HomeMy WebLinkAbout078-270-038m
R u5c
036W3-903 PERMIT#98-2895
ROE, Ester
2440 V-6 Rd., Oroville
Cont: CAA orim9 L 24- 97
Replace Htr/SF
B07-1796 078-270-038
MISCELLANEOUS Re -Roof
REROOF24SQ
2440 V-6 RD
ROE 1 A & ESTER LEE.
078-�-�o-o3X �38
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
g�5 PR®JECTINFO k TION
•'-`:s; ..a .:+' .. .MN _ ,t .. tr. t `�,..d�.,.T y th�....,. .a,r<., 1 , «..�,y=Saw srt. z.. x� a .a, '� -� •*4'� r.�,F�S,;: � .c:?�a,' ?i ,. ..`��',s , .
it Site Address: 2440 V-6 RD - Owner: � � Perm
NO: B07-1796
APN: 078-270=038 ROE J A & ESTER' LEE,
2440 V6 RD
Perinit type: MISCELLANEOUS Issued Date: 8/22/2007 By MAK
SuhtyPe: Re -Roof OROVILLE, CA 95966 Expiration Date: 8/21/2008
J
Description: REROOF 24 SQ Occupancy: Zoning: AR
'I Contractor Applicant: Square Footage:
�i
GEORGE ROOFING GEORGE ROOFING Building Garage : Remdl/Addn
6810 LINCOLN BLVD 6810 LINCOLN BLVD
OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch/Patio Total
(530) 533-6393 (530) 533-6393
r� FEEINFORIVIAT OWN ' `
&.115
..L. „r..
DBMSC Re -Roofing $144.50
}
�I
i Total.Charged:. $144.50 Fees Paid: $144.50
�4
Balance Due $0.00 Receipt No.. B4340
--,0NTRACD`ECLARATION�'� r s" g
.� ER'°/ BUILDER DECLARATION
„<. , ,.,
' l Contractor (Name) State Contractors License No. / Class /Expires I HEREBY AFFIRM UNDER PENALTY OF. PERJURY that I am exempt from the Contractor's License
i GEORGE ROOFING `452266 / C39 B C43 / 2/28/2008 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
tt- requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
( I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 also requires the applicant for such permit to file a signed statement that he or she is licensed
(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 r e and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
y f basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
1�
^ 8/22/2007 the applicant to a civil penalty of not more than five hundred dollars [$500];
t.07
aj Contractor's Signa re Date Please check one of the following:
/1 n
I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
r WORKERSC�OMPENS�ATIONDEC�RA�TION� COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR
" t OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: Law does not apply to an owner of the property, who builds or improves thereon, and who does
the work himself or herself or through his ocher 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
c` 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
t performance of the work for which this permit is issued. improve for the purpose of sale.).
❑AVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, s required by I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
coon 3700 of the Labor Code, for the performance of the work for which this CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: permit is issued. The Conlractofs'License Law dows not apply town owner of the property who builds or improves
My Workers' Compensation 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.).
