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073-090-009
9Z 1831E 7 � . HILLMAN,' Dale•&�•_HtVA-kA4y. p 073-090-009 Peggy _ 99-80AG . 1 Dale & Peggy Hillman i Binet t d,, Clipper` Mill's,. AGRICUL-T.U-RAL_EXEMpPFRMIT �'contr: John Fowler = Storage of Farm ImplementsHay elec for well & lot development..Y` 073-090-009, 94-1232E HILLMMAN; DALE & PEGGY BITNET RD. ACROSS•FROM LOST CRK, ELE •FOR'ti�IELL 1 6-73. Dio -0001 63 V4 ,. NeW M IF /0' County of Butte Oroville, California GENERAL CLAIM I I ( �{ • (_ P _ 'J CLAIMANT: William Kotko °()YTE COUNTY ADDRESS: 2839 Bradshaw Road CITY & STATE: Sacramento, —.A 95827 DATE OF CLAIM- 08/23/05 SUBMIT CLArM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Refund Claim - See attached calcilation sheet APN: 073-090-009 Permit No 03-3362 PAID RETAINED REFUND Development Services $ 442.75 $ 323.00 $ 119.75 SRA $ 43.00 $ 43.00 $ - Sheriff $ 335.00 $ - $ 335.00 Other: $ - $ - $ - TOTAL $ 820.75 $ 366.00 $ 454.75 ............. ............................................... ............. ................................................ ::.::::::::::: . :: .. .:.:.:.:.: ................................................. ................................................ ............................ ............... ............... : .............................. .............. .............................. .............. . ACCOUNT ............... ............... :'-AM0UNT::: Development Services 440-001 4210500 $ 119.75 SRA 0100 4617240 $ Sheriff 280 1011811 $ 335.00 Other $ - TOTAL 1 1 $ 454.75 $ 454.75 I, the undersigned, declare under penaltg of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. c /� a �° �,� `, Dated this day of J 4 i 1 , 2005, at—f!iC414-ke ®lif. 4v v — Signature of Claimant I, the undersigned, hereby certify that, tc the best of my knowledge, the services or articles specified above have been performed or delivered and that there is a Budget ApproprialjA�i� (dor Specific Board Approval (Check one for the same. Dated this day of \ �C.1L` 2005, at Oroville Cali . 115 Department Head or Authorized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY SEPT & SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT. 8/23/2005 Butte Cou', my Department of Development Services 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile TION * BUILDING * PLANNING William Kotko 2839 Bradshaw Rd. Sacramento, CA 95827 I . RE: Permit No. 03-3362 ! APN#073-090-009 Owner: same On 10/30/2003 a deposit was made in the amount of $820.75, of which $366.00 was retained. The remaining fees will be reimbursed to you. Please sign, date, and return the enclosed claim form to this office. Once we receive the claim form, we will then process your refund in the amount of $454.75. Should you have any questI ns, please contact this office Monday through Friday, 8:00 a.m. to 4:00 p.m., at 538-7601. Sincerely, Diane Lewellen Senior Account Clerk Administrative Division enclosure 03-3362.1tr DIFFERENCE: (Should be blank) APPROVAL Date Reviewed 08/16/2005 Michael aa Mn Building Manager Butte County Department of Development Services Building Div don 7 County Center Drive Oroville, CA 95965 (530) 538-7541 BUS Cow NOV - 31004 D SERnc�NT 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 the 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 -it no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees paid 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 receipt) and return to Develo ment Services for payment processing. CLAIMANTS NAME: W ( LL-( A, M le O Zg _�,9 ';�.> (A -D S 1-E A -W P_J S'R Cdr CA 951n MAILING ADDRESS: ( I to PHONE: ASSESSOR'S PARCEL NO.: S2 2.2. - 2.12- S2 - Q o 2 ✓ [Please use one claim form per permit.) BLDG PERMIT NO.: 3 _Z .Receipt No. 1 Receipt No. 2 Receipt No. 3 Q l t 9 — — — — ------ ------ RECEIPT NO.:3 13'60 3 — -- -- -- -- -- -- -- -- RECEIPT DATE:L RECEIPT AMOUNT: REASON FOR REFUNDo M REQUEST: fA�[ L ice. e r o o ✓L t _p of S fYL,_crCO N 70 Check those fees which you wish to have considered for refund: =Building Permit Fees =Sheriff Fees =SRA Fees (CDF Fire Planning) =Other (specify): L� D t s M tai e�4 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 ick them up prior to that time. Signature K:/Forms/Refund Application 082203 ( W�/©y Date S Or— NOTES RESIDENTIAL 073-090-009 K6TKO, WILLIAM Cont: OWNER 62 L N/ER,e Z4 Ile THEHCDHIS MH. CANNOT BE RECORDED UNTIL ONE OF THE FOLLOWING HAS BEEN TURNED IN TO THE BUILDING DIVISION: (1) LICENSE PLATE(S) OR DECAL (THE INSPECTOR MUST RETREIVE). (2 STATEMENT OF FACTS (ONLY ON NEW MH' S). . iPECTOR TO VERIFY SERIAL & LABEL #'S. SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER t\ D -1-Z JOB FINALED (Date) Signature '' J = OK 0 = Not OK • = Not Readyable 1. MOBILE HOMES -- Date MOBILE HOME UTILITIES (Plans) OK exceot #'s Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements _ 2. Soils; Special MH Support Sketch _ 3. Sewer; Location -Test -Fall -C/O -Concrete Electric 4. Water; Location -Test -Easement Needed ;Sketch) _} 5. Electricity; Location -Clearance -Grn - r mp-Concrete 4. 6 as; Locations rap;-/ 11L P Nat. or/ " L "ft /' LPG 5. 7. Well Clearance & Disconnect 6. 8. Utility Clearance Date /0,41 Card B-1 Date Card B-1 Date I Card B-1 . Date Card B-1 30 8 !4`77 1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Date Footings; Soils -Size -Depth -Spacing -Connectors -Steel Card B-1 Date Card B-1 Date 4. Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s _ 1. Zoning Req uirements-Setbacks-Easements Electric 2. Footings; Size -Spacing -Marriage Line Card B-1 Date Card B-1 3. Gas; MH Test-Demand-Valve-Connector- est-Demand-Valve-Connector4. 4. Electricity; MH Test -Crossovers -Breaker: -Clearances _ 5. Drain; MH Test -Fall -Flex Connector I 6. Water; MH Test -Regulator -Connector j 7. Water and Sewer Connected -C/O to Grade -HD Approval Pool Structure; Steel -Connections -Thickness Dead Men -Lining 8. Gas and Electricity Tagged _ 9. Tie Downs -Type -Installation Cert. Elec.; Pool Lighting; 15 Volts-GFI 10. Exits; Insp.-Sketch Elec.; Enclosures; Conduit Entries -Terminals -Listed 11. Cert. of Occupancy 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures-Panel boards- Ins. to Main Conduit 9. Health Department Approval Date 10. Card B-1 Date Card B-1 Date 11. Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Enclosure; Fencing -Alarms oning Requirements-Setbacks-Easemeits _ Date Footings; Size -Spacing -Marriage Line Card B-1 _ Date Card B-1 4!8rocking &Iellas; MH Test -Demand -Valve ectricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date /0,41 Card B-1 Date Card B-1 Date I Card B-1 . Date Card B-1 30 8 !4`77 1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum..Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and. Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures-Panel boards- Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 _ Date Card B-1 Date Card 13-.1 Date Card B-1 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 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 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 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors _ 48. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. _ 49. Fireplace Ties or Type 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 -Wal Is -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 t 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 Cl Yes 0 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, Pibg-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: p 3l, �o�E' �RoPEf �jlpS'SOd` GA / w Gcc rel --- - -�_q o COU9TY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street - Chico, CA - (530) 891-2751 7 County Centerbrive -,0rovide, CA - (530) 538-7541 CORRECTION NOTICE L C> 3 - -3-3 4. 2 - OWNER PERMIT No. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please motice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. Al 21 71-6 el Q /I cN- e- C 40- // /( � — g- ) A^ / A,- , ' <' /2- - Date Z/ 5/ inspector REV 10�2 COUNTY OF BUTTE - DEPAFTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION ' 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO. (Rev. 12/967 APPLICATIONANI5PERMIT 04x'2 --iRZ ASSESSOR("TN �11E��R oo^ ZONING BUILDING PERMIT OWNER WILLIE KATKO CELL, 916-20$ 0338 NE SO. FT. OCC. BUILDING VALUATION OWNERS Ip�uyt B�X 5 176 CLIPPER MILLS 95930 R 55,242-00 CONTRACTORS NAME owm L\ TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation 1$55,242.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 220.75 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 23.00 BUILDINGADDRESS Energy Plan Checking Fee $ 21y $ PERMIT FEE $ 263.75 LOT NO. SUBDIVISIONS NAME P EL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 - Solar or heat um water heater 23.00 Water piping 15.0015.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: NEW MH PERM FND Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 , PERMIT FEE :rc; on ELECTRICAL PERMIT Filing Fee 20.00 Main Service zo.A OR LEOOOV OR SS 23.0023-00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licansed 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 Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees wits wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. $ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Busiress and Professions Code for this reason Main Service TO 46.00 WEE200A rcu000A NEW CONST. DWELLING OCCUP. OR ADDNS. ( a ACC. SLDS. SO 3.5QFT: NoµR6ID MULTI -OUTLET 97,50 PowER APPArurLrs 8 SINGLE OvrL.tT CIR. EX. OCCU OUTLET OR FI TURES 20 @'.50 BAL Q .50 Ex. Occup. Gur,Et°T5A R61o) E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE S WORKERS' COMPENSATION DECLARATION 1 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 permt is issued. ❑ I have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed r the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to 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 with those provisions. a X Date ��^ �� ^ .J Signature of Applicant - Owner ❑ Contra Agent An OSHA permit is requ're ore i e p and demolition or construction of structure 3 t h' MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ 371.75 HAZ. �. D. FEJ6 IM j V cD P EL PQ 11 v D/ H v ISSVE This permit is hereby issued under the applicable provisions of a Butte County Code and/or Resolutions to do work indi sled above for which fees have been paid. / ` Q a� u P IT EXPIRES ON 1 7;,Jo ate ReceiptN f WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT 60ROPMENT SERVICES -BUILDING DIVISION 7 County Center Drive,-Drovilie, CA 95965 Phone (530)538-7541 Fax'(530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: pl (' av�, ff(-)4& ASSESSOR PARCEL NUMBER -3 - O _66 '7 - Proposed Building Use: t1 p (,t_) Yr f - oef .. Irv, /% Counter Technician: Date: Ite s required in order to apply for a permit. All boKes MUST be checked OR marked NA in order to,apply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the prepai er of the plans. (L7/lty S ubw ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ej1-f I rcC% ❑ 4. Engineered truss details and layouts in duplicate No faxes! 0yL klu-n- ❑ Energy compliance desi n and supporting documentation in duplicate. ,V416. Manufactured homel( Data sheets and instal ation inst, (B) Marriage line infolc4loor Plan' lie dow fnd plans, in duplicate. ❑ 7. Metal bld s: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor p1l ate. All of these must be stamped and wet -signed by the engineer. k Items required for initial plan review. If checked iters have not been received, plan review cannot proceed. The permit will be indexed and! returned to the plan review line-up when required items are received. Date Received By . ❑ 8. Flood Elevation Certificate, wet -stamped and sicned, in duplicate ................................ ❑ 9. Site plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings........................................................ ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... 1 . Fire Sprinklers............................................................................................ 14. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 15. Other pxaining items needed to issue the permit. (May equire additional plan review upon receipt Q o Qw g PR5 Fees as shown on the attached Schedule of Fees Due Sheet..�hCen Cjy?k f ...... ❑ 7. Statement of Intent for Non -heated and A/C Bu ldings.................................... ` Sanitation and site plan approval from the Environmental Health Department in �J 14P_1 �9- City of Chico Plumbing permit ......................... ..�.�...............t by:....... .... - r .. 0. California Department of Forestry plan approval Jif paid. Sent by: ��.......1 x.[. f U "❑ 21. Planning approval for (A) Use: o1C(B)Parking: (C) Parcel Check: Contact Land Development about ❑ Improverr.ents, ❑ Drainage ............................... 5Td25J eY c) �2 0P5 PDES Form............................................................................................. ncroachment Permit for driveway from the Public Works Dept ................................. re -Inspection for required ................ ❑ 26. Contractor's license information. (Number, Name Style, Classification) ...................... � - Worker's Compensation Carrier a Policy Number ............................................. ' 28. Owner -Builder Verification ( Iven to owner, ❑ Mailed to owner) ..................... eLetter of Signature authorization....................................................................Recorded copy of Agricultural Acknowledgment Statement ............................... Manufactured home utility clearance............................................................... 0,9. E isting violatio nd/ r expired permits ............................................... .... [5 3�3� Grant Deed I Title/Statement of Facts. ❑ Letter from Legal Owner, heck to H.C.D. $� F�'34. Other: ' When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: e 1 qj_ 3 1. Index permit application for the above items numbered: Ian Check Letter 2. Additional items required Contractor, designer, 2t�=was advised of the above data by phone, mail, ❑( counter, by D 3 Contractor, designer, owner, was advised of the above data by ❑ phone, mail, ❑ co nter, by Date: Plans reviewed by: ��Date: Plans approved by: C/' Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division I EA. USE GANIL hot Plan Artachad Floor Man Anachad Sent to G.D. TO: Building Department U FROM: Environmental Health 1) . SUBJECT: Sanitation Clearance AV '? 'ZO-4 7- lu Owner Location AP# Plan Approved for: Sewage Disposal Water.Supply: Public Private Well v1 Clearance for dwelling. Cther c>? �6�—ARQ07Y7 Hold final for: Final clearance O.K. for: NOTE: Environmental Health RVRI Date COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE„ OROVILLE, CA 95965 TELEPHONE (530)538-7541 j f u SCHEDULE OF RECEIPT OF FEES OWNER ��! l I ! C�1 1 r n J� A.P. # U ' /^' ..(/ Lam-✓ —/: PROPROSED BUILDING USE , gfM �Q DATE RECEIPT # DATE REC. 1. BUILDING PERMIT FEES --- Balance Due ..................... $ --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ 2. SCHOOL DISTRICT FEES t. AUpnfl;�' Q Q (paid at School District Office) (form avail bl after Plan heck) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Commercial (sq. ftg.)..... 4. URBAN AREA FEES Residential (per unit)..... Units Sq.Ftg. X X $0.03 = $ # Units I Amt. Commercial (Sq. Ftg.).... X Sq. Ftg. Amt. (paid at Building Division) 5. RECREATION DISTRICT FEES (paid at Recreation District Office) Qform 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) ( J 8. WATER TENDER FEES BATTALION # $200.00 (paid. at Building Division i 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Jnits Amt. Commercial (sq. ftg.) ......... X = $ S�. Ftg. Amt. 10. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT DATE 10 —3 n 03 Pursuant to Government Code Section 66020, you we 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 projec. or from the imposition of the above mentioned items during which you may protest. The requirements for a protest ai•e specified in Government Code Section 60020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) National Pollutant Discharge Elimination System (NPDES) Phase II & SWPPP Non -Certification for Project # for'13 utte County Storm Water Permit Compliance. By signing below, I, the !project architect/engineer of record, indicate that I am aware that a construction project thatl disturbs more than l .acre of land requires a Construction Storm Water Permit from the State Water Resources Control Board. I, additionally, understand that it is the project owner's/owner ' s lagent's responsibility to submit a Notice of Intent (N. 01), a Storm Water Pollution Prevention Plan (SWPPP) and a fee of $700.00 to the State Water Resources Control Board to obtain such a permit. I, further, certify that this project will not disturb more than 1 acre of land. I have also reviewed the Best Management Practices Handbooks, California Storm Water Quality Task Force, Sacramento, CA. I certify that appropriate BMPs will be implemented to effectively minimize the negative impacts of this project's construction activities on storm water quality. I acknowledge that it is my obligation to make the project owner and contractor aware that thel selected BMPs must be installed, monitored, and maintained to ensure their effectiveness. K at any time, site conditions and/or observations by a County official warrant reevaluation and irevisions of the chosen BN4Ps, the appropriate changes will be made without unnecessary delay. I am aware that failure to properly implement and maintain the BMPs necessary to prevent the discharge of pollutants from this project during construction could result in significant, penalties and/or delays. Signed: Title: Date: By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs more than 1 acre of land requires a Construction Storm Water Permit from the State Water Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP) and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit, if my project disturbs more than 1 acre of land. I, further, certify that this project will not disturb more than 1 acre of land. This document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified individuals properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons directly responsible for gathering the information, I certify, to the best of my knowledge and belief, that the information submitted is true, accurate, and complete. Signed: (�- Title: Date: / o ls•: NPDES & SWPPP Non -Compliance Certification Draft Butte County Stormwater Plan OWNER -BUILDER VERIFICATION I 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 i; rovemerit :YES E3 NO ❑ 2. I HAVE -HAVE,' NOT Elsigned 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: U-) t _, ',I A- � _ t,, — -r--i- ' ADDRESS: 1 ; 0 , i3 ox 1 `Z !o CITY; C PHONE: _-90 21y CONTRACTOR'S LICENSE NO. T 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: A1-6 -r .45 C-�, ec- V •27" PHONE: i CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK V -n 0 G 14 A -L -t- C gt 4-0 S7 z -• 119 n SIGNED: PROPERTYOWNER:__ ! ,,._,r_� SOCIAL SECT ury N uAsER: DATE: /Q-3C>— NOTE. Q-3U-1!'OTE: This ®wne -w ilder Verification is required by ,Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit: I OWNER BUILDER INFORMATION Dear Property Owner: 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 are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself; you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $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 carry 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 Builder 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 the verification is returned. rely, Mic el C. Vi ira, C.B.O. M ger, Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code Butte County Department of Development Services www.buttecountv.netldds 7 County Center Drive Oroville,�CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile November 9, 2004 William Kotko p PO Box 176 Clippermills, CA 95930 w RE: Permit process for 433A (mobile home on a permanent foundation) 27 Moonville Ridge Road, Clippermills, CA Ap# 073-090-009 Pen -nit # 03-3362 Dear William Kotko N Your check, payable1 to HCD (Housing and Community Development) is being returned to you; due to one ofti�the following: ❑ Due to procedure changes, we are no longer holding HCD checks, and ask that you please resubmit one at the time you pick up the 433A form for recording at the County Recorder's office. ❑ Permit application process not completed, therefore no building permit issued. ❑ Duplicate submission of a'check to HCD. ❑ Failure to final the issued permit. ❑ Failure to record,, the 433A document with the Recorders office. Further information is re ' ed to prepare the _ 433A/513 forms, prior to recordation. ❑ Grant Dee rmqMH title/statement of fact ❑ Letter from legal owner. V -'Other: l '.SLP' Y A /-k-i A /9 t re r- o n o An (t c– ^ L-4 This process must be completed before the mobile home can be removed from California State license rolls and added to Butte County rolls as real property. You will need to contact our office at (530) 538-7541, and ask for a Permit Application Assistant; who wilLassist you in determining what is required to finish the 433A permit process. h Thank you. H.C.D. " • .. . ATTACH CHIECK - ` OCiartefD���/ �' %a A NAIVE: AP#: DATE: AND WHEN RECORDED MAIL TO: it BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 COPY of Document Recorded 30 -Oct_ -2003 2803-8876354 Has not been compared with original BUTTE COUNTY RECORDER AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Date 1*11 - 30 - v1 State of California County of C personauy appeareu lj 1 known to me (or r_ ori ved tc to the within instrument capacity(), and that bye the person(.0 acted, execu WITNESS my hand an*( PROPERTY OWNERS: 117070FREEMAOF2Z M_ N before me, i'ari 1l 01=k p -personally on the basis of satisfactory evidence) to be the person(k) whose name(§ is/are subscribed I acknowledged to me that a /tl>i�y executed the same in is%h@r/their authorized &/thiir signature on the instrument, the personQp) or the entity upon behalf of which the instrument. ial seal. /2 Signature C/.L A.P. # Seal:�.a dA.�a..s��..A PATn CRAY COMM. # 133O31 ROTARY PUBM-Cid FORMA we HUM O(XJNTIY My COMfffi t LM B parro °ft.1 41 2WB �� EXHIBIT "ONE" A portion of Section 25, Township 20 North, Range 7 East, M.D.B.&M., more particulpirly described as follows: COMMENCING at the Southwest corner of said Section 25; thence South 88°05'39" East along the South I-ne of said Section 25, a distance of 2306.30 feet; thence North 01 057',49" West, 74&98 feet to a point on the centerline of the existing road; thence along the centerline of the existing road; South 49055'30" West, 53.98 feet; thence South 59'44'1 0"West, 41.00 feet; thence South 65 ° 13'10" West, 56.00 feet; thence South 82°50' West, 37.00 feet; thence North 64°50'50" West, 38.00 feet; thence North 340 12'50" Weslt, 25.00 feet; thence North 11 °55'20" West, 47.00 feet; thence North 03"57'10" East. 32.00 feet; thence North 28029'40" east, 52:00 feet; thence North 23°17'30" East. 34.00 feet; thence North 11 043'20" East, 145.00 feet; thence North 05 °32'30" East. 35.00 feet; thence North 10 ° 35' West, 23.00 feet; thence North 00,014'50" East. 31.70 feet; thence North 531 16'20" West, 33.00 feet; thence North 48815' West, 63.00 feet; thence North 59008'10" West, 191.00 feet; thence North 49°32'23" West, 42.04 feet to the point of beginning for the herein described parcel; thence from said point of beginning North 22 ° 18' East, 96.00 feet; North 181338'10" East, 129.70 feet; thence North 24057'20" East, 224.12 feet to a point on the North line of the land described In Deed to Butte County Title Company, a Corporation, dated November 20, 1964 and recorded January 5, 1965 in Book 1342 of Official Records, at Pages) 664, records of Butte County, California; thence along the boundary lien of the Is -id described In the Deed to the Butte County Title Company, the following two (2) courses and distances: South 860 West 607.60 feet and South 01 057'49" East, 324.07 feet; thence South 88 1105'39" East, 153.35 feet; thence South 02021'26" East, 193.14 feet to a point on the North boundary of that certain parcel of land described in Deed to Darryl Loftin and Sophie I. Loftin, husband and wife, as joint tenants, recorded April 29, 1965 in Book 1370 of Official RecorJs, at Page(s) 579, records of Butte County, California; thence along sald North boundary, North 66°28'37" East, 62.56 feet; thence North 51026'10" East, 148.48 feet; thence North 641144'30" East, 35.00 feet; thence North 73113'00" East, 58.76 feet to the point of beginning. Assessor's Parcel No: 073-090-009 RECORDING, REQUESTED BY FIDELITY NATIOINAL TITLE CO. RECORDING REQUEST IED BY Placer Title Company Escrow Number: 1201-10496 AND WHEN RECORDED MAIL TO WILLIAM KOTKO 2839 BRADSHAW ROAD SACRAMENTO, CA. 95827 Arp"ZL O`►3-0�`t 0 —l-,og Recorded I REC FEE 13.00 Official Records. I TAX 71.50 County Of I MOMJMEN 10.00 BUTTE 1 CANDACE J. GRUBBS I Recorder I ROSEMARY DICKSON I Assistant I Kathy 09:00AM 11—Jul-2003 1 Page i of 3 SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED The undersigned grantor(s) declare(s): Documentary transfer tax is $71.50 I City Transfer Tax: $0.00 3 �' (X) computed on full value of property conveyed, or h () computed on full value less value I f liens and encumbrances remaining at time of sale. FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, DALE F. HILLMAN AND PEGGY HILLMAN HUSBAND AND WIFE Hereby GRANT(S) to WILLIAM KOTKO AN UNMARRIED MAN all that certain real property situate in the State of California, County of Butte, described as follows: SEE EXHIBIT "ONE ATTACHED HERETO AND MADE A PART HEREOF Dated: July 03, 2003 1 , SIGNATURE PAGE FOR GRANT DEED DALE F. HILLMAN By: PEGGY IL M N STATE OF CALIFORNIA as COUNTY OF SH�LA On -V-B/-03 before me` ` h' A��! f personally appeared —MALE 12. Hit I I M EDGY i{t IIf'K f4iJ proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) Mare subscribed to the within instrument an acknowledged to me that OR>< AeAhey executed the same in his, w/their authorized capacity(ies), and that by NeAieWthe.'r 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. LipROSE L. AYALASignature: Comm. ! 1252120 �fl �7' O y NOTA Tehama' Co CALIFORNIA ry OANIA N Commission Expir ion Date: My Comm. Expires 4;b 27, 2004 "a MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE, IF NO PARTY SHOWN, MAIL AS DIRECTED ABOVE SAME AS ABOVE Name Streit Address City & State O:\StrPkg.doc (4/1002) Order No. 406984 EXHIBIT "ONE" A portion of Section 25, Township 20 North, Range 7 East, M.D.B.&M., more particularly described as follows: COMMENCING at the Southwest corner of said Section 25; thence South 8805'39" East along the South lite of said Section 25, a distance of 2306.30 feet; thence North 01 °57'49" West, 748.98 feet to a point on the centerline of the existing road; thence along the centerline of the existing road, South 49°55'30" West, 53.98 feet; thence South 59°44'10"West, 41.00 feet; thence South 65113'10"West, 56.00 feet; thence South 82°50' West, 37.00 feet; thence North 64°50'50" West, 38.00 feet; thence North 34°12'50" West, 25.00 feet; thence North 11 °55'20" West, 47.00 feet; thence North 08057'10" East: 32.00 feet; thence North 28°29140" east, 62:00 feet; thence North 23017'30" East. 34.00 feet; thence North 11 043'20" East, 145.00 feet; thence North 05°32'30" East 35.00 feet; thence North 10035' West, 23.00 feet; thence North 00014'50" East' 31.70 feet; thence North 530 16'20" West, 33.00 feet; thence North 48815' West, 6B.00 feet; thence North 59008'10" West, 191.00 feet; thence North 49°32'23" West, 42.04 feet to the point of beginning for the herein described parcel; thence from seid point of beginning North 2211 S'East, 96.00 feet; North 18 °38'10" East, 129.70 feet; thence North 24057'20" East, 224.12 feet to a point on the North line of the land described In Deed to Butte County Title Company, a Corporation, dated November 20, 1964 and recorded January 5, 1965 in Book 1342 of Official Records, at Page(s) 664, records of Butte County, California; thence along the boundary lien of the lend described In the Deed to the Butte County Title Company, the following two (2) cowses and distances: South 860 West 60760 feet and South 01 057'49" East, 324.07 feet; thence South 881105'39" East, 153.35 feet; thence South 02121'26" East, 193.14 feet to a point on the North boundary of that certain parcel of land described in Deed to Darryl Loftin and Sophie I. Loftin, husband and wife, as joint tenants, recorded April 29, 1965 in Book 1370 of Official Reco-ds, at Page(s) 579, records of Butte County, California; thence along said North bourdary, North 66128'37" East, 62.56 feet; thence North 51026'10" East, 148.48 feet; thence North 641144'30" East, 35.00 feet; thence North 73°13'00" East, 58.76 feet to tre point of beginning. Assessor's Parcel No. 073-090-009 BUTTE COUNTY Marysville Joint Unified School District Exhibit 3610 #1 NOV. 1 0 2003 1) VELO'r1re CERTIFICATION 'OF COMPLIANCE SERVICES SCHOOL DISTRICT DEVELOPMENT IMPACT FEES To be completed by applicant and taken to: Marysville Joint Unified School District 19.19 B Street, 1V`Iarysville, CA 95901 Part 1 (530) 749-6114, Room 106 Property Owner's Name: 6;. Owner's Address: Project Address: Parcel No: �l 'F'�f%� 't�iy% Lot No: _ Building Dept: a7 /r '_ r(-). i y if`i O;Fermit No: TYPE OF CONSTRUCTION: Residential Construction Residential Reconstruction Commercial Construction Commercial Reconstruction Total Number of Habitable Square Feet: ' V Cityor County: Single Family Dwelling Multiple Family Dwelling No. of Units ,,--Mobile Home THIS CERTIFICATION COVERS ONLY THE AMOUNT OF SgUARE FOOTAGE INDICATED ABOVE. ANY ADDITIONS OR CORRECTIONS TO THE SgUARE FOOTAGE FOR THE PROJECT WILL REgVIRE AN AMENDMENT TO THE CERTIFI- CATION OF COMPLIANCE. FALSIFICATION OF SgUARE FOOTAGE AND/OR TYPE OF CONSTRUCTION IS CAUSE FOR REVOCATION OF CERTIFICATION OF COMPLIANCE. ACCORDING TO GOVERNMENT CODE SECTION 66020 (d) (1), I HAVE BEEN NOTIFIED THAT WITH THE IMPOSITION OF THIS FEE, THE 90 DAY APPROVAL PERIOD IN WHICH I HAVE TO PROTEST THE FEE HAS BEGUN. Applicant's Name: NU 11_ 1 A M K_ nTTIL o Date: 1 0 —3 c) — O Applicant's Signature: Part II TO BE COMPLETED BY BUILDING DEPARTMENT Total Number of Habitable Square Feet b a City of Marysville � County of Yuba Signature r` l'%� % ,� ;t,� County of Butte Part III . TO BE'COMPLETED BY SCHOOL DISTRICT Certification of Compliance No. (Receipt No.): .'13 � v 0 -- Fees Collected: Exempt from Fees: No. of Square Feet x's $.34 for Commercial = $ No. of Square Feet �/ O a3- x's $2.14 for Residential = $ ) C1 . Reason: AS THE AUTHORIZED SCHOOL DISTRICT OFFICIAL, I HEREBY CERTIFY THAT THE REQUIREMENTS OF GOVERNMENT CODE SECTION 65995 HAVE BEEN COMPLIED WITH BY THE ABOVE SIGNED APPLICANT. Signature ► 1 1 (f t Li t ' �'' ►. tR (t • (�aureen Fitzgerald, Assistant superintendent of Business services Date white: - School District Yellow:- Applicant SD:co Pink - Building Dept 6/10/02 l ?7l., i- :' t 'ra'a''";C:c :_= ?iKR'rM_ Y"�.yr ►r: +`''a',"'4;�.iaT.•�ashtea;-�„� nom`s'-.'!'–+' T: '7y�F.i;`r'�1 ,Y�s ,F' ;r'"ffi-` .asp•:; s 073-090-00994-1232E } .a HILLMAN, DALE & PEGGY • {. BINET RD -`ACROSS FROM LOST CRK, BC i ELE FOR WELL } ! OFFICE COPY' Address GAS Meter By Date ELECTRIC Meter By Data Pep C� C , 0 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, Callifornia 95965 - Telephone (91'6) 538-754 PERMIT No. APPLICATIOWAND PERMIT Q ASSESSOR PARCEL NUMBER , 73-09-009 ZONING U ILDING PERMIT OWNER dile & peggy hillmaa TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 2500 I.AMMERS ROAD - CONTRACTOR'S NAME RROHN'S RONST. TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEERucEN4 E NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS\� i Penalty $ BUILDING ADDRESS IIINET ROAD PERMIT FEE $ CLIPPER MILLS PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 ACROSS FROM LOST CRR Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE i SF ❑ Duplex ❑ Mobilehome ❑ Other WELL ELECTRIC SPECIFY - Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( '2"ORLESS 200A OR LESS ) 23.00 23.00 Main Service ( 200A TO IOOOA ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONIS. ( & ACC. BLDS. ) SO. 3.50 FT, CONTRACTORS LICENSE LAW 1 tare under penalty of perjury (check one) I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Co ,& and Ty license is in full force and effect. License No. G4 :70Classification /(,3 O I, as the owner, or my employees with wages as.their sole compensation, will do the work, and the struaturi) is not intended or -offered for sale. (Sec 7044) O I, as the owner, am exc sive l} contracting with licensed contractors. (Sec 7044) ❑ 1 am exempt under Sec. 7 _, Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET -NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. EX. OCCUP• ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. @ .so Ex. Occup. FIXED APPWS. OR p' ( OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATIO INSURANCE I declare under penalty of perjury (check one) O This permit is for, $ 100.LO v a 'oil) or ss. ❑ 1 have�piaoea4on file wi th `ty of Ba4t. Dept. of Development Services, Building Divisi C rti ' ate o rk e s Compensation Insurance or a �f Certificate of„ ons �j� iTaaure.t. _ r I I shall not emp�lny an'y efso I , y.r�ianner,so become subject to the Worker's / Compensation laws of Calif Notice to Applicant: If after making this en hould you become.subject to the Worker's Compensation provisions of the Latioir, d , you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE S • Contractor MECHANICAL, PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comPlylto all Butte County Ordinances and California 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. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, gists nd'exp s s which may in any way accrue against said County in conspqueJe o the gra i g of this permit. X Date Signature of Applicant O Owner Contractor ❑Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories,in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 43.00 HA?_ D. FEES IMP FLOOD CDF PARCEL PD HO ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. / .:: - Y? r `Date I 5/2/95 PIR�SON (Da te) Receipt 162734 cHPERMIT WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT .D. COUNTY OF BUTTE - DEPARTMENT OF DEM,ELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, Caiifiornia 95965 - Telephone (916) 538-754 PERMIT NO. APPLICATION AND PERMIT Q �/V �� :31 ?- ASSESSOR PARCEL NUMBER 73-09-009 ZONING u UILDING PERMIT OWNER dale & peggy hillman TELEPHONE SO, FT, OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 2500 LAMMERS ROAD CONTRACTOR'S NAME KROHN'S KONST. TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS BINE. ROAD PERMIT FEE $ CLIPPER MILLS PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 (ACROSSSolar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobilehome O Other WELL ELECTRIC SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W @20.00 TYPE OF WORK New ❑ Addition ❑ Remodel ElUtilities CIInstallation ❑ Other ❑ Describe Work: PERMIT FEE g Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( OOOV OR.LESS ) 200A OR LESS 23.00 2 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCC P. OR ADDNS. ( a ACC. BLDS. ) 3.50 FT,SD. CONTRACTORS LICENSE LAW IXlare under penalty of perjury (check one) I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code aggnd rrppy license is in full force force effect. �D �r(OUTLETS / dC� d Classification License No. Co1 ❑ I, as the owner, or my employees with wEges as their sole compensation, 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 contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET .NON.RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) -&SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) B20@1:00 Ex. Occup.FIXED APPLNS. OR (RESID.) EA. ) S.CI] Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or'ess. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. I shall not employ any person in any mannerso as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ 4 3. Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certifythat I have read this application and stage that the above information is correct. I agree to comply to all Butte County Ordinances and California 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. 1 also agree to save, ind nify and keep harmless the County of Butte against all liabilities, judgments, COs n xp s which may in any way accrue against eid County inc quenc o the g a i of this permit. X Date Signat e o Applicant - Owner Contrac or 1:1 Agent An OSHA permit is required fo excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 43.00 HAZ• D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. Date PERMIT EXPIR SON 5/2/95 (Date) Receipt No. 162734 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINE -INSPECTOR GOLDENROD -APPLICANT • COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO,, $ 7 County Center Drive - Oroville, baliforn+ 95965 -Telephone: 916/538-7541 --� r i+, APPLICATION AND PERMIT ASSESSZ5R PARCEL NUMBER 73-9-9 ZONING U BUILDING PERMIT OWNER DAL9 & P=Y" HILI3W 203) TELEPHONE 835-4558,so. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 2501 LAMMS ROAD CONTRACTOR'S NAME JOHN P FOWLER ELEPHONE T 675-2230,' CONTRACTOR'S MAILING ADDRESS P.O.BOX 20 C10ft KIM 95930 F i rep l ace CONSTRUCTION LENDER', UNKNOWN Total Valuation is Filing Fee a' $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENISE NO.� ;Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS BTM ROAD'42ne k4 / (/ Permit fee $ PLUMBING PERMIT Filing Fee 15.00 + AMI WR CREEK Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other WEM ELEM SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JW @ 15.00 TYPE OF WORK New❑ Addition❑ Remodel❑ UtiliittiiesE]- Install I n❑ Other;"❑ Describe work: E'� FOR WELL: RMJRE OEVI _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00` Main service 600V OR LESS 200A OR LESS 50 p 18t� 18..50 Main service 200ATO t000AI 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F1 am licensed under provisions of Chapt. 9, Div. 3 of the_•Business and Professions Code and my license is in full force and; effect. License No. Classification Fl 1. as the owner, or my employees with wages as their sole :compen- sation, will do the work,and the structure is not intended orloffered 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 OCCUPM OR ACDNS. ACC. BLDGS. II 3.64sq.ft. NEW CONSTR ULTI.OUTLE-r NON•RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 76 Ex. Occup. OUED P TLETS (RESID.)REA.) I .3.00 Temporary service 15.00 Mobile Home Facilities 15.00Lill Misc. Wiring g 15.00 PRE TNSP 20.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte. Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIIng Fee 15.00 Heating Cooling g Hood 6.50 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way,.accrue againnssLsaid,EZin/c/ihssee4Uhce of the granting of this permit.,-•' ' Q^� '.Lu Date / 1 Signature pp ❑ Contractor ❑ Agent ❑ si nature of Applicant — owner An OSHA permit is required for excavations over S'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEES 53.50 HAz OFEES IMP FLOOD CDF —" PARCEL r✓ PD D IssuF,i f This permit is hereby issued under the sions of the Butte County Code and/or �y w work indi ated above,for which fe4s J DIRLYCTO~R OF PUdUd BY iA.t; lir, ow PERMI EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date G 7 4 7#j Receipt No.T�_7 WHITE-D.P.W., YELLOW-A33E330R, PINK -INSPECTOR. GOLDENROD -APPLICANT Iq 73 SW 1/4 ., SEC. 25' T. 2'0 N. R. 7 E. Tax Area 64-0 f, �r +J !498.24 m 14.72 Ac. I'9 115 •Vi 18.7 AC. N 88 vl _° r 460,55- 93� 93 �Q 6 45 hl 14 It IO �J ` C ;e 1 N N 7.39 AC.— :ry 4AG 1 5.53 Ac. a of ,54-1 � ' � 11 �I 1 Ikq .�1 ` 0 1j w 665.4 4.90.3 _' ! m' ti 1 490.3 23 \ M ;211 N 4.92 ac• _ • -- _ 0cj 20 ac. �% 4 o cy ° 0 746 AC - /8 24 20 m _ �o ! 397 A i 1 302- 309 Ac.- ;_. o+ - - M 440 ,,. 307, . I 3 cli /% 625 A 2.9 Ac- r 25 ' I N- 14 0l 5.94 ac. t0 Z �I cs, I►n I w 2.9 a�. 665.4 90.3 1-, 490.3 660.3. '29. t QE S 88 ° 05' 39 E 2636.27 S1/4 corn or 0.1 SEC. 25 YUB_A CO•- = _ A ssessors M County°. of COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - OroviJle, California 95965 - Telephone: 916/538-7541 APPLICATIOWAND PERMIT PERMIT NO ASSESSOR PARCEL NUMBER 73-9-9 ZONING U BUILDING PERMIT OWNER DALE & PEGGY HILLMAN 209) TELEPHONE 835-4558 SO. FT. OCC.1 BUILDING VALUAT N OWNER'S MAILING ADDRESS 25001 LAMERS ROAD <ac V 9,75-M30 CONTRACTOR'S NAME JOHNP. FOWLER TELEPHONE 675-2230 CONTRACTOR'S MAILING ADDRESS P.O. BOX 20 CLIPPER MILLS 95930 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS INET ROAD Permit fee $ PLUMBING PERMIT Filing Fee 15.00 ACROSS FROM LOST Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other WELL ELECT SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: ELECT FOR WELL: FUTURE DEVELOP Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check oee): ❑ I am licensed under provisions o' Chapt. 9, Div. 3 of the Business and Professions Code and my Ircense is in full force and effect. License No. Classification ❑ I, as the owner, or my employee: 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 Main service 200A To 1000A) 37.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. 3.64 sq.ft. NEW CONSTR. MULTI -OUTLET NON.R ESID BRANCH CIRC ITS 5.00 @ POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURESFIXED 20 76 APPLNS. Ex. Occup. OUTLETS (RESID )REA.1 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 1 PRE TNSP 20.00 Permit Fee $ 53.50 — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check o:ie): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the G:)unty of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. fel I shall not employ any person in any manner so as to become subject �l 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 15.00 Heating Cooling Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue X ains sai ouin 41s ce of the granting Dateof is permit. �j/ l ^ Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations ovmr 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ DCC CONST TYPE TOTAL FEE $ 53.50 HAz I DFEES 1 1M:4 FLOOD CDF PAflCEL PD Issu This permit is hereby issued under the sions of the Butte County Code and/or work in ) ted above or whic f DI F P By PER I E PIRES Date applicable provi- resolutions to do s have been paid. WORKS o at / Receipt No. T1(j i `7 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR GOLDENROD -APPLICANT • .z/'t.:.;'Wf � . ... �. a'�,;,b..T'rtwY'.n..""11'nts' r ^--+n.��N+.T•<r'.-�.n', r'�r.�,i-....��.,�„jrw.+':.�„+�:.. ..i'.,_._.. -..r- �-��.: .„�✓ . •J COUNTY OF BUTTE PARTMEI�T•O PUBLIC WO BUILDING DIVISION j . �. 7 COUNTY CENTER DR VE - OROVILLE, CALIFORNIA 95986 - TELEPHONEf 8 638.7541 / ,_. 91 Q./ N. PERMIT APPLICATION DATA SHEET - n OWNER I �G �/ A. P. No. / 7-9 - ,I Proposed Building Usea� l Building Inspector Date f �7_ At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED By 1 • All items have been submitted. 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3. Complete plans, 3/4 segs, signed by preparer of plans . ...................... 4. Engineered plans and talcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ ... N .................................. 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ........................ . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval jJ Health Department . ........... . 15. City of Chico plumbing permit . ........................................ . 16. Plot plan and business Ocense approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. ,Contact Land Development about (A) Improvements (B) Drainage. .......... . �L 19. Driveway permit (constr-fiction approval required prior to occupancy). . . q - 20. Pre -inspection for required. .:Ito Bu ingInsnpereqdo03t 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmaris Compensation Insurance . .......................... . 23. Owner -Builder Verification (Given to owner , Mail to owner ...... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authcrization. ..................... ................ . 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on buildirg use . .................... . .................. . 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ........................................ 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B)•Parcel meets,zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list. ................................................. . 33. 34. When you issue the permit process as follows: Mail to owner. Mail to contractor. Telephone A 75 1 t Z3() and held for pickup at --0 office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date l Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by. _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in =ile cabinet AP folder Copy - Department of Public Works OWNER: PRE -INSPECTION DATE ` jj ` /_ f Z LOCATION: A . P. # 93— CONTRACTOR: 3—CONTRACTOR: �o Q W �'e +' ZONING u PRE -INSPECTION FOR: ( �l� c -- DATE TO INSPECTOR -------------------------------------------------------------------------- PERMIT HISTORY: NONE F-1 AS FOLLOWS: TYPE OF OCCUPANCY BUILDING USAGE: TENNANT: OCCUPIED [] [� HEATED -COOLED OTHER COMMENTS: ACTION RECOMMENDED: "ISSUE OTHER: FIELD - INFORMATION HAS ELECTRIC Q HAS GAS Q HAS SANITATION FACILITIES_ PERSON CONTACTED. = HOLD FOR BY IJ -2- DATE ' " 3 _ 7 Z COUNTY OF EIPPLICATION TTE - DEPARTMENT OF PUBLIC WORKS 7 County Ce - Oroville„California 95965 - Telephone: 916/538-7541 1er Dr AND 'PERMIT PERMIT NO kE-,z ASSESSOR PARCEL NUMBER 73-9-9 ZONING U BUILDING PERMIT OWNER DALE & PEGGY HILLNIAN209 U TELEPHONE 835-4558 S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 25001 LANMERS ROAD 91SM30 CONTRACTOR'SNAME JOHN P FOWLER TELEPHONE 675-2230 CONTRACTOR'S MAILING ADDRESS BOX 20 CLIPPER MILLS 95930 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS NET ROAD �� �ti1 f .� Permit fee $ PLUMBING .PERMIT Filing Fee 15.00 FROM LOST REEK) Each Trap I 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other WELL ELECT SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: ELECT FOR WELL: FUTURE DEVELOP Permit Fee $ Contractor ELECTRICAL PERMIT 1 Filing Fee 15.00 Main service 200AORLESS 1 18.50 18.50 Main service 200A TO 1000AI 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license Is In full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONST. / DWELLING OCCUP.eI\ OR ADDNS. 1 ACC. BLDGS. // 3.6Q sq.}t. NEW CONSTR ULT' -OUTLET NON-.ESI.,BRANCH CIRC ITS @ 5•00 ( POWER APPARATUS .&) SINGLE OUTLET CIR. Ex. OCCUp\/ OUTLETS OR FIXTURES 76d rIXED Ex. Occup. OUTLETS (RESID,)REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring '15.00 PRE INSP 20.00 Permit Fee $ 53.50 Contractor — 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. MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue X ains sai ou�in fis ce of the granting is permit. Date�j/ Si nature of Applicant - owner ❑ Agent ❑ g pp ❑ Cs over i n 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 $ Ener Inspection Fee $ 9Y P OCC CONST TYPE TOTAL FEE $ 53.50 HAz 1 11 FEES 1 1M:4 FLOOD I cOF — PARCELS �; Po - ISsu This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date /, Receipt No- d -A / 79 vNITE•O.P.W., YELLOW-ASDESDOR. PINK -INSPECTOR. GOLDENROD -APPLICANT BUILDING. DIVISION COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: (530) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT 14 W �/: Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO.® qe���� ZONING f OWNER 'LOP , 6 6- ,4QX� AV PHONE NO. 2-Q -73S` q4� OWNE 'S ADDRESS S —2,C601 LOCATION OF BUILDING A e An FAo --c7— ic�-ak Zi -s USE OF BUILDING SIZE OF STRUCTURE SO. FT. TYPE OF CONSTRUCTION: WOOD FRAME STEEL CONCRETE OTHER (Specify) TYPE OF SIDINGS_ ROOF COVERINGFLOOR TYP ESTIMATED COST OF CONSTRUCTION AG Buildings shall comply with the minimum front, side, and rear yard setback requirements of the applicable County Ordinances as follows: ' r FRONT�SIDES REAR��_ AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. AG Buildings must comply with Flood Zone requirements. Finish floor elevation must be at or above elevation USGS Datum. I declare under penalty of perjury that the building will be used as stated above and the purposed use confirms with the AG Building definition. If any change in use or occupancy of the building is made, II will contact the Building Division and obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date 7— 4 Permit Fee - $60.00 Receipt No.97 J, -s o Signature of Owner The above described AG Building is exempt rom a building permit. FL P71L P ROOF G ISSU U Manager Building Division ✓Y1. 11— By Date < V White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant r _ ) r '� _ply 1.-... •: , APPROVED Bufit®County - , mental Health -77 91, Vi •-J�i';A. id a S 'ue' -' - /(�/ a,.. _ t _ . •• '' ♦. QQ V do ., � 13S �CY _ ° ENVIRONMENTAL HEALTH 41 UUT 3 NO a =� 7 COUNTY CENTER DRIVE t� _--'� z r _ ) r '� _ply 1.-... •: , APPROVED Bufit®County - , mental Health -77 91, Vi •-J�i';A. id a S 'ue' -' - /(�/ a,.. _ t _ . •• '' ♦. QQ V do ., � 13S �CY _ ° ENVIRONMENTAL HEALTH 41 UUT 3 NO a =� 7 COUNTY CENTER DRIVE t� _--'� `' ... Al UNENJ —RAC 10 1 .—MSTR. D-EDROOJ►� _ s 7316 SO. _ Tr 111 BATVI o o 45'-3 1/4 V-1 S/8' C_A SG. 9 �n . o, oroy Pw 1 11 S._3 1/2" O ♦ J �� OrT. pv►.-s en. v 7" 10�-8" 16'-0 1/4- IWAT T&Pt II&CM aM UWDCR5M 6f ADM -3 1/S" H - OPT.. JR0 BEDROOM) 4- am M u �`RAG— Niel BEDROO2 1.6.3 ' E APPROVED 3 3 c-2003 PFS Corporation `' ... Al UNENJ —RAC 10 1 .—MSTR. 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