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072-270-053
AP 72-27-234-24�- f53 r t- Charles Simpfendorfer t � <- Y'CERTIFICATE OF MERGER ,. A. P': # 7072-270 n., � �3 t:1,17,M? 072-270-053 04-2127 JOHNPEER, BRIAN • - FORBESTOWN ITT T Cont: E&R CONST NEW MH PERMrND u 3� r072-270-053 04-2128 JOHNPEER, BRIAN'. 130g FORBESTOWN RD, OROVILLE Cont: E&R CONST NEW GARAGE t ` , 4 p FMO -M. M m; M��� N - 0 ! _ ,. • •. � -.. __ _ _ ,-,tea. o =•---•-�-• --.. .� �.,✓_. -... _ .. ,. _ NOTE:—All Materials &Workmanship Shall Be in -------Accordance with Recognized Good Practices and of a quality prescribed for the Specified use in ihe } : • A�yrv�r �' Uniform Building, Plumbing.& Mechanical Codes and r / the National Electrical Code. - , . • � td l T / �- - R , � - . S / f �s.l �'� , � �" (/ G�LZ �✓li /� � �Y1 � 0 � ?.i IA setback of 5 ft. from the r" ti property lines and a setback of 50ft. from the road • centerline shall be clear of structures or equipment except _�. ._ __ j t d _ _ _ _ ._ s .4 ,�: G€.:. �, ___ ._. -,. • o for a 2 ft. eave overhang. 4^ TIte #®f of pIgF13 at1a 8peC8fiGatiOns MUST e, - •.. . • � ._. -� i ��� �nq hang stoP�alf�rati®nd i � is unlawful to same without - - writf�en permission from the Department of Publ'oc V✓orPcs, County of Butte. 10, s Ie4 CY�94--. BUTTE COUNTY BUILDfNG. DEP'ARTMNT IV -a 1-1 IJ -_____.-I TOP rail to be 36 in. high with intermediate rails to be not Ovtr &in, I � BUTTE COUNTY BUILDING DE I PARTMENT APPR- V E. D: 5/0 (3) s� 3 1 W > 1 no p o W —ar ,s•—r s•—,• 4M �21•—lar 4M 4M 4m --'-avi cw+c � , -p�s ��• OFF. KcEm cti+c 1 1 1 1 KITCHEN 1 •� 1 ;MASTER BEDROOM: --J--- ula '"' LIVING✓ROOM 1 __ �. o. m I II Ia II 1 1 ; ----�j , F M(fF b 1 1 " 1 1 - CGIU BRIDfi FFAW WLL BIItiCE gripm X11 on. DOORS �-' c -"^ - STUQYA " �`" ' ' R `� DINING <BEDR M 2� #P # �C PT"BEDR170M—/3--, ; ; ' MASTER uEw ��, . I ;` 1 BATH ;� ATH �' � VAN" /ROME 1 OOL nye �'r D�IOOR� ' �'r come :� � `� I � In x�e PORCH I � ; ns/s�a�x �. `� Aeolc ------- ---------------- -------- ' ovti ,aa WE F' m -as OFF. HUHU-M 1 i'-4 7 8• 11'-4 5'-6• 13'-tCr 24'-C 66'-$ T NOTES RESIDENTIAL PERMIT NO. _270-053 04-2127 / JOHN�P/EER, BRIAN Up /3FORBESTOWN RD. OROVILLE Cont: E&R CONST I c �„�./ t, j NEW MH PERM FND I S t \ 1 i y� SPECIAL CONDITIONS CHECKED BY i SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER &-iib COPY y Address S _ GAS t Meter By--6,Dat ELECTRIC G/ "j Meter By Date N � JOB FINALED (Date) Signature.�r�✓'" ;I,� J=OK 0 = Not SK = Not Ready ble MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s Setbacks -Easements "1. Zoning Requirements -Setbacks -Easements Soils; Compaction -Structure Stability 2. Soils; Special MH Support Sketch Pool Structure; Steel -Connections -Thickness Dead Men -Lining 3. Sewer; Location -Test -Fall -C/0 -Concrete Elec.; Receptacles and Lighting, Distance-GFI 4. Water; Loca ion -Test -Easement Needed (Sketch) Elec.; Pool Lighting; 15 Volts-GFI 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or / /" L "ft./ P LPG 7. 7. Well Clearance & Disconnect 8. 8. Utility Clearance 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Light Niche Card B-1 Date Card B-1 Date Enclosure; Fencing -Alarms Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Date 1. Zoning Requirements -Setbacks -Easements tDate 2. Footi gs; Size -Spacing -Marriage Line 3. 99, MH Test Demand Valve -Connector 4 lectricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date YERMANENT END SYSTEM (ONLY) o ' g Requirements -Setbacks -Easements o i ; Size -Spacing -Marriage Line o ing 4 6. as; MH Test -Demand -Valve lectricity; MH Test Water; MH Test 7. Water and Sewer Connected _ 8. as and Electricity Tagged C Exits 10. License Decals 11. Verify #'s with Office Date Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 KAP 1 L) 17L(0 15 �' G MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s, ( 1. Zoning Requirements -Setbacks -Easements 1 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails j 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed y 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 tDate Card B-1 Date Card B-1 i i J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. 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 63. 16. Insulation Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 65. 17. Water Htr.; Vent -Access -Combustion Air Baffle 66. 18. Water Pipe; Test & Anchor -Nail Protection 67. 19. D.W.V.; Test Fittings & Anchor -Nail Protection 68. 20. Shower Pan; Test, First Floor -Tub Access 69. 21. Test Tub & Shower, Second Floor -Tub Access 70. 22. Gas Pipe; Sixe & Anchors 71. 23. Fire Sprinkler; Test 72. Elec. Outlets at Wood Panel, Int. & Ext. Date Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance Card B-1 Date Card B-1 Date Elec. Outlets & Receptacles at Kit. Counter 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. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes O No _ 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector 87. Water Well, Disconnect, Electrical, Plumbing Date 88. Card B-1 Date Card B-1 Date 89. Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Glass Protection 36. A.C. Ducts Insulation & Support Corrections from Previous Inspections 37. Vent Fan, Exhaust above insulation Gas Test -Meters Tagged, Gas -Electric 38. Condensate Drain & Overflow, Size & Grade Water & Sewer Connected -C/O to Grade -HD Approval 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet Energy Compliance Certificate -Other Certificates 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date 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 A Flue -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 -Bolts 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 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 Instld./Drive 0 Yes D No/Walks 0 Yes 0 No/Planters 0 Yes 0 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: Feb 14 05 08:53a Dev Svcs & Env Health 530 538-7785 P.1 BUTTE COUNTY DEPARTMENT OF PUBLIC HEALTH DIVISION OF ENVIRONMENTAL HEALTH SEPTIC SYSTEM INSPECTION CERTIFICATE 1469 HUMBOLDT ROAD 7 COUNTY CENTER DRIVE CHICO. CALIFORNIA 96928 OROVILLE, CALIFORNIA 95965 Telephone (916) 891-2727 Telephone (916) 538-7281 The Sewage Disposal System was inspected at �� �'`�/� - 4 `V 7 r'� FOR _ f SEPTIC TANK LEACHING FIELD Size ') "I L2 Gallons Material n i Length ��/I- _ feet Width — _ a_l� inches No. of lines U Rock Under pipe inches The above dimensions meet the minimum requirements of Butte County Code, Chapter 19. Additional leaching area will be required if experience shows it to be necessary. Remarks: Date: �, L/ S2 •778R (Rev. 6)94) ENVIRONMtNTAL-HEALTH SPECIALIST i :.b:.F:.rd,��:rCl�:•:::i✓��, `•- �......i.ri����•s'�:1=_�S:iSti:r��11';".' ';sJ�.e'� 3•;a.::'` _ _ `ai��.ti'.':i ���•i riS:l.i'v' �='"''_; x'.:;•"��'".`L:.ri� ' t / BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.net\dds . 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 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): O I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code Date: Owner: 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. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Policy #: O2ic1 certify that in the performance of the work for which this permit is issued. 