HomeMy WebLinkAbout072-570-010�� _ _
�,�
--
_.
r
f
-�
,1
•i
� ��
�•
�.� '3
,z
� j.
,. +�
a'
-- - _ ---- _ _ � . � � __. v __ _
'�
_ ���
S`
�' l -
p
4
�r
� t
�� � �� ��
�1
,..
� -
ti
.,
.,
; s. ���
�-0
��
a
,,
,'
�� _ _
�,�
--
_.
r
f
-�
,1
•i
� ��
�•
�.� '3
,z
� j.
,. +�
a'
-- - _ ---- _ _ � . � � __. v __ _
'�
_ ���
S`
�' l -
p
4
�r
� t
�� � �� ��
lwaft LIM
RESIDENTIAL
72-26-85 479-91P,E —�
TAYLOR & LARSON
204 Empire Pointe Dr, Oroville
Contr: Michael Evans',,'
(utilities/mh)
Pb
Na
JOB FINALED (Date)
Signature
ccr tis b6r-"6,
11=OK
O = Not OK
Not
= Not Readyable MOBILE HOMES
Date 'MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
MISCELLANEOUS
Date
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap: / /"L"ft.
/ /"Nat. or/ /"L"ft./ /"LPG
7. Utility Clearance
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
Date
4. Electricity; MH Test -Crossovers -Breakers -Clearances
Date
5. Drain; MH Test -Fall -Flex Connector
Date
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Boxes-Enclosures- Panel boards- Ins. to Main in Conduit
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
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, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
'8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures- Panel boards- Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
V OK
O=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 -Bloc kouts-Wrapped
6. Stemwalls, Garage; Steel -Bloc kouts-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. Gas Pipe; Size -Anchors
11. Water Pipe; Test -Anchor -Regulator -Service Test
12. Electric; Underground
13. Pienums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Insulation
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permit) OK except #'s
16. Water Htr.; Vent -Access -Combustion Air -Baffle
17. Water Pipe; Test & Anchor -Nail Protection
18. D.W.V.; Test -Fittings & Anchor -Nail Protection
19. Shower Pan; Test, First Floor -Tub Access
20. Test Tub & Shower, Second Floor -Tub Access
21. Gas Pipe; Size & Anchors
Date Card 671 Date Card B-1
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except #'s
22. Fixture & Transformer Clearance -Ins. Protection
23. Elec. Receptacles Spacing -Lights & Switches at Doors
24. Size Boxes & No. of Conductors -Stapled
25. Romex Installed Close to Edge of Studs & C.J.
26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga.
Cu or At
29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral ❑ Yes ❑ No
30. Service -Riser Conductors & Ground -Main Disconnect
31. Equip. Clearances Panels-Motors-Mech. Equip.
32. Clothes Closet Light -Shower Light -Spa Light
33. Smoke Detector
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except #'s
34. A.C. Ducts Insulation & Support
35. Vent Fan; Exhaust above insulation
36. Condensate Drain & Overflow; Size & Grade
37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet
38. Attic Access & Platform if Furnance in Attic
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except #'s
39. Sils, Proper Material & Anchors
40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
41. Bearing Walls over Girders & Floor Nailing
42. Draft Stop in Walls (rat proof)
43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearing
Date FRAMING (Continued)