Carrier: State Fund Policy Number: 272-0000596 Exp. D,10/11/2008(This section need not be completed if the permit is or one hun re ollars ($100) or ass:
I AM EXEMPT under Section B. BP.C. for this reason:
yt ❑ I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
'[4 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 8/22/2007
} compensation provisions of Section 3700 of the Labor Code, i shall forthwith comply with those
provisions. Owners Signature Date
X t 8/22/2007? tiv t 1*1- e;11 4_11777 7 ...f% ,77777-7777,7337a. ,'77777777az
I hereby certify that I have read this application and state that the above information is correct. I agree
' SignatureDate to comply with all City and County ordinances, rules, regulations, and State laws relating to building
WARNING: FAILURE TO SE CUR ORKERS' OMPENSATION 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
,j AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, includingdeath, and property damage caused b arising out of, or in an wa
.; HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, I is P Y 9 9 Y Y connected with
the issuance of this permit. hereby acknowledge that issuance of this permit does not authorize the
t DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEYS FEES County to enter the. above mentioned property for inspection purposes. I hereby certify that I am the
CO.INS,TRUCT�ON;LENDIN'GA�7ENC Pro yo erefamthorizedtoact onth propertyownefsbehalL
8/22/2007
V l HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for - NarnLs of Permittee [SV4]-.) P nt Date
6> the performance of the work,for which this permit is issued. (3097 civ, code) ,
Owner Contractor �A Agent for Owner
/14 El
OR: 9 Agent for Contractor
t:� Lender's Address City State Zip FILE COPY
'
l;
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
APPLICANT IGNATURE
X
For office use only:
OWNER
Name
BARBARA WILSON
Address
4507 SAN SEBASTIAN CIRCLE
City
ORLANDO
State FL
Zlp 32808
Phone
407-291-2313
Fax
E-mail
Lic.#Class
APPLICANT IGNATURE
X
For office use only:
CONTRACTOR
Name
GEORGE ROOFING
Address
6810 Lincoln Blvd
City
Oroville
State CA Zip
Phone
(530)533-6393
Fax (530)533-0287
E-mail
dan@abcgc.com
Lic.#Class
dan@abcgc.com
452266
C39
APPLICANT IGNATURE
X
For office use only:
ARCHITECT/ENGINEER
Name
N/A
Address
6810 Lincoln Blvd
City
Oroville
State CA Zip
Phone
(530)533-6393
Fax
E-mail
dan@abcgc.com
State License Number
APPLICANT IGNATURE
X
For office use only:
APPLICANT NAME
Name
GEORGE ROOFING
Address
6810 Lincoln Blvd
City
Oroville
State CA Zip 95966
Phone
(530)533-6393
Fax (530)533-0287
E-mail
dan@abcgc.com
APPLICANT IGNATURE
X
For office use only:
Zoning Flood Zone SRA Yes No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
PERMIT NO.
NO. f�07q _
BP I-7
BIN #
LOCATION
AP#
Property Address
2440 V6 RD.
OROVILLE, CA. 95966
Cross Street
WORKER'S COMPENSATION
Policy Number 272-596
Carrier STATE FUND
If hiring anyone other than license contractors, a certificate of workers
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work
Reroof - House - Com
Sq. Footage 24 sq.
❑ 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 required.
REQUEST FOR REFUNDS
Refunds can only be, made upon written request by the person who paid the
fee. The request must be made prior to the expiration of the permit and no
construction work has been done. Filing fees, plan check fees for work plan
checked and other department costs are not refundable.
Received by: Amount: Bldg
SRA
Receipt #: Sheriff
SMIP
Other
Date: Total
REV: George Roofing
vyo U- I lb I
ICON
AUG, 2 2 2W
DEVELOPMWT
SERVICES lir
. . � � r ':R:l�a.'C.DYTT';C'} � ._.R+ r"T .s(S. � yY`r,T� vtyt;���•{9�.' �Yr�QMJ'-'w��`_�S _ '
M
' N
r2'Ja�Q••L /T,:��'%Ye�d�i J!L� ..� {b`�.�1C r�.fi'�=Ai a��-�C�'r rC%T.L�iL
036-073-003 PERMIT#98-2895 14
ROE, Ester
2440 V-6 Rd., Oroville
Cont: CAA
Replace Htr/SF
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISdON/•
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541`�; .�r�tnniT No.
(Rev. 12/96) APPLICATION AND PERMIT t� `�
ASSESSOR PARCEL NUMBER
ZONING
BUILD( G PERMIT
OWNER
nor:,, rSTRR
TELEPHONE
534-819?
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS 2440 V_6 F.OAD, nROVTLT,r. CA
CONTRACTORS NAMETELEPHONE
fT t rm Aran A a OF i' nw. (n
ITY 535--755rq
CONTRACTORS MAILING ADDM55 TIFL ORO AvrNTT., ORmnu, C10
`'�
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation is
ARCHITECT OR ENGINEER
LICENSE NO.