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply wit those provisions. Date: L �y 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 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Address: PERMIT NO. BP042127 Issued Date: 09/21/2004 APN: 072-270-053-000 Site Address: 1308 FORBESTOWN RD FRT Map Index: Description: NEW MH NEW SITE PERM FND (1980) Owner: BRIAN & ROCHELL JOHNPEER 6109 ALPINESPRING WAY ELK GROVE, CA 95758 Cgl1).%aLo Applicant: BRIAN & ROCHELL JOHNPEER 6109 ALPINESPRING WAY ELK GROVE, CA 95758 Contractor: License #: Architect: Engineer: Total Square Ft: 1980 S.F. Valuation: $128,700.00 Census Code: ec U- z I r7 z A0 -we) z ��. �s s herebyy issued under the to do,fer6rk indicated aboy, PERMIT EXPIRES ON: -L 4 ` Q4. % S cions of the Butte County Code ?nrUor have been paid. Date: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct. and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: <) '1�!c /lax Signature: �/ l Date: 2& A 0 Owner ❑ Contractor 31-`Xgent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) - ' OFFICE #: (530) 538-7541 PERMIT NO. BP eD+2 12-7 DATE: to APN: ZONING: U OWNE 'S LAS NAME: OWNER'S FIRST NAME: PHONE: TO� n a'V3 l&, -D(e3 n e -v— STREET ADD SS: FAX: cp Ale_,4Y/�J CITY, Z P: �D/otJt'rA IL: ,p f / SITE ADDRES . o�`6e "J A) CITY. ZIP: 0rvvr /40 NEAREST CROSS STREET: TRACT/LOT #: 0'72-- 2-70 0S3 APPLICANT NAME: PHONE: STREET ADDRESS: / / FAX: 6l `l/'6VL W CITY, ZIP: � ro �_ E-MAIL: CONTRACTOR NAME: PHONE: STREET ADDRESS: FAX: CITY, ZIP: CS CIO- rca 6 S E-MAIL: LICENSE NUMBER: LICENSE TY ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: FAX: CITY, ZIP: LICENSE NUMBER: E-MAIL: DESCRIPTION OR SCOPE OF WORK: AkH • (a8o ❑ Structure B It 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 fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: Notes: 2 -7 ¢ a dC Application Received by: Daty-6p-0 Receipt number: r^ Amount Recei g� • q or Ue/ Master application 34-04 ~! E.H. USE ONLY Piot Plan Anoch.d,✓ Roar Plan Ansalud Sent to S.D. c TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance -70 --©5 Owner Location AP# Plan Approved for: Sewage Disposal ✓ Water Supply: Public Private Well Clearance for ./dwelling. Other 06F1_Ce-)gt:-cam ck I A. AA ., _ N 1) ��,l ) Hold final for:�- Final clearance O.K. for: NOTE: Environmental Health Wpialist Date 8/96 ._.-tw•--''`,"`l.-:.w '-"'""l`�.'.:""�,.,air<n.�=:r•Kr.m.�`."+-raw?^'�+.`.-ri'^•+y(w�i+i%�';�:�kT:.eK�tv,�-- �'-i�-,al..-•.ry..-^�.. �..'l-.�-•�n%'�'�� �J:.. ti'"'�"_,�,,..:-�,,.•.�i 31 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: J0 W ~1 TE"E0:2ASSESSOR PARCEL NUMBER b Proposed Building Use: 0E W wJ N a(E W 5 ITE _ 62M r r'D Counter Technician: 1<1 Date: 7 ' r L gems required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. , d 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. 8. Manufactured homes:,(Data sheets and installation inst,•( Marriage line info,'Floor Plan,) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs • ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) O17. Fire Sprinklers............................................................................................ ,�• 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent bj . t. ❑ 19. Soils Report and/or Engineered Foundation required ........................................... 1 ........ I 20. Erosion Control Plan Required........................................................................ ........ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. 22. City of Chico Plumbing permit.......................................,,"t�p 23. California Department of Forestry plan approvalpaid. Sent by: 24. Planning approval (A) Use:(B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... AO26. NPDES Form............................................................................................. $(Afit 27. Encroachment Permit for driveway from the Public Works Dept., �r. .�S.�......... zo,o lD� ❑ 28. Pre -Inspection for -required ....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization.................................................................... r7� 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ "35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction ........................................ ........ ................................... .. �. Q� 37.4Gran t Deed, 99 M. H. Title/Statement of Facts, ❑ Letter from Legal Owner, Check to H.C.D. $ � a • • 0 38. Other: MA►-f1Jr- e_Tf7?S c-ee-iFicn-•r_ c -,F- ❑ 39. Other: When issued Telephone 9 f !a • 82r� - &n� 4-. and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant 1. Index permit applicationf r the above items numbered: Ian Check Letter 2. Additional items re Contractor, designerj twne Xas advised of the above data by - ne, ❑ mail, ❑ counter, by ate: Contractor, designer, ow was advised of thea e d to y phone, ❑mail, ❑ counter, y Date:�-� Plans reviewed by: � i Date: •o Plans approved by: Date Structural reviewed by: Date: Structural approved by: Date: \ Note transfer by: Date: Yellow: Building Division COUNTY OF BUTTE `a4Z ( z-7 DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER _Ja r+'���Z A. P. # O X53 PROPROSED BUILDING USE DATE 'y • I(. • ='`t•• -- RECEIPT # DATE REC. 1. BUILDING PERMIT FEES -y --- Balance Due ..................... $ a/ �" 9 4-12) 9 3 0 4 --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ 22. CHOOL DISTRICT FEES 012 Ea -e-1 (paid at School D's ct fice) o a ilable aft Plan ChMSD/ ) TESD o 3. SHERIFF FEES (paid at Building Division Residential............ X $360.00 =$ 3(00 . Units Commercial (sq. ftg.)..... X $0.03 = $ _ Sq.Ftg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Ftg. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) 15:2 .�18 8. WATER TENDER FEES BATTALION # $200.00 (paid. at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... X = $ ccSq. Ftg. Amt. l 0. OTHER d'�l l (� 1 - g 2 •• ' 3.O At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT DATE 9 16 ` 0 Y Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a Protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) 4�1 �F - - _ .� -------- --------- .. - --'r-------- � . � An OROVILLE CITY ELEMENTARY SCHOOL DISTRICT DONALD L. REMLEY, Ed. D. ' Superintendent Extension 3001 August 27, 2004 (S30) 531-3050 FAX SUSAN JEFFERS, C.P.A. Asst. Superintendent, Business Extension 3008 ' (530) S32-3030 FAX LYNNE C. VINCENT, Ed.D. Director of Instruction (530) 532-S690 Butte County Dept of Developmental Services ANDREA DUNN Director of Personnel 7 County Center Drive Extension 3002 WELDON Oroville, CA 95965 PAPA Director of Special Education . (S30) 532.3001 RE: 072-270-053 BOARD OF TRUSTEES: Brian Johripeer KATHY WHITE President TOMASA FRAZIER Vice President Check number 2006 received in payment for school impact fe es on the above property BRIAN D. FRIDRICH was returned by the bank. I have had phone contact with Mr. Johnpeer and expect a C.lerk GALE L. GLENN, replacement check to be mailed. It has been 10 m days since request and the check has Y y req Ed.D. Member not yet arrived. SAN WICKLAS Member Please do not final this project until a replacement check has been.provided. I will send a follow up when this has been cleared. SCHOOLS: BIRD STREET SCHOOL 1411 Bird Street Oroville, CA 95 965-4 78 3 (530) 532-3001 (530) 532.3041 FAX CENTRAL MIDDLE SCHOOL 2565 Mesa Avenue Oroville, CA 95966-6000 (530) 532.3002 (S30) 532.3042 FAX EASTSIDE SCHOOL 2775 Yard Street Oroville, CA 95966-5113 (530) 531-3003 (S30) 532-3043 