereby issued unser the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. 96828 85.75 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE �M FtOVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER Zfc' V rC4 Ir fe ' . A. P. No. O72 1.00 G) � Proposed Building Used 01' 1 Building Inspector J\ Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have b ubmitted. ........ ............. 2. Plot plans i duplicate/ ' licate, signed by preparer of plans ........ �3. Complete plans in uplicat triplicate, siygned by preparer of Dlans _ . 4. Complete engineered plans and calcs, ith Het signature on plans .. 5. Hazardous Material Form ......................................... . 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. X14. Sanitation approval from QC'OU t 1 l -e_ Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner .... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. JZ Telephone 5-82 ZZ.D% and hold for pickup at office. Deliver w/inspector. Other Applicant� .Date Copy of !-laz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other- 5DaP'1 By The following data must be submitted prior to permit issuance: (Circleew "it eln n t-•chtrcke above). 1. Index permit for above items No. 2. Additional items required: jV Contractor, designer, owner, was advised of above required data by_phon_0__counter to 03-9 Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive - Oroville, CA - (530) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. ti i •_� �i 1 r'%'•. � ' , � �, � ..� � � :A � iia. � t:j Date I.� __<� Inspector%`..Jc��• ��j ��L.-n -, a ,P... REV 4/05 Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive - Oroville, CA - (530) 538-7541 CORRECTION NOTICE l l OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. y Date Inspector REV 4/05 Phone # _Z) FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 O o; 50'-0" • L�...11c TANK I i OPANETANK — WATER WELL 165 -0„ LINE OF • PROPROSED LEACH FIELD AREA EXSITING DWELLING REPLACE WITH NEW DWELLING 'o i REPAIR EXISfTING� II SEPTIC 482'-7 5/16' PROVIDE MINIMUM DISTANCE FROM FOOTING OF STRUCTURE OF 5 FT FROM ALL PORTIONS OF PRIVATE SEWAGE DEPOSAL SYSTEM INCUDING SEPTIC TANK, LEACH AREA AND PITS TREE EXISITING DANE 150'-0" D�NPG�o�jcH ELECTRICAL SERVICE POLE . -1 NO CONSTRUCTlu"4 " EASEMENTS TD BF - E OF STRUCTURE OUT OF EASEMENT ATipNS WALLS, FOOTINGS, FOUND EAVES & ROOF -7 F coin OTT ime- BUTTE COU3 w JAN 2 9 2008 W WELL ' %'DEVELOPWNT i i I SERVICES PD %•� /��'�' NE OFN�P�ESONP i cE`s`�Pv P1AIyN DIVISION- BUILDING �.:.a LA APPROVAL _-..._ Use: Date: PLA PLAN APPROVAL Q' pNISION - BUILDING Parking:_____- L /. N �. nate: �� 1 Other. Ping:---- c rl L'- IE 12'-13/40 31'-101/4" 15'-0" 5'-101/8" 8'-3 5/8" 5'-T 19'-3 1/4" 7'-0" rWN3 t0 4 I I O I I I S �i I la i I ly I 8 3088 DINING i . LIVING I I MASTER BDRM t GARAGE t 31/8° X it 24F -V4 9 z 12 01 D.F. Header TYP --�-4 coo N ....--- g 07D` -+ OIrY 2488 - 4 ENTRY / /—� -T 2888 o oeW e = I p lo ENTRY m I Z o NOO 26ee------ -----—� v I BATH cn KITCHEN D r I+ . N2C 40 UP c I 3 U8" X 1r 24F V4 2- 2 X's a H L� I ----HM I I 3C B89'-0'3 i1r X 101R' — —4,—� 10170 �4 rr PORCH 24F -v4 LIVING AREA 1183 sq ft NOTE: USE CONVENTIONAL FRAMING FOR ALL RAFTERS 4'-21/2° 3'-5 3/8" 8'-9 7/8" 4'-11 7/8" 4'-9 5/16" 4'-9 5/16" 4'-2 5/16° —�d'- T-8 3/4" i -T 4'-41/8" T-7 7/8" 11'-9 3/4" 9'-8 5/8" 1'-41/16" 5'-9 5/18" 3'-41/2" 15'-1314 FLOOR PLAN - Scale: 114" s 1'-0" vaoe IIB+Ear WF C011PlLWLiE� . WRX ATTNJED . F II 2nd FLOOR PLAN 114'-m 1'-W w o - v . v t No.64 Z< �o m,�, ucw s a Of! cAusa rom RAN! MASwm ONLY RW M91M A1TA0� ma�uw waunor