617201
Filing Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS 7440 V-6 ROM). 0ROVTLLr
Energy Plan Checking Fee $
t
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Fling Fee 20.00
Each Trap 7.00
USEOFSTRUCTURE
�
SF ❑I Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater 23.00
Water piping 15.00
Each gas water heater or vent 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: FEPT.ACF UVATFR
Gas piping syste!2 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home S G W @20.00
t
PERMIT FEE $
ELECTRICAL PERMIT Fling Fee 20.00
800V 0 R LESS
Main Service 20 AOR LESS 23.00
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in fu rce and effect. /
License Class ll o
Lic. No. f, / 2a C) /
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 with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service z TO 46.00
Eo
NEW CONST. DWELLING OCS. SO
Or-0000AUP.
OR 8 ACC. 3.5¢FT.
CNS.
OUTLET
,pµRSSID T.MU LTI-OUTLET @7.50
POWELER APUS
8 SINGOUTPARATLET CIS.
20 @ ISo
(, CCU ounFroRFaTUREs
�OX.
Ex. Occu OUMUTLEE0T5 2.16.GERw 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring23.00
PERMIT FEE $
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 permit 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 / e. ? Al tr .iso%,fit =
MECHANICAL PERMIT Filing Fee 20.00
Heating 15.00
Cooling
Hood 6.50
Ventilation
35.00
PERMIT FEE $
Policy Number — ) ..Ys/!
(The above sections sed not be complefecrif the permit is for work of a valuation
of one hundred dollars ($100) or less.)
1 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 HJ should become subject to the
workers',c tnpensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X 6/ -r / % Date' —Z ;ZJ2 _
Signature of Applicant - ❑ Owner ❑ Contractor LtAgent
An OSHA permit is required for excavations over 60" deep and demolition or construction .
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE 35.00❑
TOTAL FEE $
HAZ.
D. FEES IMP
I FLOOD
I CDF
PARCEL
PO
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.
Q
By Date
PERMIT EXPIRES ON Z 1-7 7
Data
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
completed. If you have questions pertaining to this matter, or need additional explanation,
please contact this ce immediately.
�77)zt�',,OPjxi
v�
1 6d cCAfSS Sc��
Date Ing
REV 10/92
L
• COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISIO
7 County Center Drive • Oroville, Gaiiforn4a 95965 • Telephone (530) 538-7541•
(Rev. 12/96) APPLICATION AND PERMITOTT
ASSESSOR PARCEL NUMBER
i_
ZONING
BUI G PERMIT
OWNERTELEPHONE
ROE, ESTER
534--4192
SO. FT. OCC. BUILDING VALUATION
T�
- OWNER'S MAILING ADDRESS 2440 V--6 ROAD , OROVI.LLR , CA.
CONTRACTOR'S NAMEI
�' llj-`1
('IIET:1-'.I AMO\T t^G,.U, T T5= OOT..
TELEPHONE
�' 538-7559
CONTRACTORS MAILING ADOR
55 DEL ORO AVEHTTE, OROVILL F, CA
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation Is
ARCHITECT OR ENGINEER
LICENSE NO.
617201
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDINGADDRESS
2440 V--6 ROAD, OROVILLr
Ener Plan Checking Fee
Energy g
$
$
PERMIT FEE
$
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF ❑X Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: REPLACE WEATER
Gas piping syste!n 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
@20.00
PERMIT FEE
$
ELECTRICAL PERMIT
Fling Fee 20.00
600VMain Service zo.A OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in yribirce and effect.// > n
License Class Lic. No. (l / /� D /
OWNER -BUILDER DECLARATION
I 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 with 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. Business and Professions Code for this
reason
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 permit is issued.
1 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' om sa 'on i ,Si�ranc Carrie end policy number are:
Carrier
Policy Number —
(The above sections need not be comple a if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 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' pensation p ions of section 3700 of the Labor Code, I shall
forthw' omply NA th rovisions.
XDatec/,_)�_
Signa ure Applicant ❑ wner ❑ Contractor XAgent
An OSHA permit is required for excavations over 5'0" deep and demolition or construction T
of structures over 3 stories in height.
Main Service 200A TO 1000A
46.00
NEW CONST. OWEWNG OCCUP. O
OR ADDNS. ( 8 ACC. 'Fr.
NEW
gESID BRANCH CIRCUITS97.50
POWER APPARATUS
& SINGLE OUTLET CIR.