FAX OAKDALE HEIGHTS SCHOOL 2255 Los Pumas Avenue Oroville, CA 95966-6920 (530) 532-3004 (530) 532-3044 FAX OPHIR SCHOOL 210 Ookvole Avenue Oroville, CA 95966.9494 (530) 532-3005 (530) 532-3045 FAX SIERRA DEL ORO 2900 Wyandotte Avenue Oroville, CA 95966-6539 (530) 532-5690 (530) 532-5691 FAX STANFORD AVENUE SCHOOL 1801 StanfordAvenue Oroville, CA 95966-5231 (530) 532-3006 (S30) 532-3046 FAX WYANDOTTE AVENUE SCHOOL 2800 Wyandotte Avenue Oroville, CA 95966-6538 (530) 532-3007 (530) 532-3047 FAX Thank you. Evelyn Mortell Account Technician LI DONALD L. REMLEY, Ed. D. Superintendent Extension 3001 (530) 532-3050 FAX SUSAN JEFFERS, C.P.A. Asst. Superintendent, Business Extension 3008 (530) 532-3030 FAX LYNNE C. VINCENT, Ed.D. Director of Instruction (530) 532-5690 ANDREA DUNN Director of Personnel Extension 3002 WELDON PAPA Director of Special Education (530) 532-3001 BOARD OF TRUSTEES: KATHY WHITE President TOMASA FRAZIER Vice President BRIAN D. FRIDRICH Clerk GALE L. GLENN, Ed.D. Member JAN WICKLAS Member SCHOOLS: BIRD STREET SCHOOL 1411 Bird Street Oroville, CA 95965-4783 (530) 532-3001 (530) 532-3041 FAX CENTRAL MIDDLE SCHOOL 1565 Mesa Avenue Oroville, CA 95966-6000 (530) 532.3002 (530) 532-3042 FAX EASTSIDE SCHOOL — 2775 Yard Street Oroville, CA 95966-5113 (530) 532-3003 (530) 532-3043 FAX OAKDALE HEIGHTS SCHOOL 2255 Las Plumas Avenue Oroville, CA 95966.6920 (530) 532-3004 (530) 532-3044 FAX OPHIR SCHOOL 210 Oakvale Avenue Oroville, CA 95 966-94 94 (530) 532-3005 (530) 532-3045 FAX SIERRA DEL ORO 2900 Wyandotte Avenue Oroville, CA 95966-6539 (530) 532-5690 (530) 532-5691 FAX STANFORD AVENUE SCHOOL 1801 Stanford Avenue Oroville, CA 95966.5231 (530) 532-3006 (530) 532-3046 FAX WYANDOTTE AVENUE SCHOOL 2800 Wyandotte Avenue Oroville, CA 95966-6538 (530) 532-3007 (530) 532-3047 FAX OROVILLE CITY ELEMENTARY SCHOOL DISTRICT 530 532-3000 August 27, 2004 RE: 072-270-053 Brian Johnpeer Check number 2006 received in payment for school impact fees on the above property was returned by the bank. I have had phone contact with Mr. Johnpeer and expect a replacement check to be mailed. It has been 10 days since my request and the check has not yet arrived. Please do not final this project until a replacement check has been .provided. I will send a follow up when this has been cleared. Thank you. Evelyn Martell Account Technician BUTTE COUNTY AUG 3 0 2004 Butte County Dept of Developmental Services 7 County Center Drive DEVELOPMENT SERVICES Oroville, CA 95965 RE: 072-270-053 Brian Johnpeer Check number 2006 received in payment for school impact fees on the above property was returned by the bank. I have had phone contact with Mr. Johnpeer and expect a replacement check to be mailed. It has been 10 days since my request and the check has not yet arrived. Please do not final this project until a replacement check has been .provided. I will send a follow up when this has been cleared. Thank you. Evelyn Martell Account Technician V • Sctiool�District A.P. Number U -41Z Property Owner Rroperty Location/Address BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (O n .form per Building) Building Department No. County Subdivision Lot No. Residential Development Q � 0� Q 4� Sq. Footage • ! No of Living Moblle Wome Addition/ *Supplemental to (Group R) Units Installation Conversion Permit # i *((No foundation inspection) !I Deed Restricted Sq. Footage (Attach a'signed copy of Deed Restriction and Notice of Limited Use Facility document) Building Department 'Sq. Footage (including Exterior Roofo Areas) Date 1 District Identcation.No. 05-01.I--:,i-� i a jA,(yiku 1 '� 1 f1 1, School. District dertifies that j r 'Qxx- (Applicr�nt) (Street Address) 4, C (U l I has complied with the requirements of Resolution No. representing C% U square feet. Paid by Check Remarks: (Phone Number) F` (State) (Zip Code) " g L . by payment of $ 2826. FULL MRIGATION .. : Date Notice: You may protest the Imposition of tin fats identified above by submitting a written protest to tha Distrlet,.ln compliancewlth Govemnrard Cods Section 66020(aj, wNhln 80,days from ths.dats Ms are paid. Fallurs to submit a timely written protest wilt proh"* you from challenging the Imposition of the fees in any court action. M. subsequa t to tin School District Representable signing this Butte County Schools bnpad Fee Certification Fon% ft School District is nodfled by the applicable Local Planning Agency that this project is tieing ravlewad under #w CMNornla Erwirornra "QualNy Act (CECA� Oft prefect may bs subjed to additional school fess to fully mlNpats.Ns Impact onthe school dlebkft schools. White (applicant), Yellow (building department), Pink.(school district) tesforrrr.xh 410/03Wmm AND WHEN RECORDED MAIL TO: �c,: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 IIII I'I IIS � III' I'II") II�' I II �I I�I 2014—I®04�749 Recorded I REC FEE 10.00 Official Records I CONFORM 1.00 CoBUTT Of TE CANDACE J. GRUBBS I Recorder I ROSEMARY DICKSON I Assistant I Kathyh 01:28PM 06 -Jul -2004 I Page i of 2 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this. property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Date(,--30.ay PROPERTY OWNERS: wState of California ) County ofsac fayv%CAO ) On ,Ap ?)(7 _ r]ap.y before me, personally appeared Rfia.� :Tn�n,r��P,y�r_a,A V-Acdl, known to me (or proved to me on the basis of satisfactory evide to the within instrument and acknowledged to me that *e/s capacityie , and that bythei signatur6on the instrl the persons acted, executed the instrument. WITNESS my hand_apd official seal. Signature Seal: A.P. # 0722-70-053 r personally be the person whose namq@wthei subscribed ) executed the same in hWheauthorized the personu3 or the entity upon behalf of which rASHLEY WILSON UQM COMM. #1423691 UNOTARY PUBLIC - CALIFORNIA n I -.SACRAMENTO COUNTY n Y COMM. EXPIRES JUNE 12, 2007 EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: Order No. 00215921-001 ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: ALL THAT REAL PROPERTY DESCRIBED AS A PORTION OF SECTION 15, TOWNShi"IP 19 NORTH, RANGE 5 EAST, M. D. B. & M., BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: ALL THAT PORTION OF THE MIDDLE ONE-THIRD OF THE EAST ONE-HALF OF THE SOUTHWEST QUARTER OF THE SOUTHEAST QUARTER OF SAID SECTION 15, LYING SOUTHERLY OF THE NEW FORBESTOWN ROAD AS DESCRIBED IN DEED TO THE STATE OF CALIFORNIA, RECORDED APRIL 5,1966, IN BOOK 1421, PAGE -272, OFFICIAL RECORDS, AS DESCRIBED IN THAT CERTAIN CERTIFICATE OF MERGER RECORDED AUGUST 25, 1997, UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 97-31749. AP NO. 072-270-053 SITE PLAN REVIEW APPLICATION Date: FA/ AP# ®Z Z Permit Number (if applicable) Bin Number.' APPLICANT INFORMATION Parcel Size: �- 76 Owners Name: A �,R w Owners Address: Telephone No.: - l G Z O 6 3 -? Situs Address:cc-c-c- Proposed Use: 2- � ,2wvZrj Residential ❑ New Single Family Residential ❑ Single Family Addition IN Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition ❑ Single Family Remodel a . , . A ❑ Commercial Remodel ❑ Industrial Remodel Other ❑ Septic ❑ Well ❑ Agricultural Exempt Building ❑ Agricultural Buffer Form ❑ Applicable ❑ 7N,/A A Other: 6f42* c F_ P Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) 0 Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval W Siteirlan Sta ed Approved ByDate Page 1 of 5 N ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: 19 Snow Load Area: l5-00 f W Qp ' ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) ® SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: • Flood Panel No.: I 0016 (OZ 5-D 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: S -r A " .5- G P: kf � Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. 