HomeMy WebLinkAbout073-320-039BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 175 PROVENZA DR
Owner:
Permit No: B06-2669
APN: 073-320-039
RUSSELL KOEHN
Issued Date: 01/04/2007 By KCG
Permit type: RESIDENTIAL
4497 FOOTHILL BLVD.
Subtype: SFD-Mobile Home SFT
OROVILLE,
CA 95966
Expiration Date: 01/04/2008
Description: MOBILE HOME INSTALLATION /
(530) 990-6818
Occupancy: R-3 Zoning: A5 0(
Contractor
Applicant:
Square Footage:
NONE
RUSSELL KOEHN
Building Garage Remdl/Addn
4497 FOOTHILL BLVD.
840
OROVILLE, CA 95966
Other Porch/Patio Total
(530)990-6818
840
FEE INFORMATION
County Impact - Mobile $1,548.32
Res Impact Fees - Mobile $1,690.40
EH Building Review Fee $70.00
SMIP - Residential $5.46
Fire Inspection (SRA) -Fire -Res $95.00
Fire Plan Review (SRA) -Fire -Re $95.00
Impact Processing Auditor $50.00
Impact Processing DDS $50.00
Mobile Home $329.94
Mobile Home Plan Check $219.96
Total Charged: $4,154.08 Fees Paid: $4,154.08
Balance Due: $0.00 Receipt No: B890
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
NONE / /
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect.
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
X
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil of not more than five hundred dollars
01/04/2007
penalty [$500];
Please check one of the following:
Contractor's Signature Date
1, AS OWNEOF THE PROPERTY, OR MY EMPLOYEESWAGES AS THEIR SOLE
12 COMPENSATION, WILL
WORKERS' COMPENSATION
DECLARATION
DOT E WORK, AND THE STRUCTIURE IS NOT INTENDED OR
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
the work himself or herself or through his or her own employees, provided that such improvements
❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued,
improve for the purpose of sale.).
I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
E] Section
❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
3700 of the Labor Code, for the performance of the work for which this permit is issued.
My Workers' Compensation insurance varier and policy number are;
The Contractor's License Law dows not apply to an owner of the property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
Cartier. Policy Number: Exp. Date:
(This section need not a completed if the permit is or one hundred dollars ($100) or less.
❑ I AM EXEMPT under Section B. & P.C. for this reason:
rl I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
L� ISSUED, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation laws of California, and agree that if I should become subject to the workers'
X 01/04/2007
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
Own is Signature Date
provisions.
XXIA� 01/04/2007
1 hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Signa a Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
injury, including death, and property damage caused arising out of, in any way connected with
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
the issuance of this permit. I hereby acknowledge thatt is issuance of this pea rmit does not authorize the
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
property owner ora ho' ed to act on the property owner's behalf.
/ p 01/04/2007
CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is construction lending agency for
N e o P rmittee [SIGN] Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
® Owner ❑ Contractor OR. Agent for Owner Agent for Contractor
FILE COPY
Lender's Address City State Zip
we
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TIME OFAPPLICATION
Website: www.buffecounty.net/dds
"PLEASE PRINT CLEARLY"
-
OWNER INFORMATION
Last Name
e
first Name pZell
Mailing Address
City
City
State
State
Zip
Phone
Fax
Fax � , D
E-mail
Lic. #
-
CONTRACTOR
Name
u
Address
Address0A7 7 vOD J
!'
City
City
State
Zip
Phone
Phone
Fax
E-mail
E-mail
Lic. #
Class
-
ARCHITECT/ENGINEER
Name
u
Address
Address0A7 7 vOD J
!'
City
City
State
Zip
Phone
Phone
Fax
E-mail
E-mail
State License Number
-
- APPLICANT INFORMATION
Name
u
Subdivision Nam,^
Address0A7 7 vOD J
!'
11/ v
City
D
State
Zip
Phone
/' �
E�
Fax 'D
E-mail
APPLICANT SIGNATURE r!
X
For office use only:
AP# o3%
Zoning s
Occ. �
Flood Z;,ne L� SRA e� No
84Type Const.
Subdivision Nam,^
Map Book
I Page Lot #
Planner
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
Date Approved:
PERMIT
NO.
BIN #
PROJECT LOCATION
AP# o3%
Property Address
211&za
City
Cross Street es / e R5q&Y
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
'Mokle On P Sin
Sq FT- Living v Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
i
i
Received by: Amount:—�2—r.=Bldg R
x Z SRA
Receipt #: _ Sheriff
env, t4-
f
f Date:
�O CJw == Total
..x
Butte County, Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
PERMIT APPLICATION DATA SHEET
Reference Number: B06-2669
Location: 0 PROVENZA DR
Parcel Number: 073-320-039
Owner Name: FREEMAN, JOHN
Date: 11/16/2006
By: TMP
Sub Type: SFD-Mobile Home S1
Phone:
Description: MOBILE HOME INSTALLATION / SOFT SET
The above permit application has the following Clearances required prior to permit issuance. Please contact each department
indicated below regarding specific requirements pertaining to your permit application.
Yes No
■ ■
LVA ! ■
■ ■
*slum
DRAINAGE DISTRICTS
Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740
LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000
City of Chico, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711
PARKS & RECREATION DISTRICTS
Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711
Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921
Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011
Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393
SCHOOL DISTRICTS
Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281
Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006
Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675
Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723
Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000
Oroville Elementary School District, 2795 Yard Street; Oroville CA 95966 - (530) 532-3000
Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext:105
Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400
OTHER
Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions
City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530)x868-5447
Other: �i>>/1. fiF % v�►�� X 9. J ul Zr
Other:
Other:
Signature of Property Owner:
FILE
Date: 11/16/2006
i
r
BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM
M-hATHER RIVER RECREATION AND PARK DISTRICT (FRRPD)
❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD)
❑ PARADISE RECREATION AND PARK DISTRICT (PRPD)
❑ DURHAM RECREATION AND PARK DISTRICT (DRPD)
Assessor Parcel Numbers
() �� g P
����, Buildinermit Number ,�� - c
Property Owner (s) 7iO S.S
Project Location /Address
Subdivision Name Assessable Sq. Ftge((
Type of Residential Development (check one)
New Development Single Family -Detached
Single
g Family -Attached
�Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling
f/ Mobile home Mobile home replacement verified by Assessor Department
Demo Permit (date issued �-) v rified by Building Department
Comments: i�ih,, i2, ` /,ie�„ t-�/��.,'1��,�"L..,,, L��,,
- • LOLL
FRRPD ❑ CARD ❑ PRPD ❑ DRPD certifies that:
Applicant
Mailing Address'
r
Number
City
— O --7-6
State Zip
Has complied with requirements of the Butte County Board of Supervisors Resolution No.