20 10
X. CCU TL
EOOUTLET OR FDCTURES B @ 0
FU(EPPLNS. OR 5.00
EX. Occup.ovrLErsD ARESID. EA
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating 15.00
Cooling
Hood 6.50
Ventilation
PERMIT FEE $ ' UU
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 35.00
:.AnD.
FEES
IMP
I FLOOD
I CDF
PARCEL
PD
HD
ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for hich fees have
B Y
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Q
Date ���!' ?'[
G
�-r%7 "7
pgNQ
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF'DE-ELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev.12/96) APPLICATION AND PERMIT
momm BUILDING PERMIT
SO. FT. I OCC. BUILDING VALUATION
oorSTRucran u'oeR — -
�y,��
PERMIT FEE _
MECHANICAL PERMIT Fling Fee 1 20.00
Heatina <'O _d2x I I / r
6.50
PERMIT FEI= $
Mobile Home Installation Fee $
Energy Inspection Fee $
E
CONST' TYPE TOTAL FEES, �1
nA1. D. fEE9 IMP p=0 Cef PMitCEl PO I0 6SUE
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.
By Date �---
ReceiptNo. PERMIT EXPIRES ON
Fireplace
Total Valuation S
ARe++rtEeTCREHmnEaN ENO�J �/
Filing Fee
$
20.00
ARaffZeT OR ENMOas MALM AO
Permit Fee
S
Plan Checking Fee
S
OU ADOR85a
Energy Plan Checking Fee
i
oe� 16
PERMIT FEE
_
X110 tU°°N°""� PAAcn W°
PLUMBING PERMIT
Filing Fee 20.00
Each Tr
7.00
USEOFSTRUCTURE
Solar or heat pump water heater
23.00
SIX Duplex O Mobilehome O Other
Water piping
15.00
�esv
Each gas water heater or vent
15.00
TYPE OF WORK
Gas in 1 -5 outlets
15.00
(/
New a Addition O al a LUdw O O Other I '
Building sewer
15.00
/
Mobile Home I S I G I W
@20.00
Describe Work:
PERMIT FEE
S
ELECTRICAL PERMIT
FIM • Fee 20.00
Main Service ao=ooRR=
23.00
Main Service 2ooA To Noom
46.00
NEW CONST. OWELLM oceuv
OR ADONS. t ACC. SDB.
3.SCSo.
NONNRESM MWNCI CL
07.50
POWER APPARATUS
9 OUnET GR.
i
Ex. Occup. oUnbT OR mmam
BAL P N.SO
Ex. Occu ovraEsm.APPUNQ�Ew
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
PERMIT FEE _
MECHANICAL PERMIT Fling Fee 1 20.00
Heatina <'O _d2x I I / r
6.50
PERMIT FEI= $
Mobile Home Installation Fee $
Energy Inspection Fee $
E
CONST' TYPE TOTAL FEES, �1
nA1. D. fEE9 IMP p=0 Cef PMitCEl PO I0 6SUE
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.
By Date �---
ReceiptNo. PERMIT EXPIRES ON
BUTTE COUNTY DEVELOPMENT SERVICES
COMPLAINT FORM
This information is not available to the public!!!!!!!
DO NOT COPYFOR THE PUBLIC OR THE FIELD INSPECTOR!!
The following information is required for Housing Complaints and the
Complainant MUST BE the person living at the complaint address!
Complainant:
Address
Phone Number:
The above information is not available to the public!!!!!!!
(2)
KAFORMS\Complaint Form revl.doc
NPL - REVS/94
RECORDING REQUESTED BY AND RETURN TO:
PAC/F/CCA5ANDELECTRIC COMPANY
LandDeparlinent
450 Rio LindoAvenue
Chico, Cal/fomia 95926
Location: City/Uninc
Recording Fee
Document Transfer Tax $
[X] This is.a conveyance where the consideration and
value is less than $100.00
] Computed on Hill Value of Property Conveyed, or
[ ] Computed on `dill Value Less Liens & Encumbrances
Remaining at Time of Sale.