4l CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 � Zoning Code& 5 Streets & Highways Fire Prevention Subdivision Map Front c Side Side Street Rear J Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. 4l CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Applicable Development Fees: Standard Fees Amount Formula ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other -------------------------------------- Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * 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: D a61) N -or: o(67 0-�AJgD , AN 0) LEL 0Q2CFEFA"j�M A16r G,_pt-0aa ❑ 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 ❑ Subdivision ME/Parcel Map: Map Date of Recording: Lot: Book: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Page: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ 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 B1.utte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. ■❑ Page 4 of 5 Y ;J Ll i Summary of Specific Requirements: This information provided in this summary is based on the application information and on the best available data at the rime of review. CALarrys\Building Permit Site Plan Reviewl.doc Page 5 of 5 I A_af 1 RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 2005-001.3529 7 COUNTY CENTER DRIVE Recorded I REC FEE 10.00 Official Records I CONFORM 1.00 Couunnty Of CITY COUNTY STATE BUT 04-2127,--'- (530) CANDACE J. GRUBBS I Recorder I ROSEMARY DICKSON I Assistant I Cheryl 12:06PN I"ar-2005 I Page 1 of 2 SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code ? Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit '1 described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. BRIAN JOHNPEER AND ROCHELL JOHNPEER REAL PROPERTY OWNEP/LESSOR 6109 ALPINESPRING WAY MAILING ADDRESS ELK GROVE SACRAMENTO CA 95758 CITY COUNTY STATE ZIP 1308 FORBETOWN ROAD INSTALLATION MAILING ADDRESS, IF DIFFERENT FOREST RANCH BUTTE CA 95942 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE 66012 MAILING ADDRESS DATE OF MANUFACTURE OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 04-2127,--'- (530) 538-7541 BUILD ERMIT / /'^ TELEPHONE NUMBER /O/0 q - rr4AmP OF LOCAL AGENCY/OFFICIAL DATE NONE DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO. KARSTEN 2004 66012 MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMU/NUMBER 32029A/B 66'X 30' RAD 1411748/9 SERIAL NUMBERS) LENGTH X WIDTH INSIGNIAILABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER 072-270-053 NICD FORM 433(A) REV. 8/91 WHITE - County Recorder CANARY - HCD PINK - Applicant GOLDENROD- Building Dept. Order No. 00215921-001 EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: ALL THAT REAL PROPERTY DESCRIBED AS A PORTION OF SECTION 15, TOWNSHIP 19 NORTH, RANGE 5 EAST, M. D. B. & M., BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: ALL THAT PORTION OF THE MIDDLE ONE-THIRD OF THE EAST ONE-HALF OF THE SOUTHWEST QUARTER OF THE SOUTHEAST QUARTER OF SAID SECTION 15, LYING SOUTHERLY OF THE NEW FORBESTOWN ROAD AS DESCRIBED IN DEED TO THE STATE OF CALIFORNIA, RECORDED APRIL 5,1966, IN BOOK 1421, PAGE 272, OFFICIAL RECORDS, AS DESCRIBED IN THAT CERTAIN CERTIFICATE OF MERGER RECORDED AUGUST 25,1997, UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 97-31749. AP NO. 072-270-053 e ' RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 C®PY of Document Recorded 10 -Mar -2005 2005-0013529 Has not been compared with original BUTTE COUNTY RECORDER SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. BRIAN JOHNPEER AND ROCHELL JOHNPEER REAL PROPERTY OWNER/LESSOR 6109 ALPINESPRING WAY MAILING ADDRESS ELK -GROVE SACRAMENTO CA 95758 CITY COUNTY STATE ZIP 1308 FORBETOWN ROAD INSTALLATION MAILING ADDRESS, IF DIFFERENT FOREST RANCH BUTTE CA 95942 CRY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 04-212'%x^1 (530) 538-7541 BU1LDrNG ERMIT �-/ TELEPHONE NUMBER j� SIG TUBE OF LOCAL AGENCY OFFICIAL DATE NONE DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO. KARSTEN 2004 66012 MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMEJNUMBER 32029A/B 66'X 30' RAD 1411748/9 SERIALNUMBER(S) LENGTH X WIDTH INSIGNIA/LABELNUMBER(S) REAL PROPERTY LEGAL DESCRIPTION 'ASSESSOR'S PARCEL NUMBER 072-270-053 SEE ATTACHED HCD FORM 433(A) REV. 8/91 :ANARY. HCD PINK . Aonli—, ( BUILDING PERMIT NUMBER:04-2127 Address or location of unit: 1308 FORBESTOWN ROAD FOREST RANCH CA Legal Description of Real Property: AP#: 072-270-053 SEE ATTACHED (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: BRIAN JOHNPEER AND ROCHELL JOHNPEER Owner's address: 6109 ALPINE SPRING WAY, ELK GROVE CA 95758 INSIGNIA OR HUD NUMBER: 32029A/B SERIAL NUMBER OR V.I.N.: RAD1411748/9 MANUFACTURER'S NAME: KARSTENYEAR: 2004 OFFICIAL APPROVING INSTALLATION: • DATE: __-3 10 D 5 - PHONE: (530) 538-7541 H.C.D. 513C 4 - RECORDING REQUESTED BY I{II 111 III I II{i I ii i IIII II IIII I IIII i2�104-034576 Bidwell Title & Escrow Company Recorded I REC FEE 10.00 Official Records I TAX 49.50 AND WHEN RECORDED MAIL TO County Of I MONUMEN 10.00 BUTTE 1 Name Brian Johnpeer CANDACE J. GRUBBS I Street 6109 Alpinespring way Addrem Recorder. . . I ROSEMARY DICKSON 1 Elk Groves, Ca.: 95758 Assistant I Lisa 09:00AM 09 -Jun -2004 I Page 1 of 2 City, State Zip Order No. 00215921-001 SPACE ABOVE THIS LINE FOR RECORDER'S USE Parcel No. 072-270-053 GRANT DEED 2 THIS FORM FURNISHED BY BIDWELL Ti FLE & ESCROW COMPAN"I a The Undersigned Grantor(s) Declare(s) Documentary Transfer Tax is $49. 50 ❑ City/Town of ✓ computed on full value of interest or property conveyed, or ✓ Unincorporated Area ❑ full value less value of liens or encumbrances remaining at the time of sale ❑ Monument Fee of $10.00 FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Charles K. Anglin and Penny E. Anglin, husband and wife hereby GRANT(s) to Brian Johnpeer and Rochell Johnpeer, husband and wife as joint tenants the following real property in the ❑ City of ✓ Unincorporated Area County of Butte, State of California: SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HLREOF Charles K. Anglin Penny E. Anglin Document Date: June 2, 2004 State of Eaiifomitr OcecSpq County of" _- SS. On —Sc xne, 3 ,-2b614 , before me, the undersigned, a Notary Public in and for said County and State, personally appeared Charles K. Anglin and Penny E. Anglin Personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signatu 4d,la FOR NOTARY SEAL OR STAMP OFRCIAL SEAL NATALIE A. MANGIS NOTARY PUBLIC -OREGON COMMISSION NO. 362427 I:' . �. *my COMMISSION EXPIRES OCTOBER 27, 200£ MAIL t�'STATEMENTS TO: Same as Above BTEC/GRANTDEED Order No. 0021.5921-001 EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: ALL THAT REAL PROPERTY DESCRIBED AS A PORTION OF SECTION 15, TOWNSHIP 19 NORTH, RANGE 5 EAST, M. D. B. & M., BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: ALL THAT PORTION OF THE MIDDLE ONE-THIRD OF THE EAST ONE-HALF OF THE SOUTHWEST QUARTER OF THE SOUTHEAST QUARTER OF SAID SECTION 15, LYING SOUTHERLY OF THE NEW FORBESTOWN ROAD AS DESCRIBED IN DEED TO THE STATE OF CALIFORNIA, RECORDED APRIL 5, 1966, IN BOOK 1421, PAGE 272, OFFICIAL RECORDS, AS DESCRIBED IN THAT CERTAIN CERTIFICATE OF MERGER RECORDED AUGUST 25,1997, UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 97-31749. AP NO. 072-270-053 STATE OF CALIFORNIA ' BUSINESS, TRANSPORTATION AND HOUSING AGENCY0` DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DMSION OF CODES AND STANDARDS REGISTRATION AND TITLING PROGRAM STATEMENT OF FACTS This unit is a: 0 Mobilehome 0 Commercial Coach ED Floating Home 0 Truck Camper Decal (License) No.