by Payment o -
Dwelling Units @ $ �(O per unit for a total of S
Square Feet @ $ per sq foot for a total of $
Remarks:
Paicj� y Check No: �� ; —Paid by Cash: Receipt No:
INN
RECORDING REQUESTED BY
Mid Valley Title & Escrow Company
AND WHEN RECORDED MAIL TO:
Russell Koehn
64 Nigget Ranch Road
Oroville, CA 95966
y
I
1
A.P.N.c 073-320-039-000
2006--0057572
Recorded I REC FEE 10,00
Official Records I TRI 99.90
Co�yeof
CRiO1pCE J. BiiM I
County Clerk-Recorderl
I
1 JC
09:NW1 "ov-m I Page 1 of 2
Space Above This Lin for Recordees Use Only
GRANT DEED
The Undersigned Grantor(s) Dedare(s): DOCUMENTARY TRANSFER TAX $99.00; CITY TRANSFER TAX $.00;
SURVEY MONUMENT FEE $
X ; 1 computed on the consideratlon or full value of property conveyed, OR
File No.: 0403-2582471(MM)
computed on the consideration or fuH value less value of Hens and/or errcvmbrances remaining at time of sale,
X . 1 unincorporated area; [ ] City of, and
FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged, John Freeman, an unmarried
man
hereby GRANTS to Russell Koehn, an unmarried man
the following described property in the unincorporated area of, County of Butte, State of California:
PARCEL I:
LOT 19, AS SHOWN ON THAT CERTAIN MAP ENTITLED,-ROBINSON MILL RANCHES
SUBDIVISION-, WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE
COUNTY OF BUTTE, STATE OF CALIFORNIA, ON APRIL 22,1983, IN BOOK 91 OF MAPS, AT
PAGE(S) 21 THRU 25.
PARCEL 11:
A RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES OVER RESTIVE DRIVE,
PROVENZA DRIVE, APRIL COURT AND ANGELA COURT, AS SHOWN ON THAT CERTAIN MAP
ENTITLED,-ROBINSON MILL RANCHES SUBDIVISION-, WHICH MAP WAS RECORDED IN
THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON
APRIL 22,1983, IN BOOK 91 OF MAPS, AT PAGE(S) 21 THRU 25.
EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL 1,
DESCRIBED HEREIN.
Map Tax State nents To: SAME AS ABOVE
A.P.N.: 073-320-039-000 Grant Deed - continued File No.:0403-2582471
(MM)
Date: 11/01/2006
4
STATE OF �U� �J�M%/} )SS
COUNTY OF
On I&Vt?mber a�� �0�0 . before me, 1kAN A . 1 1'10 n QS
Notary Public, personally appeared�
�(� �'"� �I'Y)4f'1 ,personally known to me
(or proved to me on the basis of satisfacbDry evidence) to be the person(s) whose name(s) Is/are subscribed to
the within instrument and acknowledged to me that he/she/they executed the same In his/her/their authorized
capacity(les) and that by his/her/their signature(s) on the instrument the person(s) or the entity upon behalf of
which the person(s) acted, executed the Instrument.
WITNESS my hand and official seal.
Sin re
My Commission pires: i
.::
Notary Name:6 kbu M0
Notary Registration Number.
E
f
t
MARY A THOMPSON
OOMrrd610n !1857914
W "Pa tc-callfauda
Cc
My COMM. Exp. AP .15, 2010 r
77W area for offal notarial sera/
Notary Phone 52 - &(D96
County of Principal Place of Business:
vase 2 or 2
A.P. Num ;
Property Owner
Property Location/Address
"Subdivision
COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
Building Department No.
Lot No.' •,
11
Residential Developmen€ Sq. Footage
No of Living Mobile Home Addition/ "Supplemental to (Group. R)
Units Installation Conversion Permit #
*(No foundation inspection)
.........................................................................................
Deed Restricted Sq. Footage
j (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
County
Commercial/Industrial 0
District Identification No. -1 R l 0
Sq. Footage
(Including Exterior
Roofed Areas)
bro J: llc i%\Q ;,,r- School District certifies that
(� (Applicant)
(Street Address) (Phone Number)
Cir ,`1tc Sq (oL
(City) j (State) (Zip Code)
has complied with the requirements of Resolution No. O S,cjb-a Q by payment of $ZP\
representing ( V4 O square feet. B2926 f
ULL MITIGATION $
School District Repre ntative Date
Paid by Check # \
Remarks: -k --I-, q
Sri fl (2 .2 t'3
�.A. 12 �e,. t _;A CJ
1
Nodes : You may protest the Imposition of the fees Identified above by submitting a written profsst to the District, In compilance with
Govemmem Code Section 66020(a), within 90 days from the date face are paid. Falture to submit a timely wrkten protest will prohibit
you from challenging the Imposition of the fees In any court action. t
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee CertMation Foran, the School District is
notified by the applicable Local Planning Agency that this protect is being rsvWmed under the California Environmental Guahity Act (CEOA),
this protect may be subject to additional school teen to fully midgete its Impact on the school districts schools.
White (school district), Yellow (building department), Pink (applicant). teetonn xte (3f0S*w
ti
Butte County Department of Public Works
J. MICHAEL CRUMP, DIRECTOR
LAND DEVELOPMENT DIVISION
Storm Water Managment Program
7 County Center Drive
Oroville, CA 75965
(530) 538-7266 Telephone
(530) 538-7171 Fax
www.buttecounty.net/dds
O
0
O
0
0
�Ic $
National pollutant Disharche Elimination System (NPDES) Phase II Construction Storm
Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment
[LESS THAN 1 ACRE 1
Reference Number: B06-2669 Date: 11/16/2006
Location: 0 PROVENZA DR By: TMP
Parcel Number: 073-320-039 Sub Type: SFD-Mobile Home SI
Owner Name: FREEMAN, JOHN Phone:
Description: MOBILE HOME INSTALLATION / SOFT SET
By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more
of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California
Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but
when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm
Water Permit from the state of California Regional Water Quality Board.
I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water
Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or
more of land may result in revocation of grading and/or other permits or other santions provided by law.
Signed:
Title: &AL
FILE
Date: 11/16/2006
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
NOTICE TO BUILDERS
Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In
addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental
Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to
expedite your permit:
0 Make sure your application is complete.
0 Be responsive to requests from County departments for any additional materials or requirements.
The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes
without a complete application adds to processing time.
Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not
started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to
expiration an indefinite number of times, provided construction progress has been documented by the Building Division during
each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In
order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking
and documentation may be required. Upon completion of work covered by this permit, please contact this office for final
inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is
issued without a final inspection.
EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY
Application for which a permit has not been issued will expire one year after date of application.
Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications
(not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are
for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn
before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of
$54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration
of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any
refund amount) to determine no work was done.
Fee/refund information can be read on-line at hgp:Hmunicit)alcodes.lexisnexis.com/codesibutteco/
Reference Number: B06-2669
Location: 0 PROVENZA DR
Parcel Number: 073-320-039
Owner Name: FREEMAN, JOHN
Description: MOBILE HOME INSTALLATION / SOFT SET
Date: 11/16/2006
Phone:
Signature of Property Owner: 4Date: 11/16/2006
FILE
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
n If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
o income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business
Administration). For more specific information about your obligations unders state law, contact the Department of Benerit 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 thier work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons prefessing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not requir3ed to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
I PERSONALLY P TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMPROVEMENT. YES R NO)
2. I (HAVE/HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK.
3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION:
ADDRESS CITY.
PHONE CONTRACTORS LICENSE NO
4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE
THE MAJOR WORK:
NAME_
ADDRESS
CITY
PHONE CONTRACTORS LICENSE NO
5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED:
NAME ADDRESS PHONE TYPE OF WORK
Description: MOBILE HOME INSTALLATION / SOFT SET
Reference Number: B06-2669
Applicant Name: RUSSELL KOEHN
Signature of Property Owner: Date:
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION (IVR): (530) 538-4365
OFFICE: (530) 538-7541 FAX#: (530) 538-2140
ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 175 PROVENZA DRIVE
Owner'
Permit NO: B07-1209
APN: 073-320-039
KOEHN,
RUSSELL
Issued Date: 09/08/2008 By KCG
Pennit type: RESIDENTIAL
175 PROVENZA DR
Subtype: SFD-Custom/Model
OROVILLE,
CA 95966
Expiration Date: 09/08/2009
Description: NSF 2568' GAR 663' COV 2661, REP
1(530) 589-0767
Occupancy: R-3 Zoning: A5 0(
Contractor
Applicant:
Square Footage:
KOEHN, RUSSELL
Building Garage Remdl/Addn
•
64 NUGGET RANCH RD
2,568 663
OROVILLE, CA 95966
Other Porch/Patio Total
(530) 589-0767
1,535 4,766
FEE INFORMATION
DB R3 Dwelling -Custom, Model $1,380.63
DB R3 Dwelling -Custom, Model $2,070.95
DB SRA Fire Plan Check Fee $115.98
DBEH Building Review Fee $75.70
DBFIRE Fire Inspection (SRA) R $102.70
DBFIRE Fire Inspection (SRA) R $102.70
DBFIRE SRA Fire Plan Review (S $102.70
DBSMIP Residential $16.69
Total Charged: $3,968.05 Fees Paid: $3,968.05
Balance Due: $0.00 Receipt No: B8510
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect.
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
X 09/08/2008
the applicant to a civil penalty of not more than five hundred dollars [$500);
Please check one of the following:
Contractors Signature Date
AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
OMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
WORKERS' COMPENSATION DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
the work himself or herself or through his or her own employees, provided that such improvements
I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
❑❑
1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code:
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractors License Law dows not apply to an owner of the property who builds or improves
My Workers' Compansation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
Carrier: Policy Number. Exp. Date:
(This section nee not be completed if the permit is or one hundred dollars ($100) or less.
❑ 1 AM EXEMPT under Section B. 8 P.C. for this reason:
I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation Laws of California, and agree that if I should become subject to the workers'
' '
X 09/08/2008
compensation pro ns of Section 3700 of the Labor Code, I shall forthwith comply with those
O rs Signature Date
provisions.
X 09/08/2008
�
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Signat Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
injury, including death, and property damage caused by, arising out of, or in any way connected with
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
Coun to enter the above mentioned property for inspection purposes. I hereby certify that I am the
pro yowneror ed wnersppehalf.
CONSTRUCTION LENDING AGENCY
Zr/y 09/08/2008
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
a of Permittee [SIGN] Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
• ® Owner ❑ Contractor OR. Agent for Owner Agent for Contractor
FILE COPY
Lenders Address City State zip
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
° ° BUILDING PERMIT APPLICATION
° ° OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
° ° A FEE WILL BEREQUIRED AT TIME OFAPPLICATION
Website: www.buttecounty.net/dds
c®UN�l **PLEASE PRINT CLEARLY**
OWNER INFORMATION
Last NameI/v /�
/�
First Name
�!
Mailing Address �� V
City `//e
State (A
Zip75
Phone Fax '
E-mail
CONTRACTOR
Name
Address
City
State
Zip
Phone
Fax
E-mail
Lic. #
Class
APPLICANT SIGNATURE
f�- V -0c "'\
PROJECT LOCATION
AP# n
Property Address
City
PERMIT
NO.
BIN
Ks
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK.
6 v
Sq FT- Livink46wyarage W Tpe Cov 1535
❑ Structure Built without Permits
❑ Proposed Change of Occupancy A& 1 ��� • V
(Note previous use): l
ARCHITECT/ENGINEER
Name
Addtets
City
l �
State TZIP
Zip
Phone
Fax
E-mail
State License Number
APPLICANT SIGNATURE
f�- V -0c "'\
PROJECT LOCATION
AP# n
Property Address
City
PERMIT
NO.
BIN
Ks
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK.
6 v
Sq FT- Livink46wyarage W Tpe Cov 1535
❑ Structure Built without Permits
❑ Proposed Change of Occupancy A& 1 ��� • V
(Note previous use): l
APPLICANT INFORMATION
Name
Address
City
l �
State-
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
f�- V -0c "'\
PROJECT LOCATION
AP# n
Property Address
City
PERMIT
NO.
BIN
Ks
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK.
6 v
Sq FT- Livink46wyarage W Tpe Cov 1535
❑ Structure Built without Permits
❑ Proposed Change of Occupancy A& 1 ��� • V
(Note previous use): l
_ Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
PERMIT APPLICATION DATA SHEET
Reference Number:
B07-1209
Date:
6/4/2007
Location:
175 PROVENZA DRIVE
By:
GLB
Parcel Number:
073-320-039
Sub Type:
SFD-Custom/Model
Owner Name:
KOEHN, RUSSELL
Phone:
(530) 589-0767
Description:
NSF 2568' GAR 663' COV 266'
The above permit application has the following Clearances required prior to permit issuance. Please contact each department
indicated below regarding specific requirements pertaining to your permit application.