Signature of declarant or agent determining tax
C U P Y of Document Recorded -
02 -Oct -2002 2002-0051647
Has not been compared with
original
BUTTE COUNTY RECORDER
(SPACE ABOVE FOR RECORDER'S USE ONLY)
JIM DAVIDSON and GLORIA DAVIDSON, husband and wife,
hereinafter called first party, hereby grants to PACIFIC GAS AND ELECTRIC
COMPANY, a California corporation, hereinafter called second parry, the right from time
to time to construct, reconstruct, install, inspect, maintain, replace, remove, and use
facilities of the type hereinafter specified, together with a right of way therefor, within a
strip or parcel of land or along a route as hereinafter set forth, and also ingress thereto and
egress therefrom, over and across the lands of the first parry, situate in the County of Butte,
State of California, described as follows:
(APN 036-073-036)
The parcel of land described in the deed from Joe T. Yates to Jim
Davidson and Gloria Davidson, husband and wife, dated November 10,
1989 and recorded as Recorders Serial Number 89-47528, Butte County
Records.
Said facilities shall consist of:
Such underground conduits, pipes, manholes, service boxes, wires, cables, and electric
conductors; aboveground marker posts, risers, and service pedestals; underground and
aboveground switches, fuses, terminals, and transformers with associated concrete pads;
and fixtures and appurtenances necessary to any and all thereof (underground easement), as
second party deems necessary for the distribution of electrical energy and communication
purposes; and one or more underground pipes with suitable service pipes and connections, as
second party deems necessary for the conveyance of gas (gas easement); located within:
P.G. & E. CO
COPY
Y.1
A strip of land of the uniform width of 5 feet, lying contiguous to
and westerly of the easterly boundary line of said Parcel, and
extending from the northerly boundary line of said Parcel (also being
the southerly boundary line 'of V-6 Road), southerly 60 feet (measured
along said easterly boundary line). The location of which is
delineated by the heavy dashed lines shown upon second party's map
EXHIBIT °A", attached hereto and made a part hereof.
Second party shall have the right to trim, cut down, and clear away or otherwise control any
trees or brush on said strip of land, as hereinbefore set forth, whenever considered necessary
for the complete enjoyment of the rights hereby granted.
First party further grants to and confirms in second party all necessary rights for second
party's existing poles, wires, and other appurtenances located on said lands.
First party shall not erect or construct any building or other structure or drill or operate any
well under or within said strip of land.
First party acknowledges that they have read the attached Grant of Easement Disclosure
Statement (Exhibit `B"), which by this reference is made a part of this Grant 'of Easement
Deed.
The legal description herein, or the map attached hereto, defining the location of this utility
distribution easement, was prepared by Pacific Gas and Electric Company pursuant to
Section 8730(c) of the Business and Professions Code.
The provisions hereof shall inure to the benefit of and bind the successors and assigns of
the respective parties hereto.
Dated
' North Valley Division
Chico Office
PM 30225590 m Davidson
.r Plat No. 1909 F-6
Dwg No. A 19-4-21
T19N, R4E, MDB&M
SEC. 21:•NE1/4 OF SWI/4
File No. 2002-35-30225590a.ugGE.doc, Gloria Davidson
i
n
62.4202 Notary (Genera[) Rev.8/91
STATE OF 0A. n � a
COUNTY OF
�� SS.
O Z before me, the undersigned, a Notary
Public for said Stare, personally
appeared _ J "r.") rfiV d SJn Cn d
[ j personally known to me -OR. [ -Proved to me on the basis of satisfactory evidence to be the person(s) whose
name(s)Xare subscribed to the within Instrument and acknowledged to me that bdshr/they executed the same In
[t VIjP f their authorized capacity(les), and that by bktherttheir signarure(s) on the Instrument the person(s),
or
the entity upon behalf of which the person(s) acted, executed the Instrument.