(s) I/We, the undersigned, h reby stat I/We further agree to indemnify and save harmless the Director of Housing and Community Development, State of California, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the above-described unit in California, or from issuance of a California certificate of title covering the same. I/We certify under penalty of perjury that the foregoing is true and correct. Executed on Sud Irate) Signature(s) ./J n Address `Printed name(s) olelKno-vr/— City , State . r HCD 476.6 (REV 9/91) (State) OROVILLE CITY ELEMENTARY SCHOOL DISTRICT ..(530) 532-3000 DONALD L. REMLEY, Ed. D. Superintendent Extension 3001 A August 27, 2004 (S30) 532.3050 FAX SUSAN JEFFERS, C.P.A. BUTTE Asst. Superintendent, Business Extension 3008 COUNTY (530) S32.3030 FAX LYNNE C. VINCENT, Ed.D. (� Q SEP �% `r ` 1 Director of Instruction .'' (S30) S32-5690 Butte County Dept of Developmental Services DEVEL®PA Nr ANDREA DUNN Director of Personnel 7 County Center Drive SERVICES Extension 3002 �+ Lc Oroville, C- — 65 WELDON PAPA Director of Special Education (130) 532.3001 072-270-053 BOARD OF TRUSTEES: peer KATHY WHITE President TOMASA FRAZIER Vice President Check number 2006 received in payment for school impact fees on the above property BRIAN D. FRIDRICH was returned by the bank. I have had phone contact with Mr. Johnpeer and expect a C.lerk replacement check to be mailed. It has been 10 days since my request and the check has GALE L. GLENN, Ed.D. Member not yet arrived. SAN WICKLAS Member Please do not final this project until a replacementhas been.provide I will e�� a follow up when this has been cleared. / SCHOOLS: BIRD STREET SCHOOL 1421 Bird Street Oroville, CA 9S96S-4783 (S30) 532.3001 (530) 531-3041 FAX CENTRAL MIDDLE SCHOOL 2S6S Meso Avenue Oroville, CA 95966-6000 (530) 532-3002 (530) 532.3042 FAX EASTSIDE SCHOOL 2775 Yard Street Oroville, CA 95966.5113 (S30) 532-3003 (530) S32-3043 FAX OAKDALE HEIGHTS SCHOOL 22SS Las Plumps Avenue Oroville, CA 95966.6910 (S30) 532-3004 (530) 532-3044 FAX OPHIR SCHOOL 210 Ookvole Avenue Oroville, CA 95966.9494 (S30) 532-3005 (530) 532.3045 FAX SIERRA DEL ORO 2900 Wyandotte Avenue Oroville, CA 95966.6539 (530) 532-5690 (530) 532.5691 FAX STANFORD AVENUE SCHOOL 1801 Stanford Avenue Oroville, CA 95966-5231 (530) 532-3006 (S30) S32-30.46 FAX WYANDOTTE AVENUE SCHOOL 2800 Wyandotte Avenue Oroville, CA 95966.6538 (530) 532-3007 (530) 532.3047 FAX Thank you. Evelyn Mortell Account Technician o�OTrFo Butte County Department of Development Services o Building Division r - 7 County Center Drive G cOUN�y Oroville, CA 95965 (530) 538-7541 REFUND REQUEST APPLICATION REFUND POLICY - Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the fees, whose name is on t he receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt. 2. The request must be made within two years from the date of fee payments on permits not issued, and two years from the date of permit issuance for permits issued -if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees aid to other County Departments are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the CLAIMANT'S NAME: CA,� MAILING ADDRESS: W� ST'S 72c� _ _�I. PHONE: Check those fees which you wish to have considered for refund: E building Permit Fees =Sheriff Fees =SRA Fees (CDF Fire Planning) Other (specify): (Plans for cancelled permits will be disposed of within 10 working days upon submission of a Request for Refund. If you want the plans, you may pick them up prior to that time. Signature Date K:/Forms/Refund Application 082203 Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX DETACHED ACCESSORY BUILDING OWNER'S STATEMENT OF USE Plan review will not be started until this form is completed, signed by the property owner, and returned to the Butte County. Building Division. Attached Accessory Buildings and Additions will be checked for residential use. Exception: Garages "and Carports. Owner: Phone: Mailing Address 60/(� Site Address: ,moo N 0 7 Assessor's Parcel Number: 6 29 —off `70 96' 3 Zone: ©5 - Please answer questions 1-16, and explain any yes answers for questions 2-14 in the space provided on page 2 of this form GENERAL LNFORML ATION: 1 1. Is there a primary dwelling on the property? Yes ® No ❑ 2. Is the structure already built, under construction, or under notice of code violation? Yes ❑ No 3. Will items produced in this building be offered for sale? Yes ❑ No 10 4. Will the public have access to this building? Yes ❑ No 5. Will any advertising, on or off site. be associated with the use of this building? Yes ❑ No SITE CONDITIONS: 6. Is the structure foundation within 5' of septic tank or 10' of leach lines? Yes ❑ No (� 7. Is any portion of the structure located closer than 20' to your front property line? Yes ❑ No S. Do you plan to add a driveway or modify existing access to a county maintained road? Yes ❑ No 9. Will the proposed structure encroach within any recorded easement? Yes ❑ No CONSTRUCTION FEATURES: 10. Will this building have insulated floor, walls, or ceiling? Yes ❑ No 11. Will this building be heated or cooled? Yes ❑ No 12. Will this building have a water closet/toilet? Yes ❑ No [t 13. Will this building have a sink? Yes ❑ No 14. Will this building have a water heater? Yes ❑ No 15. What type of floor covering «ill the building have? lyb 16. What type of %vall covering will the building have? &x' OVER 1 of 2 PROPOSED USE: (check only one box) 1. ❑ Residential Storage Shed — I will be storing in this building and it wi1J no be used for any other purpose (no bathroom and no heating or cooling). 2. IQ Private Garage — "A building or a portion of a building not more that 1,000 square feet (3,000 by exception) in area in which only motor vehicles used by tenants of the building or buildings on the premises aie stored or kept." A garaee door is reouired. 3. ❑ Residential Carport — A covered structure intended for parldng of vehicles. Two or more sides must be entirely open. 4. ❑ Residential Occupancy — Structures meant to be occupied, as opposed to a storage shed, garage, or carport If you checked #d, please check the uses below which best fit this building ❑ GuestHouse ❑ Pool House ❑ Studio Apartment ❑ In-law quarters ❑ Recreation Room ❑ Game Room ❑ Study ❑ Library ❑ Bonus Room ❑ Playroom ❑ Den ❑ Studio ❑ Artist Studio ❑ Hobby Room ❑ Craft Room ❑ Sewing Room ❑ Canning Kitchen .❑ Music Room ❑ Family Room ❑ Sun Room ❑ Private Office ❑ Workshop' ❑ Home Occupancy Z ❑ Other— Use = 1. Doabe tape orWortshop &fust be approved by the Butte Cotaay Planning Division Explanations: This area is for explanation of any "yes" answers on questions 2-14. Please indicate the question number before the explanation. Additional Information: Plan review will not be started until this form is completed and received. A Plans Examiner will contact the owner with specific requirements per the use indicated. I hearby affirm under penalty of perjury that the above information is true and correct. I understand that any changes to the use, or character of use, of this building will require permits from the permitting authority. I understand that Real Estate Disclosure laws require disclosure of this information if or when the property is offered for sale Owner's Name: Please Print �f l�a� �'� A, � p— Owner's Signature: 2of2 Date: 'j'-1'3_04 D.B.