45. Hangers -Post Caps -Anchors -Connectors
46. Cing. Joist-Rftr. ties -Pu rlin -roof Brac-Truss-Shthng.-Rfng.
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
50. Garage Fire Protection Framing
51. Property Line Firewall & Openings
52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
55. Siding -Nailing Veneer
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
57. Glazing Area -Glass Protection -Skylights -Plastic
58. Shear Walls; Nailing -Bolts
59. Insulation -Walls -Ceilings
60. 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
61. Ext. Steps -Door & Sidelight Protection -Landings
62. Smoke Detector
63. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
64. Bedroom Exiting
65. G.F.I. & Bath Fixtures & Tub Access -Spa
66. Elec. Trim & Subpanel; Breaker Sizes & Labels
67. Stairs & Rails
68. Fireplace or Stove; Clearances -Hearth
69. Elec. Outlets at Wood Panel; Int. & Ext.
70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
71. Elec. Outlets & Receptacles at Kit. Counter
72. Garage Fire Door; Swing -Landing -Closer
73. A.C. Duct in Garage -Damper
74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage; Above Floor-Mech. Protection
75. Plb., Elec. & Mech. Equip. Listed for Location
76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection
77. Insulation -Foam -Looked in Attic 11 Yes
78. Guard Rails & Deck Construction -Post Caps
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
80. Following instld.; Drive O Yes ❑ No; Walks 0 Yes ❑ No;
Planters 0 Yes O No
81. Stucco; Brown -Finish
82. A.C. Unit; Disconnect, Electrical, Plumbing
83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to
Openings
84. Water Well; Disconnect, Electrical, Plumbing
85. Exterior Elec. Trim; G.F.I. Receptacle -Underground
86. Ventilation Throughout House
87. Glass Protection
88. Corrections from Previous Inspections
89. Gas Test -Meters Tagged; Gas -Electric
90. Water & Sewer Connected -C/O to Grade -HD Approval
91. Energy Compliance Certificate -Other Certificates
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:
(NOTE: An entry must be made each time you visit job site)
` COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
/ 7 County Center Drive - Orovllle, Callfornla 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT N
,4 1
ASSESSOR :P RC NUMBER
r 72-26-85
ZONING
'_- _ __' U
BUILDING PERMIT
OWNER -
R.M. Ta for L.B. Larson 714
T,E EPHONE
953-4040
SO, FT. OCC. BUILDING VALUATION
OWNER'S MAIL NG A.D DRESS '
Ol W. Civic Center Dr.,#340 Santa Ana, CA 92703
CONTRA CTOR'S NAME
Michael G. Evans
TELEPHONE
589-5198
CONTRACTOR'S MAILING ADDRESS
1 Nice Place Oroville
Fireplace
CONSTRUCTION LENDER
None
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
None
LICENSE NO.
Plan Checking Fee
$
15 QQ
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT Filing Fee 10.00
�1-� ���/
ZO�`" r �e
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
4
SUBDIVISION NAME
PARCEL MAP
41-44
Water piping -
5.00
Each qas water heater or vent
5.00
USE OF TRUCTURE
SF ❑ Duplex❑ Mobilehome Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home CS 0 G
O.00ea 30.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities,/Installation❑ Other ❑
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
10.00
Main service EA. ADD'L 100 AMP
2.50 2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the BUSIneSS
and Professions Code Qand my license is in fullA force and effect.
License No.— f�28 Classification. �F
El 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.a
OR ADDNS. ACC. BLDGS.
lz0SgftNEWNON-RESID
CONSTR U TI.OUTLET
BRANCH CIRCITS
2.50 ea
POWER APPARATUS a
SINGLE OUTLET CIR.
EX. OCCUp�OUTLETS OR FIXTURES
20®90C
a ALO 30
EX. OCCUp. OUTLETS FIXED P(RESID )REA.�
1 2.00
Temporary service
10.00
Mobile Home Facilities
15.00 15,00
Misc. �yirin 9
15.00
Permit Fee
$ 37.50
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
g
t__
Hood
3.00
Ventilation
_ ---
P—
ermit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to s i fy and keep harmless the County of Butte against
al bilit' s, 'udgm nts c sts, and expenses which may in any way accrue
ain t d C unty i c ns quence of the granting of this perm t.
Date z 2L
Signature of Applicant — Owner ❑ Contractor ®- Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
on of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $ 92.50
HAz.
—
CUA
PARK
CHL
FLD
coF
PAR
PD
ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County. Code and/or resolutions to do
work indicated above for which fees have been paid.