SHAWN I. NEISON
WITNESS my hand and official seal Comm. 111363163 'A
NNOTARY PUBLIC•CAIIFORMA T►J
Yuba County
I Q n n 9MY Comm. Expires lune 30.2006 "s
Signature
62-4202 Notary (Generao Rev.8/91
STATE OF
COUNTY OF
On
appeared
T SS.
before me, the undersigned, a Notary Public for said State, personally
CAPACITY CLAIMED BY SIGNER
ndvidual(s) Signing For Onesell/Themselves
[) Corporate Officer(s) o(the Above Named Corporation(s)
[ j Guardian of the Above Named Individual(s)
( ] Partner(s) of the Above Named Partnership(s)
[ j Attomey(s)-in-Fact of the Above Named Principal(s)
[ j Trustee(s) of the Above Named Trust(s)
( ]Other
CAPACITY CLAEMED BY SIGNER
[ j Individuals) Signing For Oneself/Themselves
[ ] Corporate Offioer(s) of the Above Named Corporation(s)
[ j Guardian of the Above Named Individuals)
I ) personally Known to me -OR- [ 1 proved to me on the basis of satisfactory evidence to be the person(s) whose [) Panner(s) of the Above Named Partnership(s)
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 signatures) on the instrument the person(s), I j /utomey(s)-in-Fact of the Above Named Principal(s)
or
the entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal
Signature
( J Trustee(s) of the Above Named Trust(s)
[ ] Other
62-338 Rev. 5/85
Right of Way Map
APN 036-073-036 APN 036-073-005
JIM DAVIDSON JIM DAVIDSON and
and GLORIA DAVIDSON, � GLORIA DEAN DAVIDSON,
husband and wife husband and wife
1989-47528 \ 2530—OR-633
V-6 ROAD
0
APN 036-073-003
APN 036-073-004
LOCATION OF 5 FT. STRIP
APN 036-073-035
APN 036-073-024
1909 F-6
SEC. 21: NE1/4 OF SW1/4' EXHIBIT -A..
Cl Y,RANCH0,SU8DIVISI0N,ETC.
0 ROVI LLE EXT. TO: DAVIDSON NdNE108-29-02
SECTION TOWNSHIP I RANGE I MERIDIAN
21 19N 4E MDB&M
JVLLJ.J�U IPG &E I N. VALLEY I I A 19-4-21 I„ k
REFERENCES _2002-56-30225590,-iinGF rine �KAL�^.l .�R,,�,o�� ,,.,.,...�,. —
Pacific Gas and Electric Company
EXHIBIT -B
GRANT OF EASEMENT DISCLOSURE STATEMENT
This Disclosure Statement will assist you in understanding your rights as a property owner
when granting an easement to Pacific Gas and Electric Company (PG&E) to accommodate
your, or your neighbor's, new utility service extension. Please read this disclosure
carefully before signing the Grant of Easement.
0 You are under no obligation or threat of condemnation by PG&E to grant this
easement.
• The granting of this easement is an accommodation to PG&E's applicant
requesting the extension of PG&E utility facilities to the applicant's property or
project, pursuant to the Line Extension Rules 15 and 16, as authorized by the
California Public Utilities Commission. As this is an accommodation to a single
customer or group of customers and not PG&E, the California Public Utilities
Commission has not authorized PG&E to purchase such easements.
• By granting this easement to PG&E, the facilities installed within the easement
across your property may be used to serve additional customers in the area.
• Removal and/or pruning of trees or other vegetation on your property may be
necessary for the installation of PG&E facilities. You have the option of having
PG&E's contractors perform this work on your property, or having the applicant or
the applicant's contractor perform this work. Additionally, in order to comply with
California fire laws and safety orders, PG&E or its contractors will periodically
perform vegetation maintenance activities on your property as provided for in this
grant of easement.
• The description of the location in which the PG&E utility facilities are to be
installed upon, in, on, or across your property must be satisfactory to you.
• The California Public Utilities Commission has authorized that the installation of
certain utility facilities for utility service may be performed by the applicant. In
addition to granting this easement to PG&E, you will need to give your consent to
the applicant, or applicant's contractor, working on your property. Upon completion
of the applicant's installation, the utility facilities will be inspected by PG&E. When
the facility installation is determined to be acceptable the facilities will be conveyed
to PG&E.
By signing the Grant of Easement, you are acknowledging that you have read this
disclosure and understand that you are granting the easement to PG&E of your own
free will. Please return the signed and notarized Grant of Easement and this
Disclosure Statement to PG&E. The duplicate copy of the Grant of Easement and
this Disclosure Statement is for your records.