-1 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner-buildee' 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 materials for construction of the proposed property improvement: YES)I NO ❑ -+'2. I HAVE HAVE NOT ❑ signed an application for a building permit for the proposed work . I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: may.. PHONE: CONTRACTOR'S LICENSE NO. 4 I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAM + : ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 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: �- PROPERTYOWNER: kDATE:__ `7�lCo-dpi NOTA: phis Owner -Builder VeriTka€ion is required by Section 19831 and 19831 of the California Health and Safety Code. phis verification must be completed and returned to our o jke before we are permitted to issue the permit OWNER BUILDER INFORMATION Dear Property Owner: .A- I An application for a building pewit has been submitted in ym name listing yourself as the binder of property improvements specified. For your protection, You should be aware that as "owner-buildee you are the responsible party ofrecord on such a permit Building p=2its are not r aqua ed to fie 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 is 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 foIIowing information for your benefit and protection; 0 If you employ or otherwise engage any persons other than your immediate family, and the work (Including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. b If you are an employer, you must register with the State and Federal Govemme= as an employerand you are subject to several obligations including state and federal income tax withholding, { social security falces, workers compensation inscaaace, disability Insurance costs, and unemployment compensation contributions. There may be financial risks for you if yon do not cant' out these obligations, and these risks are with respell to worker's serious compensation ice. ♦ For more specific information about yom obligations under Federal Law, fact the Internal Revemte Service (and, ifyou wish, the U -S. Small State Law contact the D Business ' ' ). For more spedfic information about your obligations under epmtnew of Benefit payments and the Division of IndustrW Accidents. If the shuctu a is intended for sale, property owners who are not licensed contractors are allowed to perform their conditions work personally or through their own employees, wixhout a licensed contrwtar or subcoahactor, only under limited. • A frequent practice of unlicensed persons professing to be erectors is to secure an "owner bmlder" building pe=rmlts �n�s!yimplyingtat thepropertyownerisprovidinghisor herown labor and matenal Builimg are not signed by propWW owners unless OII � �ed may be obtained bythey art be g that= own wodc personally commzmity or at 102014 Street, Saerame�, CA. 95814. �iacbors State License Board is your Please complete the "Owner Budden Verification" on the reverse side of ft form so that we can confit that you are aware of these matters, The building pest wtil not be issued until the verification is retained. NOTA Y 0wner-8uflderlxf'orrnatwrt is required by Section 19830 ofBre Cafiforsfa H, I- and Safety Code Off? PgTMEjVT �vTTF o c A�eCl�r�y Department i. micnael c -rump, Public Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville. CA 95965 (530)538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement (LESS THAN 1 ACRE1 Project Description: Project Location and/or Parcel Number: 0 ?Z — 2!7 () -U SS By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: mac= Title: Date: Z -A, Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Stone Water Management Program COPY of Document Recorded 06 -Jul -2004 2004-0040749 AND WHEN RECORDED MAIL TO: r Has not been compared with BUTTE COUNTY BUILDING DIVISION original 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 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 (�-3o.-oV PROPERTY OWNERS: ".r State of California County of so (U Irclvy-ley} On�6�ll before me, personally appeared e 1 personally known to me (or proved to me on the basis of satisfactory evi ence) to be the person,0 whose namns " ar subscribed to the within instrument and acknowledged to me that -hefsh the' executed the same in ftfsfhe thei authorized capacityie , and that by *iqAtet thei signatures on the instrument, the persokos-,or the entity upon behalf of which the perso;o acted, executed the instrument. WITNESS my hand d official seal. ASHLEY WILSON Signature Seal:1J@',MY COMM. #1423691 () NOTARY PUBLIC - CALIFORNIA n F. SACRAMENTO COUNTY n - COMM. EXPIRES JUNE 12, 2007 A.P.#!_ Order No. 00215921-001 EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: ALL THAT REAL PROPERTY DESCRIBED AS A PORTION OF SECTION 15, TOWNSHIP 19 NORTH, RANGE 5 EAST, M. D. B. & M., BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: ALL THAT PORTION OF THE MIDDLE ONE-THIRD OF THE EAST ONE-HALF OF THE SOUTHWEST QUARTER OF THE SOUTHEAST QUARTER OF SAID SECTION 15, LYING SOUTHERLY OF THE NEW FORBESTOWN ROAD AS DESCRIBED IN DEED TO THE STATE OF CALIFORNIA, RECORDED APRIL 5,1966, IN BOOL{ 1421, PAGE 272, OFFICIAL RECORDS, AS DESCRIBED IN THAT CERTAIN CERTIFICATE OF MERGER RECORDED AUGUST 25,1997, UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 97-31749. AP NO: 072-270-053 Q O r BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM /1 (One form per Building) School District �/ (, �L. l/l.� Building Department No. ' A.P. Number a X+ , Jurisdiction: City County Property Owner ` Property Location/Address Subdivision Residential Development No of Living Units iMKh, / •..............................................................:................................ _... , � Foo a a tage / Mobile Home Addition/ Supplemental to (Group R) Installation Conversion Permit # *(No foundation inspection) :.................................................................................._................i Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) 0 Building Department Representative District Identification No. Ir U t/ School District certifies that (Street Address) v (City) has complied with the requirements of Resolution No. representing ' ' G '70 square feet. District Sq. Footage (Including Exterior Roof Areas) 7 � a�- Date rrah �ub4a Q� (Applicant) Paid by Check # Remarks: ' { -mow Z (Phone Number) (Zip Code) by payment of $ 7 4 IAB 2926 $ FULL MITIGATION $ 7 Date NoUoo: You rr*proted the Imposition of the foss Identified above by submitting a written protest to the District, In compliance with Goverrarrerrt Code " 66020(a), within 90 days from On date fees ars paid. Failure to submit a tlmsy wrilbn protest wlll'prohlbit you from drallenging tit Imposition of the fees In any court actlom if. subsequent to tit school District Representatlw signing this Butts County Schools Impact Fee Certification Form, the School Dls.bW Is noftlled by the applkable Local Planning Agency that this project Is being reviewed under the California Environmental Quality Ad (CEQA), this project may be subject to additional school fees to fully mitipsb.lts Impact on the school dls&kt% schools. White (applicant), Yellow (building department), Pink (school district) feeform.xis 00/03)dmm O.B.