Yes No DRAINAGE DISTRICTS
Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740
LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000
City of Chico, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711
PARKS & RECREATION DISTRICTS
❑ ❑ Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711
❑ Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921
Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011
Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393
SCHOOL DISTRICTS
Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281
Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006
Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675
Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723
Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000
Or6ville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000
Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext:105
Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400
OTHER
Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions
City of Biggs Planning Department 3016 Sixth Street Biggs CA 95917 - (530) 868-5447
1 - . . iy r P &i
Other:
Other:
Other:
Signature of Property Owner:
n
FILE
Date: 6/4/2007
BUTTE COUNTY FEE SUMMARY
7 County Center Drive
Oroville, CA 95965
Department of Development Services
Phone (530) 538-7541 Fax (530) 538-2140
Permit Number: 1107-1209'
Job Address: 175 PROVENZA DRIVE
Contractor:
Printed: 6/4/2007
2:00 pm
Fee Description
Account Number
Fee Amount
Paid Date
Pmt Amt
DB R3 Dwelling -Custom, Model
DBF DWLNG CSTM/MDL N Plan Rvv
0010-440001-4210500-1010
'$1,380.63
6/4/2007
$1,380.63
DBF DWLNG CSTM/MDL N Permit Ft
0010-440001-4210500-1010
$2,070.95
DBEH Building Review Fee
'
0021-540013-4614901-1010
$75.70
6/4/2007
$75.70
DBFIRE Fire Inspection (SRA) R
0100-450001-4617240-1010
$102.70
0100-450001-4617240-1010
-$102.70
6/4/2007
$102.70
DBFIRE SRA Fire Plan Review (S
0100-450001-4617240-1010
$102.70
DB SRA Fire Plan Check Fee
0010-440001-4210500-1010
$115.98
DBSMIP Residential
1001-0-280-1011298
$16.69
Printed By: Gwyn Benedict
39968.05 1 $19559.03
Balance Due: $2,409.02
At the time of per it application, I was advised the above fees are required prior to issuance of the
permit. These a ay cha a during the plan checking process.
Signature: Date: 6/4/2007
Pursuant to Government code Section 66020, you are hereby notified those items listed above may have been imposed on your project. You have 90 days
from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments
for a protest are specified in Government Code Section 66020(a).
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Butte County Department of Public Works
J. MICHAEL CRUMP, DIRECTOR
LAND DEVELOPMENT DIVISION
Storm Water Managment Program
7 County Center Drive
Oroville, CA 95965
(530) 538-7266 Telephone
(530) 538-7171 Fax
www.buttecounty.net/dds
National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm
Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment
LESS THAN 1 ACRE
Reference Number:
B07-1209
Date:
6/4/2007
Location:
175 PROVENZA DRIVE
By:
GLB
Parcel Number:
073-320-039
Sub Type:
SFD-Custom/Model
Owner Name:
KOEHN, RUSSELL
Phone:
(530) 589-0767
Description:
NSF 2568' GAR 663' COV 266'
By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more
of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California
Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but
when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm
Water Permit from the state of California Regional Water Quality Board.
I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water
Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or
more of land may result in revocation of grading and/or other permits or other santions provided by law.
Signed:
Title:
' FILE
Date: 6/4/2007
California Department of Forestry and Fire Protection
Butte County Fire Department
Fire Prevention Bureau
176 Nelson Avenue, Oroville CA 95965
(530) 538-7888 Office, (530) 538-2105 Fax
Reference Number: B07-1209
Location: 175 PROVENZA DRIVE
Parcel Number: 073-320-039
Owner Name:: KOEHN, RUSSELL
Description: NSF 2568' GAR 663' COV 266'
Date: 6/4/2007
By: GLB
Sub Type: SFD-Custom/Model
Phone: (530) 589-0767
To meet the requirements of Government Code section 51182 and Public Resource Code 4291, the Butte County
Development Services -Building Department requires a pre -construction inspection to pro -actively provide the below
building and site requirements to the property owner.
Your property is located within the State Responsibility Area (SRA) of Butte County. All development within the
SRA is required to meet the below requirements:
✓ Public Resources Code 4290
✓ Public Resources Code 4291
✓ California Building Code, Chapter 7A
✓ Bute County Improvement Standards
x Requirements prior to scheduling the pre -inspection:
✓ Full plan submittal to Butte County Development Services -Building Division
✓ Driveway and building pad must be identified on site
✓ Structure location must be staked out on the building site
Requests for inspections shall be made a minimum of 72 hours in advance by calling the Fire Prevention
Bureau's 24 hour inspection line at (530) 538-6837, ext. 169, (When the recording comes on, enter the
extension number).
For the pre -inspections, the property owner or authorized agent is required to meet the inspector at the construction
site with two hard copies of the site plan.
I have read and understand the above pre -inspection requirements.
6/4/2007
IX -
Date Signature
All of the Fire Safe Requirements are posted on the Butte County Fire Department website at
htti)://buttefire.org/Firearevention/nrotulan/l)rott)lan.html
Rev'd 5/7/07
FILE
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
NOTICE TO BUILDERS
Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In
addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental
Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to
expedite your permit:
0 Make sure your application is complete.
0 Be responsive to requests from County departments for any additional materials or requirements.
The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes
without a complete application adds to processing time.
Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not
started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to
expiration an indefinite number of times, provided construction progress has been documented by the Building Division during
each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In
order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking
and documentation may be required. Upon completion of work covered by this permit, please contact this office for final
inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is
issued without a final inspection.
EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY
'Application for which a permit has not been issued will expire one year after date of application.
Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications
(not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are
for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn
before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of
$54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration
of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any
refund amount) to determine no work was done.
Fee/refund information can be read on-line at hqp://municipalcodes.lexisnexis.com/codes/butteco/
Reference Number: B07-1209
Location: 175 PROVENZA DRIVE
Parcel Number: 073-320-039
Date: 6/4/2007
Owner Name: KOEHN, RUSSELL Phone: (530) 589-0767
Description: NSF 2568' GAR 663' COV 266'
Signature of Property Owner: Date: 6/4/2007
FILE
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business
Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321
-CLSB (2752) or by accessing thier website at www.CSLB.ca.gov.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION 1S RECEIVED.
1. I PERSONALLY PL TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMPROVEMENT�OR NO)
2. I 01HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK.
3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION:
ADDRESS CITY
PHONE CONTRACTORS LICENSE NO
4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE
THE MAJOR WORK:
NAME
ADDRESS CITY
PHONE CONTRACTORS LICENSE NO
5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED:
NAME ADDRESS PHONE TYPE OF WORK
Description: NSF 2568' GAR 663' COV 266'
Reference Number: B07-1209
Applicant Name: KOEHN, RUSSELL
Owner's Name: KOEHN, RUSSELL %f ^ AP # : 073-320-0�39 /
Signature of Property Owner: /`��' v Date: - / - I)
AND WHEN RECORDED MAIL TO:
o BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
COPY of Document Recorded
4 -Jan -2007 2007-0000538
Has not been compared vith
original
BUTTE COUNTY COUNTY RECORDER
F 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:
SEL A77A= MI`= "A"
Date PROPER WNER
State of California
County of I;IPi .
