HomeMy WebLinkAbout072-300-012(C
C72. -3oo _ 01 z
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
. BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP060615
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty. of perjury, that 'I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 03/20/2006 APN: 072-300-012-000
the Business and Professions Code, and my license is in full force and
effect.
License Class : License Number:
Site Address: •a (J�/�-�-�/�V' U I
Date: Contractor:
Map Index:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Description: temp elec Svc for lot development
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: FAHEY, TERRY
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
PO BOX 794
the Contractor's State License Law (Chapter 9 commencing with Section
OROVILLE, CA.
7000) of Division 3 of the Business and'Professions Code) or that he or
95965
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
530-589-3507
applicant to a civil penalty of not more than five hundred dollars ($500).):
ler 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: FAHEY, TERRY
owner of property who builds or improves thereon, and who does
PO BOX 794
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
OROVILLE, CA. '
sale. If however, the building or improvements are sold within one
95965
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
530-589-3507
sale.).
❑ 1, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
Contractor:
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ 1 am Exempt under Article 3 of the Busine s a Professions Code
Date: �wner:
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
License #:
❑ I have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
Architect:
❑ I have and will maintain workers' compensation insurance, as
Engineer:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier: _
Total Square Ft: 0 S. F.
Valuation: $0.00
Census Code: '
Policy #:
certify that in the performance of the work for which this permit.is
issued, I shall not employ any person in any manner so as to
rI become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers' '
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those/provisions.
Date:
S_
Applicant:
WARNING: Failure to securerkers compensation coverage is
�7
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permi ' her 'suedJuer the ap licable provisions of the Butte County Code and/or
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.)
Resoluti s to do rk indbove r which fees have been paid.
�20-06
By: Date:
Name:
PERMIT EXPIRES ON:
Address:
(Date) ���
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, _25533, and 25534 of the California Health and Safety Code,'which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project.
O Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. 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 to r documen of Butte County. I reby
authorize representatives/ off Butte County to enter upon the above mentioned property for inspection purposes.
Print Name: l X01 f�/t� Signature:
a dG
.--�_
Date:
Owner ❑ Contractor . ❑ Agent for Owner ❑ Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING.PERMIT APPLICATION
ANIS SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REOUIRED AT TIME 0 F APPLIC4 TION
Website: www.buttecounty.netldds
"PLEASE PRINT CLEARLY"
APPLICANT lG TURE
X
For office use o -y-.
OWNER INFORMATION
Last Name _
✓
/
ust Name
Address
a %
City
, L tate
Zip s �o
Phones
-3 0 Fax
E-mail
E-mail '
APPLICANT lG TURE
X
For office use o -y-.
CONTRACTOR
Name
&XJN
Address
No
City
Type Const
State
Zip
Phone-
Lot #
Fax
E-mail '
Lic. #
Class
APPLICANT lG TURE
X
For office use o -y-.
ARCHITECT/ENGINEER
Name
&XJN
Address
No
City
Type Const
State
Zip
Phone
Lot #
Fax
E-mail
State License Number
APPLICANT lG TURE
X
For office use o -y-.
APPLICANT INFORMATION
Name
&XJN
Address
No
City
Type Const
State
Zip
Phone
Lot #
Fax
E-mail
APPLICANT lG TURE
X
For office use o -y-.
Zoning
Flood Zone SRA
Yes
No
Occ.
Type Const
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
PERMIT
NO.
BPS oG1�_
BIN #
PROJECT LOCATION
Property Address City
ST AA1,Fri1J� �E9/t,r„ z�
Cross Street
I—A ILA- �A=A_)
LENDING -AGENCY
Name
Address
DescAlption or Scope of Work:
cF R c
S1 FT- Living, Garage Open Cov
❑ 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
Yew after the date of application. In prder to renew action on an.
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Receivedb� Amount:
Receipt
v
2�
Date:
Bldg
SRA
\ Sheriff
SMIP
Other
SUBMITTAL & PERMIT REQUIREMENTS
.The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED., ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ .2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets.of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent forNon-heated and AIC for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review;(May require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required). -
0
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractors license information. (Number, Name Style, Classification).
❑-
7.
Worker's Compensation Carrier and Policy Number,
❑
8.
Owner -Builder Verification (f required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Legal description from current recorded grant deed; ❑ Copy of M.H. Title, Title transfer, or MCO.
❑
12.
Sanitation and site plan approval from the Environmental Health Department .
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541.
EXPIRATION OF APPLICATION
Applications for -which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance. for permits
issued; however, on issued permits refunds can only be' made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
SITE PLAN REVIEW APPLICATION
Date: //IcIf-1510-6 AN 6(S)
Permit Number (if applicable) Bin Number
APPLICANT INFORMATION
Owners Name:
Owners Address:
Telephone No.:
Site Address:
Proposed Use:
Parcel Size: '5, o ,::3- C
Residential
❑ New Single Family Residential
❑ Single Family Addition
❑ Single Family Remodel
❑ Mobile Home
❑ Residential Accessory
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie)
❑ Temporary Travel Trailer
❑ Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
Other
E Septic
❑ Agricultural Exempt Building
❑ Other:
❑ Commercial Remodel
❑ Industrial Remodel
❑ Well
❑ Agricultural Buffer Form
Zone:
U
GP:
V1
Brief Explanation/Issue;
DEVELOPMENT SERVICES INFORMATION (For Staff Ise)
Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
f
❑ Resolved
By f i _ Date C�
ALL ITEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In:
❑ Williamson Act Minimum Acreage: ❑ Residence can be built per contract
❑• Watershed Protection Overlay Zone
SRA - (CDF to determine specific requirements)
100 -Year Flood Plain:
• Flood Zone:
• Flood Panel No.: Index Date:
❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan
❑ Chapman/Mulberry
❑; Cohasset Area
Use Requires:
❑
Use Permit
❑
Variance
❑
Agricultural Worker Affidavit
❑
Administrative Permit
❑
Minor Use Permit
❑
Minor Variance
Zoning:
Applicable Building Setbacks:
General Plan:
❑ Setbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
❑ Use Permit/Minor Use Permit
Permit Number:
Date of Approval:
2
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
,
Side
s c
'3 O
Side Street
Rear
Height
Waterway
N/A
N/A
N/A
❑ Setbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
❑ Use Permit/Minor Use Permit
Permit Number:
Date of Approval:
2
Parcel Created By:
Deeds:
Date of Creation: Legal Access Provided: ❑ Noes
Q�
Deed of Reference: Legal Access Required ❑ No 0 Yes
Parcel Frontage on Publicly M ' tained Road: ❑ No ❑ Yes, Road Name:
Complies with County Standards for Deed Creation:❑ No W Yes
Comments:
Parcel Deemed to be legal
Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation
❑ Obtain a Certificate of Compliance
❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current Environmental Health Department requirements
❑ Subdivision Man/Parcel Map:
Map Date of Recording:
Lot: Book:
3
Page:
I
Order No.
Escrow No.
Loan No.
WHEN RECORDED MAIL TO:
Albert 0nyvaa
h529 Queensboro
Union City, California
T
MAIL TAX STATEMENTS TO:
above
0.111 IAL RECO- -
RDS
OU.T.ZE.000NI Y -CALIF
...) kEOUETEO 8
E� --.)
04
`"tDUISE'KL•UENDER'" .- • " �.1� ��
COUNTY RECOROERru_
16599
SPACE ABOVE TNIS LINE FOR RECORDE R;S FUSE
D Owlf"' TRANSfbR TAX •
T A/� ••.• Computed on tha cornaratlon or value of P"Werw e ; OR
ld
>i computed on'the co ideratlon of value im Ikma oI
ran,alnl i of
Stgnafflare of Decwam or. dw Imn's to — Inn Name
GRANT DEED
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged. ROBERT CIARK and
ETTL*:A CLAU,bis wife
hereby GRANT(S) to AIB 3T J. GUZI-= JR., and DAMZIIE: C. QIZHAN, his 'wife
as Joint Te -ants
i
the real pro.per.ty_in the City
" of unincorporated
County of """e State of Califomie, described as
The South half of the,West half of the North half of the Northeast quarter of the
Northwest quarter Of Section 13,Townsldp 19 North, Range 5 East, H. D.B. & X.
TOGET}E WITH AYD RESF-RVZ:G i1tR:FRCM a right of way for road aid public utility
purposes 60 feet in width, over existing roads.
LX 4 017
Dates December 13th 1971 _ "�►
STATE OF CALIFORNIA - f �,�.�-_�w,-� ����•
COUNTY OF s
Butte 1 -
On December 1 131,,971
before Ina. the undwal l nea a Notary Publie in and for aid
too -
stem F IV tpPaa 0 Robert Clark a>ed
Bettina C a k Robert
— -
'�� LINDA J. LAVOYt
3.
known to Ina to ba nu Pw+on — whor menta Hare t fL 7Y !tT PUBLIC to
. t°6VTTB
K4m rI ad to M within kworu em and ackno"adW Plat CALIFORNIA
amuted the rna. tP
WITNE4Li
offield soil. `�.
IThl. nurses for wrk:w nnotariaf am)
OM OF R 9ilfa 1same)
IaVoye, 113 L'TAX STATEMENTS"AS DIRECTED ABOVE
`6
Order No.
Escrow No.
Loan No.
WHEN RECORDED MAIL TO:
Albert Cuy.—
L529 Cueeasboro
-[inion City, California
�rC7�C 7 2
oi:m 1. RECORDS
OU.T-TE•CoUf�; X -CACI g
REcUE
ED
B
04
tDUiSE-K-LUENDER.7 r
COUNTY RECORDER G� - G C
JL6595 << • 2 - S
SPACE ABOVE THIS LINE FOR RECOROEWS'-USE
MAIL TAX STATEMENTS TO:--
�p DOCUMENTARY iRAnsFER TAx ft %.
IN
. Y.. Compuad on Ma eonskiwalon or slur of property : OA
.,X Computed an'th* oomldaradon Or valUr Im Ibnr a
above r.m.lnl + of
sigrwmm of Oaclarom or1k9wmd.tarmimry tea – Inn rl.rrw® '0
GRANT DEED
FOR A VALUABLE CONSIDERATION, receipt of which is hereby ad(nowledped, ROBERT CIARK and
£,ETTD.A C L; K,bis wife
hereby GRANTISI to AjB�T J. GUZ.l=0 JR. and DARLE:E: C. OUZM&N, his wife
as Joint Tenants
i
the real property in the City of unincorporated
CoUrtY of Butte State of Califomia, described as
The South half of the West half of the :forth half of the northeast quarter of the
North est quarter of Section 13,Towr%S1,4 19 North, Rarge 5 East, H. D.B. & H.
TOGETHER E,TTH k1D RESE3VLI;G 711EREMCM a right of way for road aid public utility
purposes 60 feet in width, oTer existing roads.
. 3
6LX .a 7
. q
Dated Decetrber 11th, 1971
STATE OF CALIFORNIA 1 ,, i.- GSL, d•�
COUNTY OF
Butteon De-
-16th. 1971
balerma, the yndwz*.e4 a Nosy Puwlc in and for a.le J
Stam Faraon0ty a- - . Robert Clark a rd
>\1
Bettina Clark -.... _ a
`-� LINDA J. LAVOYL
a Ara Kfn-ly PUBLIC Tft
known m Arta to W t!a pwwrl — whaa rrnla Z :.y BUTTE COUNTY
Wbrerramd to the within laavurnent and duwwladiad that CALIFORNIA
maeutad the awn& :
fwTNPss hand officYlMd.
Siputu (Thl. a.ra for 0"6.w —u W moll
PM OF 0000MOV 9002 (Rasa!
Li J. LaVoye, 113WA TAX. STATEMENTS AS DIRECTED ABOVE
leUMW SAL HEALTH
2 3 2005
dPffY CENTER DRIVE
SITE PLAN L NJ� Pi P't, r'.
2- ((01
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