-1 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No - building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES ❑ NOO- 2. I HAVE M� 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: 6kCO CITY: s�cxa e p PHONE:_ ,-- y.3�-��� `7 CONTRACTOR'S LICENSE NO.%$�92� 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide th94 najor work: ADDRESS: ��-00 Aulov„i ��yo7 �p CITY: sG,�_ . PHONE:_ �/(o - V3-/%/Z`/�%CONTRACTOR'S LICENSE NO. 75_y ° Z�,_ 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAAM ADDRESS PHONE TYPE OF WORT{ r" sym 4b "a 9/(01l'3el-IV/7 sej- v`o I—V E.3z- va 0rAt4r (D' rn"e ql L MP3- PK33 (e,, ' - o 30 - SIGNED:, PROPER OWNER: Jg(-14") SOCIAL SECURITY NUMMEM S� y'/ E Sq— DATE:Jv114 (Pt Zoo(/ NOTE. This Owner -Builder Verykation is required by Section 19531 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: OVER OWNER BUILDER INFORAIAT-ION Dear Property Owner: OB. -I An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified For your protection, you should be aware that as "owner -builder" you are the responsible party ofrecord on such a permit_ Building permits arenot required to lie signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourseh, 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 $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments 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 for you if you do not cavy out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law, contract 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 contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner guilder Verification» on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until tine verification is returned rely, �, p ,w � Mic 1 C. Vi ira, C.B.O., M ger, Building Inspection NOTE. nis Owner BiWderinformadon is required by Section 19830 of the California Health and Safety Code OVER Department Public Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville. CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase BI Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement /LESS THAN 1 ACREI Project Description: Project Location and/or Parcel Number: By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title:��L e� Date: v) � (" , 2�vy Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 September 18, 1997 Emil E. Hensley 1318 Forbestown Rd. Oroville, CA 95966 Dear Mr. Hensley: BEAUTY ucrrn gmcnv yr, ruout, VVUMRS 7 COUNTY CENTER DRIVE • OROVILLE. CALIFORNIA 95965-3397 TELEPHONE: (916) 538-7266 FAX: (916) 538-2140 RE: AP 072-270-023 & 024 Certificate of Merger Enclosed please find the Certificate of Merger which was issued by the Butte County Department of Public Works and recorded on August 25, 1997, under Serial Number 97-031749, in the office of the Butte County Recorder. If you have any questions concerning this matter, please contact this office at 916-538-7266, Monday through Thursday, 8:00 a.m. to 4:00. p.m. Sincerely, xaav� I �'� 71 tuart Edell Manager, Land Development Division SE/kp Enclosure cc: CBuilding:-Division" Environmental Health Dept. G.D.A. AFTER RECORDING RETURN TO: Butte County Public Works . LAND DEVELOPMENT DIVISION 7.County Center Drive Orovillb, CA 95965 LANDS BEING MERGED: 97-031749; Rec Fee I IHF Recorded I Check Official Records I County of I Butte 1 Candace J. Grubbs I Recorder I 3:Olpm 25 -Aug -97 I PUBL CERTIFICATE OF MERGER AP NUMBER(S) 72-270-23 & 24 SUBDIVISION/PARCEL MAP: BOOK N/A PAGE BLOCK LOTS) BOOK N/A PAGE BLOCK LOT(S) As of the 21st day of August merged to create ONE parcel(s) of land as described in attached hereto. MIKE CRUMP Director of Public Works 11.00 , 2.00 13.00 xx 3 19 97 , those lands noted above are Exhibit(s) "A" AUGUST 21, 1997 DATE OWNERS' CONSENT TO MERGER WE, EMIL E. HENSLEY AND MARGARET M. HENSLEY. HUSBAND AND WIFE , as owners of all that real property to be merged, do hereby consent and agree to the merger of such lands into that / those parcel(s) as described in Exhibit(s) "A" attached hereto. ALL SIGNATURES MUST BE NOTARIZED: 0 '/ 1&:::;� SIGNATURE: EMIL E. HENSLEY in SI RE: MARGARET M. HENSLEY" SIGNATURE: LD 1530 17/97) 6g a A (.P � " 1 2 1 - DAT E DATE •e - Mid Valley Title and Escrow Company } STATE OF CALIFQ �NIA )ss. COUNTY OF 1yL� _ } On , before me, -Q �L personally appeared IF— !c -n i E— e .n 0 ��2cla re personally known to me (or proved to --Aa on the basis of satisfactory evidence)\o 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. WITNES: Signature (This area for official notarial seal) Title of Document ( CS�� Date of Document No. of Pa es Other signatures not acknowledged Oroville Chico Paradise EXHIBIT "A" MERGER CERTIFICATE LEGAL DESCRIPTION (AP: 72-270-23 & 24) tttttff.fffff�f�tftftttttttttt..f..ff.f}fftt�tftt:.�ttttftfttttf..tf� ALL THAT REAL PROPERTY DESCRIBED AS A PORTION OF SECTION 15, TOWNSHIP 19 NORTH, RANGE 5 EAST, M.D.M., BUTTE COUNTY, CALIFORNIA, BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: ALL THAT PORTION OF THE MIDDLE ONE-THIRD OF THE EAST ONE-HALF OF THE SOUTHWEST QUARTER OF THE SOUTHEAST QUARTER OF SAID SECTION 15, LYING SOUTHERLY OF THE NEW FORBESTOWN ROAD AS DESCRIBED IN DEED TO THE STATE OF CALIFORNIA, RECORDED APRIL 5, 1966, IN BOOK 1421, OFFICIAL RECORDS AT PAGE 1421. END OF DESCRIPTION tttfffffff•fttt•fttft•f•ftt••tfftsttftst••afftttstfffffftfffffftfffttt PREPARED BY: JOHN D. CHRISTOFF , P.L.S. G.D.A., ENGINEERING & SURVEYINGFILE <97056LD.1 > `A ND sjjq�'F �� S�T OF•c� `O V.O� F99 v � EXPIRES Z * 6130100 No. 4206 OF Cod COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. 95965 /J�A!HONE- 916-534-4541 With reference to the above subject: / Attached is: Application for permit Building Plans Engr. Calcs Labor Code Information DATE A. P. # "7 Z— Z 7 -- 7 d-- 2 7 Mobilehome Utilities Installation Sheet Mobilehome Installation Information Shee Typical Plan Sheet _ List of Codes Enforced OTHER he -1 We need the following information: Permit application signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractors License Law information or check exemption statement. Letter authorizing signature of G Complete plans in �.J„ /, 4l including plot plans. Plot plans in Structural details in . Complete plans in prepared by registered civil engineer or architect. Engr. calcs. sets of plans in accordance with the changes marked in red. Sanitation approval from Butte County Health Department at: 695 Oleander Ave., Chico 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville, for Copy of recorded parcel declaration. Recorded copy of deed showing OA vco_� w,� le d OTHER �� 1-e .4l ru" le i'1� 4 rye S . Should you have any questions concerning the above, please contact this office. JFG:dd Yours very truly, Clay Castleberry Director of Publi Works Glan er Chief Building Inspector 25 June 1979 Building Commissioner Butte County Court House Oroville, CA 95965 Dear Sir: I am in the process of making plans for building a residence in the area of Oroville in Butte County (Hurleton Area) on the new Oroville Forbestown Road. I would appreciate your sending a copy of the building codes for that area in order that I might finalize my