On JANUARY 4. 2007 before me,
MARY A. THOMP'30N. NOTARY PINLIC
personally appeared RUSSELL KOE�N personally
known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized
capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, executed the instrument.
WITNESS my hand and of lcial eal.
t
Signature (/ Seal:
MARY A. THOMPSON
CommiSSion #1657914JQ
Nota Public -California cin
A.P. # 073-320-0. U Butte County
My Comm. Exp. APR. 15, 2010
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EXHIBIT "A"
PARCEL I:
LOT 19, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "ROBINSON MILL RANCHES
SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE
COUNTY OF BUTTE, STATE OF CALIFORNIA, ON APRIL 22,1983, IN BOOK 91 OF MAPS, AT
PAGE(S) 21 THRU 25.
PARCEL II:
A RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES OVER RESTIVE DRIVE,
PROVENZA DRIVE, APRIL COURT AND ANGELA COURT, AS SHOWN ON THAT CERTAIN MAP
EknnuD, "ROBINSON MILL RANCHES SUBDIVISION", WHICH MAP WAS RECORDED IN
THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON
APRIL 22,1983, IN BOOK 91 OF MAPS, AT PAGE(S) 21 THRU 25.
n
EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I,
DESCRIBED HEREIN.
V
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It
5
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EXHIBIT "A"
PARCEL I:
LOT 19, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "ROBINSON MILL RANCHES
SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE
COUNTY OF BUTTE, STATE OF CALIFORNIA, ON APRIL 22,1983, IN BOOK 91 OF MAPS, AT
PAGE(S) 21 THRU 25.
PARCEL II:
A RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES OVER RESTIVE DRIVE,
PROVENZA DRIVE, APRIL COURT AND ANGELA COURT, AS SHOWN ON THAT CERTAIN MAP
EknnuD, "ROBINSON MILL RANCHES SUBDIVISION", WHICH MAP WAS RECORDED IN
THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON
APRIL 22,1983, IN BOOK 91 OF MAPS, AT PAGE(S) 21 THRU 25.
n
EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I,
DESCRIBED HEREIN.
V
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1
BUTTE COUNTY DEVELOPMENT FEE .�vT
CERTIFICATION FORM ;
Feather River Recreation & Park District
Assessor's Parcel Number (s): 073-320-039 Building Permit Number: B07-1209
Property Owner (s): KOEHN, RUSSELL
Project Location/Address: 175 PROVENZA DRIVE OROVILLE
Project Description: NSF 2568' GAR 663' COV 266'
I Type of Residential Development
Permit Type: RESIDENTIAL Permit Subtype: SFD-Custom/Model
Building Type: New Single Family Dwelling New/Additional Sq Ftg: 2,568
Certificate of Existing Square Footage
Existing Sq Ftg: 840 MH Replacement:
Existing Construction Type: Residential- Mobile/Manufactured Home
Demo Permit Issued?,, Demo Permit Issued Date:
Verified by Building Records: Building R Verified by Assessment Records: BUTTE
Comments: Replacing mobile home (606-2669) that was never finalegwith new dwelling. COUNTY
SEP » R 2008
tin 07/02/2008 L,, v ,_% rX-iiIENT
Buil ing Department RJWsentative Date S!:R% ICES
FRRP ❑ CARD 11PRPD
ElDRPD certifies that:
I' �ss� 1C
L, YJ
Applicant Name
1_
Phone Number
hzP
09
G �
Mailing Address
City State
Zip
Has complied with requirements of the Butte County Board of Supervisors Resolution No.
by Payment of
. Dwelling Units @ $
— per unit for a total of $
Square Feet @ $
per sq foot fora total of $
Remarks:
Paid by Check No: Paid by
Receipt No:
6-��
Recreation and Park District Representative
Date
l�
A
BUTTE COUNTY SCHOOL. FEE CERTIFICATION FORM
(One, form per Building)
School.'District Orov le:Elementary School: District : Building Permit Number: B07-1209
. .
Tax Rate Area No: l
Assessor's P,arcelNumber (s): 073-320-039 Jurisdiction: - County
Property.Owner (s): KOEHN; RUSSELL
Project Location/Address:. 175 :PROVENZA. DRIVE OROVILLE
Type of Development
Residential Development: 0 S Footage: 0 q 2,568
No of Living Mobile Home Addition/ *Supplemental to Cr. Demo - eXlstlri $4Q
Units Installation Conversion Permit N g
*(No Foundation Inspection) sq, ft.
Commercial/Industrial: =New = Addition
Project Description: NSF 2568' GAR .663' COV 266'
Net total sq. ft.
Deed Restricted Sq. Footage: 0
Attach signed copy of Deed Restriction and Notice of Limited Use Facility Document
Sq. Footage:
07/02/2008
Building llepartment Repres ative Date
District Indentification No.
•
L School District certifies that
(Payor)
Address)
(Including Brienor e ' eas
BUTTE `71
COUNTY I
SEP ti 8 2008
(City) (State) (Zip Code) (Phone Number)
I
has complied with the requirements of Resolution No. 0by payment of $
representing square feet. AB 2926 $
FULL MITIGATION S
7—P CJ$
School 'Di trict kepreAdintahve Date
Paid by Check # Remarks: /7
l
0 73 h-- 43
Notice: You may protest the imposition of the fees identified above by sumitting a written protest to the District, in compliance with
Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will
prohibit you from challenging the imposition of the fees in any court action.
subsequent o. a School Districtepresen a ive signing this Butte County Schools Impact kee Certification Form, e c o0
District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental
Quality Act (CEQA), this project may subject to additional school fees to fully mitigate its impact on the school district's schools.
White (Cchnnl Dictrirt) Vellnw (Rttilrlino l)enartmentl Pink (AnnlicanA PPC Crhnnl FPB Pn . ld Z t n nR
' CERTIFICATE OF EXISTING SQUARE FOOTAGE
Oroville Elementary School District Building Permit Number: B07-1209
Assessor's Parcel Number.(s):.073-320.-039
Project Location/Address: 175. PROVENZA DRIVE OROVILLE
Existing $q Ftg: 840 MH Replacement:
Existing Construction. Type: NSF 2568' GAR 663' COV 266'
Demo Perm it.lssued?:. Demo Permit Issued Date:
Verified by: Building R
Comments:Replacing mobile home (606-2669) that.was never finaled,with new dwelling
1
6
f.
1 07/02/2008
Buil - mg . epartme epresentative Date
1
r
' CERTIFICATE OF EXISTING SQUARE FOOTAGE
Oroville Elementary School District Building Permit Number: B07-1209
Assessor's Parcel Number.(s):.073-320.-039
Project Location/Address: 175. PROVENZA DRIVE OROVILLE
Existing $q Ftg: 840 MH Replacement:
Existing Construction. Type: NSF 2568' GAR 663' COV 266'
Demo Perm it.lssued?:. Demo Permit Issued Date:
Verified by: Building R
Comments:Replacing mobile home (606-2669) that.was never finaled,with new dwelling
1
6
f.
1 07/02/2008
Buil - mg . epartme epresentative Date
1
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: PROVENZA DR
Owner:
Permit NO: B06-2670
APN: 073-320-039
RUSSELL
KOEHN
Issued Date: 01/04/2007 By KCG
Permit type: MISCELLANEOUS
4497 FOOTHILL BLVD.
Subtype: Ag Exempt
OROVILLE,
CA 95966
Expiration Date: 01/04/2008
Description: STORAGE FOR LIVESTOCK & FE]
(530) 990-6818
Occupancy: U-3 Zoning: A5 0(
Contractor
Applicant:
Square Footage:
NONE
RUSSELL
KOEHN
Building Garage Remdl/Addn
4497 FOOTHILL BLVD.
OROVILLE, CA 95966
Other Porch/Patio Total
(530) 990-6818
1,680 1,680
FEE INFORMATION
Ag Exemption Permit $109.98
EH Building Review Fee $70.00
i
Total Charged: 5179.98 Fees Paid: $179.98
Balance Due: $0.00 Receipt No: B893
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
NONE / /
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect.
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
X 01/04/2007
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
Contractors Signature Date
1, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
WORKERS' COMPENSATION DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
HAVE AND
the work himself or herself or through his or her own employees, provided that such improvements
❑I WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
❑ I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
E]I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractor's License Law dows not apply to an owner of the property who builds or improves
My Workers' Compansation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
Cartier: Policy Number. Exp. Date:
(This section need not a completed if the permit is oris or one hundred ($100) or ess.
❑ I AM EXEMPT under Section B. & P.C. for this reason:
IiiI CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
SUED, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation laws of California, and agree that if I should become subject to the workers'
X 01/04/2007
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
provisio
He
O rs Signature Date
X 01/04/2007
/ir'' `^
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Sign ure Date
WARNING: FAILURE 70 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS $100,000, IN ADDITION TO THE COST OF COMPENSATION,
( )
injury, including death, and property damage caused arising out of, or in any way connected with
the issuance of this permit. I hereby acknowledge thatt is issuance of this permit does not authorize the
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
ATTORNEY'S FEES.
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
pi arty owner or aut orizad to act o the property o ars beha .
e �j y 01/04/2007
CONSTRUCTION LENDING AGENCY
-
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
Name o Permittee [SIGN] ri Date
the performance of the work for which this permit is issued. (3097 civ. code)
t%� I Owner Contractor OR. DAgent for Owner Agent for Contractor
FILE COPY
Lenders Address City State Zip
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
AGRICULTURAL BUILDING EXEMPTION STATEMENT
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 agriculrural products are processed, treated or packaged, nor
shall it be a place used by the public.
Buildings used for purposes other than described above or that are located in a flood hazard zone are not eligible for
an agricultural exemption.
Authorization of an agricultural exemption permit by the Department of Development Services does not preclude any
requirements and/or review by the Butte County Public Works Department, Butte County Fire Department, Butte
County Environmental Health, or any state and federal agencies
Initials * AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields.
Initials &
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 manufactured home, and 23 feet from a commercial/industrial buildings
Initials 101 AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum 23 feet from a
residence and a manufactured home, and 40 feet from a commercial/industrial buildings
Site Address:
PROVENZA DR
Permit No: B06-2670
APN:
073-320-039
Square Footage: 1,680
Permit Type:
MISCELLANEOUS
Occupancy: U-3
Permit Subtype:
Ag Exempt
Zoning: A5 00
Description:
STORAGE FOR LIVESTOCK & FEED
Required Setbacks:
Applicant:
RUSSELL KOEHN
Front: 50' Side: 30' Rear: 30'
4497 FOOTHILL BLVD.
Type of Construction:
OROVILLECA95966
(530) 990-6818
Type of Siding: SMARTSIDE
Owner:
RUSSELL KOEHN
Est. Const. Cost: $ 30,000.00
4497 FOOTHILL BLVD.
Roof Covering: Steel
OROVILLE, CA 95966
(530) 990-6818
Floor Type: Concrete
I declare under penalty of perjury that the building will be used as stated above, and the proposed use
conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will
contact the Building Divison and obtain the necessary permits, inspections and approvals to comply with the
requirements in effect at that time and prior to occupancy.
0/ Signature of owner:0,1 Date: 11/16/2006
FILE COPY
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last Name 1�^/
vl
irst Name
Mailing Address &62!z1 /
Cityo /
State C�
Zip
Phone V,, D
lax O J - Ur
E-mail
E-mail
APPLICANT INFORMATION
CONTRACTOR
Name
Citymo
Address
Zip;�yf'l
City
Faxtr6Pf, O 7Z7
State
Zip
Phone
-
Fax
E-mail
Planner
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
Citymo
Address
Zip;�yf'l
City
Faxtr6Pf, O 7Z7
State
Zip
Phone
Book
Fax
E-mail
Planner
State License Number
APPLICANT INFORMATION
Name e/ Alo v
Address
�7
Citymo
State
Zip;�yf'l
Phone 0_
Faxtr6Pf, O 7Z7
E-mail
APPLICANT SIGNATURE
X
For office use only:
Zoning
Property Address
O(/ V/a
Flood Zone
�(
SRA
es
No
Occ. / } 7
Type Const. U�
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
PERMIT
NO. �
R 16-2- "'n
BIN #
PROJECT LOCATION
AP#
Property Address
O(/ V/a
City
Cross Street
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
41afla
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
II Received by: -7pAmount: Amount: / (9 q- ' Bldg I I
Receipt #�3 T q3
Date:
SRA
Sheriff
SMIP
r7Q �
00. Qt
7 `7• C1 0 Total
t
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
PERMIT APPLICATION DATA SHEET
Reference Number: B06-2670 Date: 11/16/2006
Location: 0 PROVENZA DR By: TMP
Parcel Number: 073-320-039 Sub Type: A2 Exempt
Owner Name: FREEMAN, JOHN Phone:
Description: STORAGE FOR LIVESTOCK & FEED
The above permit application has the following Clearances required prior to permit issuance. Please contact each department
indicated below regarding specific requirements pertaining to your permit application.
Yes No
❑ ❑
DRAINAGE DISTRICTS
Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740
LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000
City of Chico, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711
PARKS & RECREATION DISTRICTS
Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711
Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921
Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011
Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393
SCHOOL DISTRICTS
Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281
Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006
Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675
Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723
Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000
Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000
Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext:105
Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400
OTHER
Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions
City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447
r' I— I .
Other: 114—
Other:
14
Other:
Other:
Signature of Property Owner: Date: 11/16/2006
FILE
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
NOTICE TO BUILDERS
Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In
addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental
Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to
expedite your permit:
0 Make sure your application is complete.
0 Be responsive to requests from County departments for any additional materials or requirements.
The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes
without a complete application adds to processing time.
Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not
started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to
expiration an indefinite number of times, provided construction progress has been documented by the Building Division during
each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In
order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking
and documentation may be required. Upon completion of work covered by this permit, please contact this office for final
inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is
issued without a final inspection.
EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY
Application for which a permit has not been issued will expire one year after date of application.
Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications
(not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are
for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn
before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of
$54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration
of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any
refund amount) to determine no work was done.
Fee/refund information can be read on-line at hqp://municipalcodes.lexisnexis.com/codes/butteco/
Reference Number: B06-2670
Location: 0 PROVENZA DR
Parcel Number: 073-320-039
Date: 11/16/2006
Owner Name: FREEMAN, JOHN Phone:
Description: STORAGE FOR LIVESTOCK & FEED
Signature of Property Owner.41i�eEl� Date: 11/16/2006
FILE
Butte County Department of Public Works
J. MICHAEL CRUMP, DIRECTOR '
LAND DEVELOPMENT DIVISION
Storm Water Managment Program
7 County Center Drive
Oroville, CA 75965
(530) 538-7266 Telephone
(530) 538-7171 Fax
www.buttecounty.net/dds
L� S
National pollutant Disharche Elimination System (NPDES) Phase II Construction Storm
Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment
(LESS THAN 1 ACRE 1
Reference Number: B06-2670 Date: 11/16/2006
Location: 0 PROVENZA DR By: TMP
Parcel Number: 073-320-039 Sub Type: Ag Exempt
Owner Name:' FREEMAN, JOHN Phone:
Description: STORAGE FOR LIVESTOCK & FEED
By signing below, I the project owner/owners' agent, certify. that this project WILL NOT DISTURB 1 acre or more
of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California
Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but
when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm
Water Permit from the state of California Regional Water Quality Board.
I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water
Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or
more of land may result in revocation of grading and/or otherpermits or other santions provided by law.
Signed:
Title:
FILE
Date: 11/16/2006
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business
Administration). For more specific information about your obligations unders state law, contact the Department of Benerit 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 thier work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons prefessing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not requir3ed to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
I PERSONALLY PL6N TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMPROVEMENT. VOR NO)
2. I (HAVE/HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK.
3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION:
ADDRESS CITY
PHONE CONTRACTORS LICENSE NO
4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE
THE MAJOR WORK:
NAME
ADDRESS
PHONE CONTRACTORS LICENSE NO
5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED:
NAME ADDRESS PHONE TYPE OF WORK
Description: STORAGE FOR LIVESTOCK & FEED
Reference Number: B06-2670
Applicant Name: RUSSELL KOEHN �-
Signature of Property Owner: ssQ/`"� Date: /X/,/I O�
1
RECORDING REQUESTED BY
Mid Valley Title & Escrow Company
AND WHEN RECORDED MAIL TO:
Russell Koehn
64 Nigget Ranch Road
Oroville, CA 95966
A. P. N .: 073-320-039-000
3�
GRANT DEED
2006--00S7S72
Official Becordc I TAY FEE 99.81
CMW of I
mm L eSi m I
Comity ClvHecerllerl
1
1 JC
89:11" 3 -*OV -116 1 Page i of 2
Above This Lhrs for Rewdees Use only
The Underslgrred Grantor(s) Dedare(s): DOOUMEIirARY TRANSFER TAX $N.00; aTy TRANSFER TAX $&00;
SURVEY MONUMENT FEE:
[ X : ] computed an the aonsidenadon or }W value of property conveyed, OR
File No.: 0403-2582471(MM)
J�
a mVuted an the awalderadon or full value kss value of Yens and/or encwtranow romalning at time of sale:
X 1 unincorporated area; [ ] city of , and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Sohn Freeman, an unmarried
man
hereby GRANTS to Russell Koehn, an unmarried man
the following described property in the unincorporated area of, County of Butte, State of California:
PARCEL I:
LOT 19, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "ROBINSON MILL RANCHES
SUBDr41SION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE
COUNTY OF BUTTE, STATE OF CALIFORNIA, ON APRIL ?2,1983, IN BOOK 91 OF MAPS, AT
PAGE(S) 21 THRU 25.
PARCEL 11:
A RIGHT OF WAY FOR ROAD AND PUBLIC UTILITY PURPOSES OVER RESTIVE DRIVE,
PROVENZA DRIVE, APRIL COURT AND ANGELA COURT, AS SHOWN ON THAT CERTAIN MAP
ENTITLED, "ROBINSON MILL RANCHES SUBDIVISION", WHICH MAP WAS RECORDED IN
THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON
APRIL 22,1983, IN BOOK 91 OF MAPS, AT PAGE(S) 21 THRU 25.
EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I,
DESCRIBED HEREIN.
P
Mae Tax Statements To: SAME AS ABOVE
A.P.N.: 073-320-039-000
STATE OF co=/Of?Mi/t )SS
COUNTY OF _ ffe )
• \fiJ
Grant Deed - continued
File No.:0403-2582471
(MM)
Date: 11/01/2006
On IAUef♦ ber ai, )W16 r before me, AA(W . 11'10 m QS1064
Notary Public, personally appeared
t��arieer n , personally known to me
(or proved m me on the basis of satisfactory evidence) tD be the person(s) whose name(s) is/are subscribed to
the within instrument and adumwiedged tome that he/she/they executed the same In his/her/their authorized
capadty(les) and that by his/her/their signature(s) on the instrument the person(s) or the entity upon behalf of
which,the person(s) acted, executed the Instrument.
WITNESS my hand and official seal.
S
My Commisslon spires: &(81 12_
Notary Name• 1 Q
Notary Registration Number:
Oornc % W N
Nfty� is - cailaotnia
CDS ExA Ate.. %z0io
Mls am for oftfal nota,*1 spa/
Notary PhoneCM!) - (Q(O,?6
County of Principal Place of Business:
Page 2 or 2
PDL SEES 20 d 21, T19M P&E Ka9&K OT #19. „_J
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VACINITY MAP
SPECIAL INTEREST
INFORMATION
PARCEL APN 0 037-320-039
LOCATION; Robinson Mill Ranches Subdivision
Lot #19,175 Provema Drive, Omville, Ca
ELEVATION; 2960' above see level
ZONING; A-5
PARCEL SIZE; 5.15 aces
- ' - CONSTRUCTION; TYPE V with one-hour animations t^ -
OCCUPANCY GROUP; R-3/ U
SrESMIC ZONE:
WIND SPEED; 0.80 mph
CLIMATE TONE; 11
BUB,DINO JURISDICTION;
FEU: RESP. AREA; CDP
SCHOOL DISTRICT; OROVILLE ELEMENTARY
CODE COMPLIANCE
STATEMENT
The design and construction of this project is in strict
compliance with all codes adopted locally in the Butte
County building jurisdiction.lt is intended to cite all
pertinent codes at the respective features on drawings
throughout these plans. When a plan feature has no code
citation, it is unintentional and all occupancy.specific codes
apply and shall, as a minimum, conform to the adopted
codes listed herein;
California Building Code 2005
California Mechanical Code 2005
California Plumbing Code 2005
,California Energy Code 2006
National Electrical Code 2002, Title 24 Compliant
1 N
PROPERTY LINE .,,
b EXISITINO MOBILE HOME
t3 LL EXIsmNo
t p LL
1 d E92'-0" 100'-0"
6.13 AC BO' -O" LEACHFREEARFA
e'
PROPOSED RESIDENCE Gravel Drive
I
A
d, ,ice 30'
45
�..
pd /
EXISITINO SEPTIC AND /
LEACH AREA
W OCT-BAOK LINE
rQ 0„
EXISITINO BARN
ENTER LINE OF ROAD
f
SITE PLAN
Scale: 1" c 50'-0"
GENERAL CONDITIONS
The builder, prime contractor, subcontractors, and their employees
are required to perform their respective work in compliance with
the listed codes and specifications. They shall comply with all
CAL -OSHA safety requirements that apply and any locally
adopted regulations that may apply to reduce construction noise,
dust control, traffic control, and any other restriction or
requirement adopted to protect the interests of other workers,
inspectors, other properties, and the general public. All contractors,
their employee, suppliers, and such shall perfomh their respective
work in a professional workmanlike manner. Each contractor shall
be responsible for their own materials and tools and report to the
owner within 24 hours when work is complete and ready for
inspection, or any time unreasonable safety issues arise or are
identified, or any time clarification of work of conditions or similar
elements is necessary. The owner shall not be liable for any
contractor's misconduct, damage, injury, or any other indemnity
that is not the fault of the owner. The nature of compliance,
responsibilities, and performance by the owner and any contractors
is typical and required, with no unreasonable clauses. The owner
and any contactors are required to immediately report to each
other anything that may violate or compromise safety or good
practices of this project.
FOUNDATIONS CBC 1801 Footings shall he trenched to
undisturbed earth as per plan and shall be of 2500 psi (min)
concrete and reinforced with 2 continuous N4 rebar located in top &
bottom of footing/wall. UBC 1806.7.1
A concrete slab 4" thick reinforced with 6" XV IOga wire fabric
shell be monolithically cast with the footings, over a 6 mil vapor
barrier with the subgrade undisturbed earth or fill compacted to
90%. Anchor bohs shall be 12" diameter with 2" bearing plate
embedded 7" (min) Into concrete and spaced G on center (max).
Anchor bolts shall be within 12" (max) from any and and no closer
than 7 rebar diameters to any end, with no fewer than two bolts per
wall plate. The finished elevation of the slab shall be no closer than
6 " of adjacent grade at all points and be trowel finished.
WA7_tr_WAYtt_ & PATIOS: All walkways and patios shall be 4"
(min) thickness of 2500 psi concrete and be reinforced with 6'X 6"
IOga wire fabric. All patios shall have six Inch down-amed footers -
at all perimeter edge and code footings — as shown on plans- at all
load bearing locations. All walkways and patio slabs shall be light
broomed finished
FRAMING: CBC 2320.11 Exterior wall frames shall be 2" X 4"
wood stud 16" on center. Interior wall frames shall be 2" X 4"
wood stud 16" on tenter. Solid wood headers 41n. X 12 in. shall be
Installed above all door and window openings. All firming shall be
N2 grade or better Douglas fir. Roof/Ceiling Gomes shall be
engineered trusses as designed, engineered and fabricated by the
truss builder. All structural design calculations and data for the
-trusses shall be Included with all sets of plans required to be
submitted to the bulldfng_ Jurisdiction. CBC 1603
SAIEATHING@ BC 2320A.1 Wall sheathing shall be applied to
all exterior wall homes. 7/16 M. OSB (or equal) rated sheathing
shall be installed for lateral -force b scing/nall backing. Sheathing
WWI be nailed with 2 in. coils spaced 4" O.C.(max) at panel edges
and 8" in the field and be backed with naming at all ed}gs.
Raaf ehentldea shall be r2 In. (min) xnified/rated exterior grade
panels with aheathing clips joining panel edge at mid points
between firming. Sheathing at overhangs, where it is visible from
below, shall be B grade veneer (min) at all exposed surfitoa and be
exterior rated plywood. All roof sheathini; shall be nailed 6 in. O.C.
at panel edges and 12 in. O.C. In the panel field with 8d common
nails, CBC 23-11-E-1.
w WINDOWS/GLAZING: CBC 1203/ Pen 6, Title 24
All windows end glaring shell be double -glazed, gas filled, rad' `
vital ft ffw4 type and size per sch Jule, end be certified by the •.
NPRC. All windows shall have a maximum U factor of 0.38
and a maximum solar hent gain coefficient of BAD All
windows exceeding 3.34 sq.f . of gland am shall have a Low E
cooing.
E= IOR WALL COVERINGS- CBC 14021 All exterior
wall surfaces shall be finished with Hardy Panel 7" Lap to the
weather, over code compliam weather-asletive barrier. All window
openings shall have trimming as shown on plans. Flaahings
shall be Installed when necessary to provide weather. ptoteodon.
DOORS; All doom shall be the type and sin as shown on the
plans and door schedule. Emerior/entry doors shall be solid cors
and all lights in all doors shall be double glazed. Interior doors
WWI be the type and aim as shown an the plans and door schedule.
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50'-11 13/16"
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UPLIFT, DBL 2X EACH END
FLOOR PLAN
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