DI EC R OF IC WORKS
BY Date E
PE MIT EXPIRES ate -
Receipt No. R�RSR
WHITE-D.P.W., YELLOW-ASSCSSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
::�.+� ♦ i .'Y^ t":�. � '-�,�''s� 4���`< �"' F, f+l•'�*M�'•� <�r.,�,"�.,; `,3�„ R r�{�S"T��' �' .�"'�•. p� �'�- 'i3'`�'� � ;;.+` � vl' -`.3.'
COUNTY OF BUTTE - DEPARTMENT, OF P,,UBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - NOVILLE, CALIFORNIA 95985 - TELEPHONE; 918/538-7541
r PERMITjAPRPLICF:TION DATA SHEET
Permit ' o. r
OWNER L 0—K�� '� A. P. o.
Proposed Building Use Building Inspector 4 Date
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: "
DATE RECEIVED APPROVED
1.
All items have been submitted . ........................ ..........
2.
Plot plans in duplicate/triplicate, signed by preparer of plans ........
3.
Complete plans in duplicate/triplicate, signed by preparer. of plans . .
.4.
Complete engineered plans and calcs, with wet signature on plans ..
5.
Hazardous Material Form ..........................................
6.
Energy Design Compliance and supporting documentation .........
7.
Statement of Intent for Non -Heated and AC Buildings ...............
8.
Engineered truss details and layout in duplicate (required prior to plan check)
-�� 9.
Mobilehome installation data including manufacturer's installation
instructions.......................................................
10.
Fees of $
11.
Chico Urban Area fees paid .......................................
12.
Park fees paid ....................................................
13.
School District fees paid ..............
14.
Sanitation approval from Health Department
15.,City
of Chico plumbing permit ......................................
16.
Plot plan and business license approval from City of
(see City for other requirements)
17.
Planning approval for (A). Use: (B) Parking: ......
18.
Improvements may be required. Contact Land Development Section DPW i
i 19.
Driveway permit (construction approval required prior to occupancy)
20.
Pre -Inspection for required Pre-inspec. request to
Building Inspector (Date)
21•.
Contractor's license information (No., Name Style, Classifications ...
22.
Certificate of Workmans Compensation Insurance ..................
24
Owner -Builder Verification (Given to owner ❑, Mail to owner 0). .
Rem owed copy of Agricultural Ackned ment Statement .- ift.bR Sem 3-f-9/ JgW
�14 �GF�1
Letter of signature authorization . �! 4� .'k Yep...........
26.
27.
When you issue the � it„proces as follows: Mail to owner. Mail to contractor.
Telephones ``g and hold for pick at office. Deliver w. /inspector.
Other
Applic
Date
Copy of Haz-Mat form sent Health Dept.Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire pt. Other Date By.
The following data must be submitted
1. Index permit for above items No. e
2. Additional items required:
to permit issuance: (Circle new item not checked above).
Contractor, designer, owner, was advised of above required data by_phone_—naiI—counter by ..date
Contractor, 'des Igner, owner, was advised of above required data by—phone —ma II—counter by date
Plans checked by lgw Date LL 91 Plans approved by &.4) Date a” 1' 94
Sets of plans on hold in
File cabinet' AP folder
Copy—DPW -.
TO Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Locat on AP#
Plan Approved for: Sewage Disposal C Water Supply 4�2`eG
Hold final for:
Water Supply
Final clearance O.K. for: Water Supply
Clearance for _4 bedro mobil ome. Other
NOTE ***
Daik
Sanitarian
TO: Building Department
FROM: Encroachment Permit Section 1
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Orovllle, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
A33F.55OR FFARC19L N 15 9RZONING
7
BUILDING PERMIT
WNH
R 1
'
S0. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
q O t w , L w I,- cE-).,�- e e- 'I"3�F0 C,,�T'A CA 1? -103
CONTRACTOR'S NAME
M cC-I�A—vr-L. 0 . Ev►"N/S
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
1 r-J\Cc PSC_ ett. ,
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 1000
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE No.
Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2,00
Solar or,.heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
W' r ng
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex[] Mobilehome(>_�_ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S
0.00 ea
TYPE OF WORK
New❑ Addition❑, Remodel❑ UtilitiesP4 Installation❑ Other[:]
Describe work:
- —
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 1 10.00
In serv' a 100V OR 00 AMP LOR ESS ESS
10.00
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check One):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. <` &7-94 Classification. A
El 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
aln sery EA. ADD'L 100 AMP
NEWC ONST. DWELLING OCCUP.y
OR AODNS. ( ACC. BLDGS.
2.550
, �zosgft
NEW CONSTR.MULTI-OUTLET
NO N.R ESID BRANCH CIRC ITS
2.50 ea
- POWER APPARATUS &
(SINGLE OUTLET CIR. )
Ex. Occup(OUTLETS OR FIXTURES
eA 0301
FIXED APPLNS. OR
Ex. OCCup. OUTLETS (RESID.1 EA.)
2.00
Temporary service
-
10.00
il
o e Ho_a Facilities
15.00
y q
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
o the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
Hood
3,00
Ventilation
Permit Fee
j
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
also agree to save, indemnify and keep harmless the County of Butte againstHAL
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
XThis
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0'• deep and demolition or construct.
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
E
CONST TYPE
TOTAL FEE $I
CUA PARK
scHL
FLD
cDF
PAR
D j HD•
ISSUE
permit is hereby issued unser the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
PERMIT EXPIRES Date
Receipt No.
WNITE-D.P.W., YELLOW-ASeES OR• PINK -INSPECTOR. GOLDENROD -APPLICANT
Return` `.to DPW AGRICULTURAL, STAMIENT OF ACKNI CWLEDGE`I=
FOR RESIDENTIAL DE.ELOPIMVf
Secti 26-8.1 of .the Butte County- Code
retquires this acknowledgement be recorded
prior to issuance of a building permit.
The property described herein is adjacent
to land or included within an area zoned r 9
for agricultural purposes,* and residents
of this property may be subject to incon-
veniences cr discomfort arising from the 91-
�Og25 4
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 agricul-
tural zones which have as a priority use for productive 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 'Shat real property situate in the County of Butte, State of California, described as
follow:
PARCELS 1, 2, 3 & 4 as shown on that certain Parcel Map filed in the
office -of the Recorder of Butte County, State of California on June
3, 1972 in Book 41 of Parcel Maps, at Page 44.
Date: Fel. 5, 1991 PROPERTY OrMNERS:
�
E-ar
son or-
o _er .lay r
State of ) On this the day o 19 before me, the
SS. undersigned Votary Public, personally appeared
` County of )
F1 Personally known to me. ❑ Proved to me on the basis
of satisfactory evidence.
to be the person(s) whose name(s)
subscribed to the within instrument and acknowledged that
executed the same for the purposes therein contained. IN WITNESS
WHEREOF, I hereunto set my hand and official seal.
? Present A.P. No. 7z
c
Notary Public
I
Sub iCr:b:ng Wilne"
STATE OF CALIFORNIA � SS.
COUNTY OF
On '7.��-= 191L. belore me, the undersigned, a Notary Public in and
rit r c N
for said County and State, personally appeared_
known to me to be the person whose name is subscribed to the within instrument as a witness thereto, wlio
Q0✓/LLE �-
being by me duly sworn, deposed and said: That he resides at �
that he was present and saw
1 401 /2 j0 personally known to him to be the person described in and
Sub -
ed instrument, execute the same: and that affia
whose name is Subscribed to the within and annexnt Sub-
scribed his name thereto as a witness to said execution.
WITNESS my hand and official seal.
No ,y Public in and for id County and Stale
Notary Seal
E:ia�:rs3I7R9R$al�ft^ :'A r1 ►J1sR�gIDF7rY�
W. -f 1 31:4 XAM 111AVC-CALIFOMIA 13
IK
Ikill"', County e
R '�:;>.,.4 %�?'�j to?y Gornmisicn E. rites
6 1!jj✓
Supt. 21, 1992 /s
hR K!c: •: J.3 i1l1UG a A, r a U 03 a V.aa a RIsM
FD -1E