plans. Very truly yours, Chari S' /''hland rfer 915 N rth Fullerton, CA 92632 CS:3 7 -z - -;1- 7 — z 3 - zc/ 0 CD Noto, o cl 0 �� ca �i 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 PERMIT NO. BP042128 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: 09/21/2004 APN: 072-270-053-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 1308 FORBESTOWN RD FRT Date: Contractor: Map Index: Description: DETACHED GARAGE (400) OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: BRIAN 8r ROCHELL JOHNPEER permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 6109 ALPINESPRING WAY 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any ELK GROVE, CA 95758 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: BRIAN & ROCHELL JOHNPEER owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 6109 ALPINESPRING WAY proving that he or she did not build or improve for the purpose of ELK GROVE, CA 95758 sale.). J/ NJ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: O 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: 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 License #: workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Total Square Ft: 400 S.F. Polis #: C1 1 certify that in the performance of the work for which this permit is Valuation: $9,600.00 issued, I shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith mply wi h those provisions. Z V Date: r� C Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one '�J /l / /�^n 11 n - L 1' i /✓1� yP hundred thousand dollars ($100,000), in addition to the cost of , (i (� ` / f (/vI �N compensation, damages as provided for in Section 3706 of the Labor interest, fees. code, and attorney's OWN CONSTRUCTION LENDING AGENCY This permit is here6 issued under the able provisions of the Butte County Code ?nrVor I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutions to do rk indicated ab ov for hich fees have been paid. +O� BY Date: Name: Address: PERMIT EXPIRES ON: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. L Print Name: /�-��/ V /� Signature: 71 Date: ��/0 —f O Owner ❑ Contractor LY" Agent for Owner 13 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQ UIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" OWNER Last�l�rge K V1 first me o -A AdrrdJJes 9 �A lVj& PA i City p State to _ D Fax E-mail APPLICANT SIGNATURE X For office use only: CONTRACTOR Name Name Address SRA City t t State Zip Phone State Fax E-mail Planner Lic. # Class APPLICANT SIGNATURE X For office use only: ARCHITECT/ENGINEER Name Name Address SRA City t t State Zip Phone State Fax E-mail Planner State License Number APPLICANT SIGNATURE X For office use only: APPLICANT NAME •5 Name L SRA Address © t t i� I (��p�-�5.� City 61l State Z of Lot # Planner Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning •5 Flood Zone I SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BP 0424 Z ' BIN # LOCATION AP# 073• o•c53 Pp y Addre s r7Ira,aees-rowu City Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: —� •�-rc H-sD C4oa 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 K.\FORMS\BUILDING FORMS\BidgApplSubRgmts.doc Page 1 of z 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. Re 'ved by: Amount: !/ l Bldg SRA RCipt #: I Sheriff 6� SMIP Other Total REV 6-16-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. i ❑ 3. 2 Engineer"ed'truss details and.layouts (if iequired) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPHPATER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. ❑ 9. Letter of intent. ❑ 10. 'Hazardous Material Form. 0 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Perm71 it Application Assistant at (530) 538-7541.:: OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS1BIdgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPOCATION DATA SHEET OWNER: v a-� ~!EC �� ASSESSOR PARCEL NUMBER Proposed Building Use: -rCounter Technician: Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order tolapply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by lth preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate` No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Flans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings 4 l 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form ,jk 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. S E h'GaArtCE ❑ 16. Other G`5 -p- 5 Pn 4-2 I Z 7 Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ 20. Erosion Control Plan Required........................................................................ ........ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. 22. City of Chico Plumbing permit ................................................ / 23. California Department of Forest plan approval ❑paid. Sent byl...... 24. Planning approval (A) Use: o(B)Parking: (C) Parcel Check: 0 87767 ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 0 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... 32. Letter of Signature authorization.................................................................... 33. Recorded copy of Agricultural Acknowledgment Statement ................................. IL d ( � ❑ 34. Manufactured home utility clearance.............................:................................. ❑ 35. Existing violations and/or expired permits.. ...... .......... ermits................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone f'I f % . laak> • and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. I Applicant: � Date: tel` I &` Utj 1. Index permit application o the above items numbered: P n Check Letter 2. Additional items requ Contractor, designer,&nqr.Aas advised of the above data by one, ❑ mail, ❑ counter, by Date: -fd` Contractor, designer, owner, was advised of the ab ve at by hone, ❑ mail, ❑ count I y Date: Plans reviewed by: Date: Plans approved by: Date : y Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division COUNTY OF BUTTE ` DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY -CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER v-0 PROPROSED BUILDING USE�eF - 1. BUILDING PERMIT FEES 2 74 95 --- Balance Due ..................... $ --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ A.P. # 0 1. ,3 16 • os3 DATE 1 6 - 4> 4 - RECEIPT # DATE REC. ¢I 2-I ;L 93 • o4- 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ _ Units Commercial (sq. ftg.)..... X $0.03 = $ _ Sq.Ftg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ _ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Fig. Amt. 5. RECREATION DISTRICT FEES ` (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) lit 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) 8. WATER TENDER FEES BATTALION # $200.00 (paid. at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... X = $ Sq. Ft 417-172-- I 10. OTHER •� W `7 z1 % 1. 3 • At time of permit application, I was advised ke above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT DATE Pursuant to Government Code S 'tio 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). 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LT 9 M Fq� ES *- ❑2 Assessor's Parcel Number Fc�) N - F6-1 IN Scale: V j(A0 6\,"A ZC4-0e- Owner Name & . L/ Address/ Phone No. 1ALX9, Womvc�arlo� Site Location Contact: Name Phone (�1���2�-0��7 0doW 23,2M3 FOR OFFICE USE ONLY PROVIDE FOR ALL Zoning: ADJACENT PARCELS SIZE (AC): General Plan Desig: ZONING: Size, Acres GEN PLAN: i 4.0(r USES: