Loading...
HomeMy WebLinkAbout078-310-060Peter and Ana Simon! 4484 V -E Rd. Oroville Ca. 95966 AP # 036-103-024 Page 1 of 1 Construction change to repair roof framing that was not built per plan. Problem: The plan called for a manufactured truss roof. The owner built with 2x6" rafters and 2x6" ceiling joist 24" oc with a 2x8" ridge. This conforms to span tables at the 12' span section of the garage, but is over spanned at the 24' section. Solution: Install 2x6" rafter scab to existing rafter and nail as per drawing on each existing 2x6" rafter resulting in 3x6 rafter spanning 12'. Install vertical strut at ridge to joist to reduce joist span to 12'. Nail joist to rafter as specified . and install Simpson H-2.5 each rafter to plate connection. Iry 3- IW 0 o� : I r�STAtit, H -2.5 Co ►�*�io� T��. .11 11-01 -P T . � �s _ N`r 78 BUTTE C®UNTY INQ DI jBUILD ROVED E Z 121D�� k 2 IS1 O G Z:yP. . 1;J d� �v 16W I�dd�s snztl-ISN .1W. Gevfo - � - 'C�AFty� �o►s, s►�o� H25 �' DEC 1.2 2006 DEVELOPMENT SERVICES L4G C --o P Y. Peter and Ana Simoni 4484 WE Rd. Oroviile Ca. 95966 AP #'036-103-024 Page 1 of 1 Construction change to repair roof framing that was not built per plan. Problem: The plan called for a manufactured truss roof. The owner built with 2x6" rafters and 2x6" ceiling joist 24" oc with a 2x8" ridge. This conforms to span tables at the 12' span section of the garage, but is over spanned at the 24' section. Solution: Install 2x6" rafter scab to existing rafter and nail as per drawing on each existing 2x6" rafter resulting in 34" rafter spanning 12'. Install vertical strut at ridge to joist to reduce joist span to 12'. Nail joist to rafter as specified and install Simpson H-2.5 each rafter to plate connection. Eva Old : I rjSTAbI, � -2.5 Cfl �►J�io� T�? '"_v �� O MTC7 . F, -A61;iwqe �l d!i octy �4�►�i, . f3"dI t(sdyGS SnTM4 t4p1HA1 a�f%/C�Cad lull -lo St✓1�a� H25 t2= COUNTY L J a 2 2006 SERVICES j a�f%/C�Cad lull -lo 678 Butte County Department of Development Services. �urrE� aa� N ® T .E S 7 County Center Drive, Oroville, CA 95965 (530) 538-7601-.buttecountynetidds, ecOUHty RESIDENTIAL APN: Permii No. Owner. 036-103-024 05-3079 j SIMONI, ANA Si te Address" 2574 V-6 RD, OROVILLE Contractor I Cont: PETRU SIMONLI PATIO COV - i ti Type of Permi 05 0 079 - SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE CHECKED BY f. 1; SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE CHECKED BY , =OK 0 = Not OK MANUFACTURED HOMES DATE PERMANENT FOUNDATION Lj SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fa11/C/0-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd . Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat Q or LP" Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test -Crossovers -Brea kers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs Q Foundation Q 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers a` MISCELLANEOUS i DATE IDECV(S'COVERS'CARPORTS'GARAGES j 6_r*(g-Setbacks-Easements 2.Pfgs; Soils-Sz-DpthSpacing-CnnctrsSteel S)r 7-17 C 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs 1 6 Carports; Wndws-Doors { '7 Electric 8 Frmg; Sills-AnchrsStuds-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing ' 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls 2.� s s 0\ DATE IPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Bones-Enclsrs-pnlboards-Insultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide ' s` S\ r = OK 0 = Not OK RESIDENTIAL (Single. & Duplex) DATE JUNDERFLOOR 1 Zoning -Setbacks -Easements -Flood -Slope 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 3 Ftg Garage;,Soils -Steel-Elec Grnd Ftg Dpth, 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 5 Stemwalls Main; Steel-Blockouts-Wrapped 6 Stemwalls Garage; Steel-Biockouts-Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test t1 Wtr Pipe; Test-Anchrs-RgltrService Test 12 Elec Undrgrnd 13 Plenums & Ducts; Clrnc-MaterialSupport-Insults 14 Girders Sills-Anchr Bolts Joists-Vnts-Cripples 15 Acc & Vntltn 16 Insulation DATE IFRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & fir Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 22 Headers & Beams-Sz & Bearing 23 Hangers -Post Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties -Purl in -Roof Brac-TrussShthg 25 Frplc Ties or Type A Flue-Frpic Throat Cirnc 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctn Framing -RC Channel 29 Prprty, Line Firewall & Opngs 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtri Vnts-Undrflr Acc 35 Glazing Area -Glass P rtctn-SkyLts -Plastic 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnis 38 Insultn-Walls-Ceilings 39 I nfi Itrati on -W al Is -W ndws e` DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ga ❑ CU or [:I AL AC Wire Sz ga ❑ CU or ❑AL 48 Range Circ ga ❑CU or ❑AL Oven Circ ga ❑ CU or FAL Insulated Neutral ❑Yes ❑No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector o'er m o'• o` PLUMBING 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr Nail Prtctn 56 Shwr Pan; Test, First flr-Tub Acc 57 Test Tub & Shwr, 2nd fir - Tub•Acc 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping \e. 0' o` a o` DATE IMECHANICAL 61 AC Ducts Insultn & Support 62 Vent Fan, Exhaust abv Insultn 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace -Vent Acc-Comb Air Rtrn[Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic o6e FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker STs & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Clrnc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Cimc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door; Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85' Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑ Yes ❑ No 87 Stucco Brown -Finish .88 AC Unit Dscnnct, Elec-Plmb _ 89 Vnts abv Roof, Pimb-Appinc-Frpic-Clrnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntltn thru.House 93 Glass Prtctn _ 94 Corrections from previous Inspctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-C10 to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT BP053079 24 HOUR INSPECTION A: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (536) 538-7541 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 12/05/2005 APN: 036-103-024-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect. Q` Site Address: 2574 V-6 RD ORO License Class : License Number: Map Index: Dale: Contractor. • Description: ADD COV PATIO(260) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or -county which requires a Owner: SIMONI; PETRU ETAL permit to construct, alter, improve, demolish, or repair any structure, prior to. its issuance, also requires the applicant for such permit to file a SIMONI, ANNA signed statement that he or she is licensed pursuanflo the provisions of 4844 V.E. AVE the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA. 95966 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the properly, 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 Applicant: SIMONI, PETRU ETAL Code: The Contractors' State License Law does not apply to an SIMONI, ANNA owner of property who builds or improves'thereon, and who does such work himself or herself or through his or her own employees, 4844 V. E. AVE provided that such improvements are not intended or offered for OROVILLE, CA. 95966 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed ' pursuant to the Contractors' State License Law.). ❑ 1 am Exempt underArticle 3 of the Business a d Professions Code Date: ��,�gowner: ^ �' License M W RKERS' COMPENSATION DECLARATION her by affirm under penally of perjury one of the following declarations: e 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 Architect: is issued. Engineer: ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number.are: Carrier: Total Square Ft: 260 S.F. Policy #: Valuation: $4,160.00 Census Code: .0-1 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 the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and onel [/J� n / / G�1 hundred thousand dollars ($100,000), in addition to the cost of 0/� l /�J / % maj, ( ! V L/. compensation, damages as provided for in Section •3706 of the Labor code, interest, and attorney's fees. 11,13630 f I.ThIs ) CONSTRUCTION LENDING AGENCY _ p .rTit ishereby issued under f applicable provisions of the Butte County Code and/orI Re olutions do work indicated/aoo for which fees have been paid. hereby afrm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) By: Date: Name: �' PERMIT EXPIRES ON: �S Addre Date O 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. O Notification in accordance with Section 19827.5 of California Health & Safety Code Is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I ag"ree to comply with I hereby all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butt,��,,,Punly. authorize representatives of Butte County to enter upon the.above mentioned property for inspection purposes. `sK',"; Print Name: �(���a/J%���'l� Signature:�!J— Date:/-). Id -Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 NOTES k RESIDENTIAL PERMIT NO. _ 036 IG:t-�1:'.=1_ _ __ _ 04-30titi — ' " -;.iOONI. ANA. � RD;. ,0 E ;:S 74"V-6 .I TION & REMODEL Lo (" a Ir {ri SPECIAL CONDITIONS y CHECKED BY - - - SRA FLOOD CERTIFICATE REQ. ' -� FIRE SPRINKLERS RECD iN+, - SPECIAL INSPECTION'. ERIFY —VERIFY— USE PERMIT CONDITIONS USE SUB -STANDARD HOUSING LETTER - 46 • ' OFFICE COPY ` '"i ';h.. Address—Z67 GAS ��, , • Meter By 1 Dat 1919 ' ELECTRIC . f Meter By Date f - a Tt `.,•�4�iY�Y`Y f, *�:'.t�_l+:Yri`E�^�',�Y7t�'�,q? ��„�.�e�A+� JOB FINALED Signature ':� J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date FRAMING (Continued) Date Hangers -Post Caps -Anchors -Connectors Card B-1 Date Card B-1 Date Cling. Joist-Rftr. Ties- Purl in -Roll Brac.-Truss-Shting.-Rtng. Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 56. 23. Fire Sprinkler; Test 57. Siding -Nailing Veneer Date Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access Card B-1 Date Card B-1 Date Glazing Area -Glass Protection -Skylights -Plastic Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled Date _/'(Y5_Card 27. Romex Installed Close to Edge of Studs & C.J. Date 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Date 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI W. 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or AI 66. 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated Neutral 0 Yes 0 No 67. 32. Service -Riser Conductors & Ground Main Disconnect 6 76. 33. Equip. Clearances Panels-Motors-Mech. Equip. 71. 34. Clothes Closet Light -Shower Light -Spa Light 72. 35. Smoke Detector 73.It. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance Date Elec. Outlets & Receptacles at Kit. Counter Card B-1 Date Card B-1 Date Gqage Fire Door; Swing -Landing -Closure Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date 83. Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s r _ 41. Sills Proper Materials & Anchors A.C. Unit Disconnect, Electrical -Plumbing 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound Vents Above Roof, Pibg-Appliance-Fireplace-Clearance to Openings 43. Bearing Walls over Girders & Floor Nailing X 44. Draft Stop in Walls (rat proof) Exterior Elec. Trim, G.F.I. Receptacle -Underground 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs Ventilation Throughout House 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties- Purl in -Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61race Interior xte ' al Panels 2�.y 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date _/'(Y5_Card B-1 ��'� Date Card B-1 Date Car B-1 Date Card B-1 Date FINA fans) OK except #'s t. Steps -Door & Sidelight Protection -Landings W. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 6 76. .I. & Bath Fixtures & Tub Access -Spa Elec. Trim & Subpanel, Breaker Sizes & Labels Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73.It. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance Elec. Outlets & Receptacles at Kit. Counter 75. Gqage Fire Door; Swing -Landing -Closure 1�X.C. Duct in Garage -Damper Wtr. Htr.; Vents -Clearance -Comb. Air Connecto 2�4pge; Above Floor-Mech. Protection Elec. & Mech. Equip. Listed for Location -/9. Elec. Receptacles in Garage (FF.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes _ 83. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Pibg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. ater & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date L and B-1 le s Date Card B-1 Date Date and B-1 Date Card B-1 Card B-1 Date Card B-1 Comments at Final: J=OK 0 = Not OK . = NotApplicable Not Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ P' L'ft. / P Nat. or / P' L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing Date 11. Card B-1 Date Card B-1 Date 12. Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line Card B-1 Date Card B-1 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date 11. Card B-1 Date Card B-1 Date 12. Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line Card B-1 Date Card B-1 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Insulation Certificate BUILDING OWNER: BUILDING LOCATION: 0 �7� Description of Installation ROOF Ma teniale? diti" f� Thickn ss (inc es) BUILDING PERMIT #: , Brand Name Thermal Resistance (R -Value) CEILINGr �. Batt or Blanket Type 4, S� � G V' I t u � J Brand Name � -+a t Thermal Resistance. (R -Value) Thiclrness ('orches) Brand Name Loose Fill Type lb Minimum thickness 1 inches Contractor's minimum installed weightlft Value) Manufacturer's installed weight per square foot to acheive Thermal Resistance (R- EXTERIOR-WA46 Material 111,15C u Brand Name Thickness (inches) Thermal Resistance (R -Value) RAISED FLOOR Material — -_ Brand Name - Thickness (inches) Thermal Resistance (R -Value) SLAB FLOOR Material Thickness (inches) Width (inches) . Brand Name Thermal Resistance (R -Value) FOUNDATION WALL Brand Name Maters ess (inches) al ";ertnal Resistance (R -Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. General Contractor (Builder)' Signature and Tide License Number Date 3Oe,6 6C Sub -Contractor (Insu anon Installer) Lic nse Number ell DaLe Signature Tide THIS CERTIFICATE MUST.BE PROVIDED TO THE BUILDING DEPARTMENT PRIOR'TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN ITH N1THE BUILDING. _rte f� S9 Date in Inspector " REV 4/05 Phone # i J FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 • -w COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive - Oroville, CA - (530) 538-7541W CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of 3* work is completed. If you have any questions pertaining to this matter, or need additionald explanation, please contact the Building Inspector as indicated below.10 : y� Fr I #.t Y' r� 2 _rte f� S9 Date in Inspector " REV 4/05 Phone # i J FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE >. OWNER _ PERMIT NO. t A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional X ation, please contact the Building Inspector as indicated below. Of IGHcL� /�G/t �cn ( . A Cr G Y, jY l r '1 V &.% c,,.lr-- A'4n,-\ - ""=- --f-,� ;,ra�� Date O (0 Inspector c REV 4/05 Phone # J FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 COUNTY OF BUTTE ' r BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive t.Oroville, CA• (530) 538-7541 ;. CORRECTION NOTICE "' OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. *r -IM r G K. Date U Inspector /4i 1 �� G REV 4/05 Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 x BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (5313) 538-7541 PERMIT NO. BP053079 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 12/05/2005 APN: 036-103-024-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. .• ' Site Address: 2574 V-6 RD ORO License Class : License Number: Map Index: Dale:. Contractor: Description: ADD COV PATIO(260) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 , Business and Professions Code: Any city or.county which requires a Owner: SIMONI, PETRU ETAL permit to construct, alter, improve, demolish, or repair any structure, prior to. its issuance, also requires the applicant for such permit to file a SIMONI, ANNA signed statement that he or she is licensed pursuant'to the provisions of 4844 V. E. AVE the Contractor's State License Law (Chapter 9 commencing with Section that he OROVILLE, CA. 95966 7000) of Division 3 of the Business and Professions:Code) or 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 the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure' is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: SIMONI, PETRU ETAL Code: The Contractors' State License Law does not apply to an SIMONI, ANNA owner of property who builds or improves. thereon, and who does such work himself or herself or through his or her own employees, 4844 V. E. AVE provided that such improvements are not intended or offered for OROVILLE, CA. 95966 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of. sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does . Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business a d Professions Code Date:Owner: License #: W RKERS' COMPENSATION DECLARATION -+Leraby affirm under penalty of perjury one of the following declarations: e 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 Architect: is issued. Engineer: ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number.are: Carrier Total Square Ft: 260 S.F. Policy M Valuation: $4,160.00 Census Code: .OSI 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section .3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This,permit ishereby issued under applicable provisions of the Butte County Code and/or -- I hereby affirm that there is a construction lending agency for the Reolutions do work indicate abo for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) By: Date: i Name:y�m C� �l/D� J>l PERMIT EXPIRES ON: / Addre Date O 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the.above mentioned property for inspection purposes. Print Name:- al z__ _2% �9�1�� Signature: Date4-).1 i /",g/ Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 Covered, Deck /%jTr BUTTE COUNTY o, o DEPARTMENT OF DEVELOPMENT SERVICES o o BUILDING PERMIT APPLICATION C) O AND SUBMITTAL REQUIREMENTS -- O 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 �0 OFFICE #: (530) 538-7541 CDU 4� A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY x ---,6-10 3 ®tel OWNER Last Name/An �First Name /VW_ Address 2S7-11, R 64 City LV'�J�q State Zip Phone Jt' 3 Gf �(� 4116 Fax E-mail CONTRACTOR Name �Lt- �% n0&/) t1l Address City State `; Zip ( / Phone' 3, S (�y Fax E-mail Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name CitySLp Address Zip q� f < City Fax State Zip Phone Book Fax E-mail Planner State License Number APPLICANT NAME Name n Addr ss ,L !� CitySLp State C; Zip q� f < Phone30 / � "G Fax E-mail APPLICANT SIGNATURE X g'w' j For office use only: Zoning Propre Ao Flood Zone Cross Street SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BP©5- ?O BIN # LOCATION AP# ^ 710-0,6 0 Propre Ao city2�� 0y9_<D 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: Sq. Footage ❑ 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. Received OVER FOR SUBMITTAL RtUUIKtMtN I s KAFORMSWILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Receipt #- ? Date: < <e_j Amount: Bldg G SRA Sheriff SMIP Total REV 6-16-04 SUBMITTAL REQUIREMENTS -The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK R idential, New, Remodels, Additions, and Accessory Structures: 1. 131 Plans, signed by the preparer. NO GRAPH PAPER! 2. 3 Com ete sets of plans, signed by the preparer. NO GRAPHPAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wetsignature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA .95965 Phone (530)538-7541 Fax (530)538-2140 PERNUT APPLICATION DATA SHEET Ll OWNER: 5>7 % oy / ASSESSOR PARCEL NUMBER -78 _ 3/0 -0 o D Proposed Building Use: � 6 V Permit Technician: Ce--7-Date: 16 -a"�_ Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. jA/ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Hazardous Material Form ❑ 12. Acknowledgement of building permit application without required clearances. ❑ 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) U1`114. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 15. Fire Sprinklers............................................................................................ ❑ 16. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... _\ 18. Erosion Control Plan Required........................................................................ (1] J 19. Fees as shown on the attached Schedule of Fees Due Sheet .............................. 20. City of Chico Plumbing permit........................................................................ ❑ 21. Site plan and business license approval from the City of 'ggs1................. 22. California Department of Forestry Ian approval aid. Sent q� / ��� 23. Planning approval for (A) Use: �B) Parking: (C) Parcel Check: ............ 24. Contact Land Development about _ Improvements, _ Drainage ........................' \ ❑ 25. Fire Marshall Review (commercial projects only). Sent by: ...................... N26. NPDES Form...................................................................................""".... ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... 29. Worker's Compensation Carrier and Policy Number .......................................... 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ . 31. Letter of Signature authorization........................................................... "".... . ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. Cl 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone h7V/v k s^s /- OL/VA and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. / Applicant: ,t9,,44-!, , �.� Date: G X-) 1. Index permit application for the above items numbered: Plan Chklktefter ' 2. Additional items required Contractor, designeyLlowneras advised of the above data by phone, ❑ mail, ❑ counter, by Date: Contractor, designer, caner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by:Date: Plans approved by: Date: ,--- Structural reviewed b . Date: Structural approved by- Date: Note transfer by: Date: Yellow: Building Division K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVtLLE,.CA 95965 PHONE (530)538-7541, FAX (530)538-2140 SCHEDULE.OF RECEIPT OF FEES Website: w".buttecounty.nettdds OWNER PROPROSED BUILDING USE P477 1. BUILDING PERMIT FEES -- Balance .................... --- FEMA Flood elevation review ... $ --- Additional plan checking Fee .... $ 2. SCHOOL DISTRICT FEES (paid at School Disti i' t ,Office) (form available after Plan Check) 4 S. 3. SHERIFF FEES (pai'Qi Building Division) Commercial (sq. ftg.).... $0.03 .= $ gk:�fg 4. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per dwelling) Zoning $ 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 8. SMIP 9. DRAINAGE FEE 10. OTHER I 11. OTHER i� i At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT 4 y2no_ t l DATE %/ — �[� — 05 Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 7/05) w.' A.P. # (? % B '–/� /D '-d 6 D DATE RECEIPT # DATE REC. Dep t f p u b t i cW o` r k s IN •1�:: �� s�H.�� ar els C o u n t y DEVELOPMENT DIVISION J. Mlchael.Crump. Director Storm Water Management Pro;rzrn y ® 7 C6un- Center Drive Orov lle. CA 95965 (530) 538-7266 . p�Uc WOF�S (FAA 538-7171 4 National Pollutant Discharge Elimination System (NPDES) Phase 11 Construction Storm. Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement TLESS THAN I ACRE P/-776 Project Description: • Gt,i / - N Project Location andlor Parcel Number: 0 3�-�n3 ^azy •. /va,-v o `7 e3 0-© 6 0 By signing below, I, the�project ownerlowner's agent, certify that this project WII�L 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 build -outs 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 Control 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 Controlother d for ora project. or other that disturbs one acre or more of land may result in revocation of grading er permits sanctions provided by law. Signed: 0- .Title:WL-'�-- Date: OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary., delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and material for construction of this proposed property improvement:S [ ] NO [ ]. 2. I HAVE [ ] HAVE NOT [ ] signed an application for a building permit for the proposed wo 3. I have contracted with the following person (firm) to provide the proposedconstruction:. NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. '1 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: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME . ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: DATE: NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. . This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Department of Development Services - Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX.... GUARDRAIL DETAIL HANDOUT Nailing shall comply with Table UBC 23 -II -B-1. Lumber shall be at least Douglas Fir #2 or better (D.F. #2).. Minimum concrete compressive strength shall be 2,500 psi at 28 days. (UBC 1922.2.4) Minimum underfloor clearances from finish grade to wood joists is 18'; (UBC 2306.3) and minimum 12" from the finish grade to wood girders or treated wood js required. No wood shall be placed closer than 6" to earth unless it is foundation grade or pressure treated. (UBC 2320.13) 4' Max. 4- ! Max. 36" Min. m v Top of SIDE VIEW 4• Max. Deck Min. 2x pressure treated ledger t Min. 2 — 3/8"X' 2•' lag bolts or screws. ITYPICAL LEDGER If the deck/porch is 30" Pier posts greater or greater above the than 3 feet in height finish grade a guardrail is need to be diagonally required. braced between posts, 4 - 16d nails or an approved post base connection If using precast piers, wet set precast pier into concrete footing Guardrail 1997 USC.xis Min. 4 x 4 post @ 5'- 0" o.c. Intermediate rails spacing shall prevent the passage of a 4" diameter sphere. Top of 3/4" cleararfce Joist to the edge of ---the wood member joist Min. 2 - 1/2" dia. thru bolts required. GUARDRAIL An approved post cap connection Girder •• or connect girder and post with IU 1/2" plywd gussett Post and 3 - 16d nails top & bottom T 6" Min. ------------ 12" x 12" Footing8" IMin. embedment W TYPICAL PIER FOOTING BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530)'891-2834 (CHICO) OFFICE M (536) 538-7541 PERMIT NO. •y BP053078 B. G. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 12/05/2005 APN: 036-103-024-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. 0— Site Address: 2574 V-6 RD ORO License Class : License Number: Map Index: Date: Contractor: Description: garage (720) OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or.county which requires a Owner: SIMONI; PETRU ETAL permit to construct, alter, improve, demolish, or repair any structure, prior SIMONI ANNA to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant*to the provisions of 4844 V. E. AVE the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE, CA 95966 7000) 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 the applicant to a civil penalty of not more than five hundred dollars ($500).): re]` I, as- owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure' is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: SIMONI, PETRU ETAL Code: The Contractors' State License Law does not apply to an SIMONI ANNA owner of property who builds or improves.'thereon, and who does such work himself or herself or through his or her own employees, 4844 V.E. AVE provided that such improvements are not intended or offered for OROVILLE, CA 95966 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of. sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s)licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the BusinessandProfessions Code 9- Date: 7 �1y`�� _swnec License #: WORKERS' COMPENSATION DECLARATION I 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 Architect: Labor Code, for the performance of the work for which this permit is issued. Engineer: ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number.are: Carrier: Total Square Ft: 720 S.F. Valuation: $17,280.00 Policy n: �� 0 I certify that in the performance of the work for which this permit is Census Code: 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r Date: Applicant: WARNING: Failure to secure workers' compensation coverage is t unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost �% /1rn��� d / t�e _/ /7 L5 compensation, damages as provided for in Section ,3706 of the Labor. code, interest, and attorney's fees. ^�J 6 Q. cY CONSTRUCTION LENDING AGENCY This permit is hereby issued under t e applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolution o do work indicated o e for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Date: A;2 57(1 Name: B PERMIT EXPIRES ON: �� �'C�(,/2 e Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. O Notification in accordance with Section 19827.5 of California Health & Safety Code Is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and stale laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the.above mentioned property for inspection purposes. ,) a n `"1 � Signature: d,2/0 Print Name: �i/(� f r��! , Dater ❑.Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. G. Building Permit 01-16-04 pg 1 Garage BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION PERMIT NO. BP05- �O7� BIN-B� "PLEASE PRINT CLEARLY" APPLICANT NAME OWNER NamefAE Last Name 1j"Al First Name Q ,/ Address State /1 City State e,R Zip f 6 Phone Lic. # Fax E-mail APPLICANT NAME CONTRACTOR NamefAE City e Address � 0 � �/ C �,ole— City 617� � Fax State Zip fS Phone �'3 �% �� Fax E-mail Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City e Address Zip City Fax State Zip Phone Lot # Fax E-mail State License Number APPLICANT NAME Name Ak 62 �!i Address City e State C Zip Phone Sib ' -- Fax E-mail APPLICANT SIGNATURE X ta- - For office use onl : Zoning — Flood Zone Cross SRA r Yes No Occ, I Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: LOCATION AP# 970 ProperPZ-5— � u ��� `Street City Cross 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: -7201 Sq. Footage ❑ 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. Received by - Receipt`( Q OVER FOR SUBMITTAL REQUIREMENTS 11 K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Dat; 16 'P� Amount: v / Bldg 9� SRA Sheriff SMIP Total REV 6-16-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BEACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: 1. 3 SitePla, signed by the preparer. NO GRAPHPAPER! ns 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER! OR a ngineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations.- ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. , ❑ 9. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ ' 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and cales in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -sinned by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KIFORMBUILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA .95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET �„r s 036 OWNER: ASSESSOR PARCEL NUMBER Lo) Proposed Building Use: 3 AAAAy 67""i Permit Technician: �C Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. A/ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ IN 3. Engineered. plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in >/ duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Hazardous Material Form ❑ 12. Acknowledgement of building permit application without required clearances. ❑ 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) LM-&10 14. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ - 15. Fire Sprinklers............................................................................................ ❑ 16. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... 18. Erosion Control Plan Required........................................................................ 19. Fees as shown on the attached Schedule of Fees Due Sheet .............................. 20. City of Chico Plumbing permit........................................................................ �\❑ 21. Site plan and business license approval from the City Oiggs'...............�.c. .-a S A 22. California Department of Forestry Ian approval-❑ paid. SeIritloy✓r ............. 23. Planning approval for (A) Use: �B) Parking: _(C) Parcel Check:............ 24. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 25. Fire Marshall Review (commercial projects only). Sent by: ...................... N26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone hw4 5-3 V-16 yq6 and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 1. Index permit application for the above items numbered: (,1 Plan Check Letter 2. Additional items required C Contractor, designe , owner as advised of the above data by Orphone, ❑ mail, ❑ counter, by Date: '�dJ Contractor, design r -was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: , Structural reviewed b . Date: Structural approved by' Date: Note transfer by: Date:*/ /Z Yellow: Building Division K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PRONE (530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds , (> 3 lv / 1, 3 2 PROPROSED B INC, USE 6i� e G� 1. BUILDING PERMIT FEES { -- Balance Due ..................... --- FEMA Flood elevation review...$ ---Additional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ RTH CHICO SPECIFIC PLAN (per dwelling) Zoning SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) A.P. # O %9 - 162 — DATE RECEIPT # DATE REC. t 7. WATER TENDER FEES BATTALION # r00.00 (paid at Building Division) .8.MIP / 7� b C:; 9. DRAINAGE FEE np 10. OTHER 11. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. / APPLICANT ��0- `%yril�-c. DATE Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 7/05) r ,:. �.. �, of Public mor s :l :� T t:, Department pb l i,A• •\ g t _ , t e kr -0 o u n t y o f U !� , /' 2 LAND DEVELOPMENT DIV ISIOt k '„a Michael Crump, Director ?� P 9 J. storm Water Management Pro;rzrn ® 7 C6un� Center Drive CO�`L / Orov lle. CA 95965 LJ Al (530) 538-7266 p�Uc WOF�S (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase ll Construction Storm Water Permit and Storm Water'Pollution Prevention Plan (SWP.PP) Acknowledgement [LESS. THAN 1 ACRE Project Description- 2 w4 6—./C) Y y �76 Project Location andlor Parcel Number: 2 7t/ v�G By signing below, L the project ownerlowner's 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 build -outs of less than one acre but when combined with subsequent phases total more on Storm Water Permit from the State of than one acre of disturbed soil will require a Constructi California Regional Water Quality Control 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 a project. - that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: Date: OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary. delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and material for construction of this proposed prope improvement: ] NO [ ]. 2. a� .] 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: NAME: _ ADDRESS: PHONE: CONTRACTOR'S 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: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: DATE: -tom NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX.... GUARDRAIL DETAIL HANDOUT Nailing shall comply with Table UBC 23 -II -B-1. Lumber shall be at least Douglas Fir #2 or better (D.F. #2).. Minimum concrete compressive strength shall be 2,500 psi at 28 days. (UBC 1922.2.4) Minimum underfloor clearances from finish grade to wood joists is 18'; (UBC 2306.3) and minimum 12" from the finish grade to wood girders or treated woad j.s required. No wood shall be placed closer than 6" to earth unless it is foundation grade or pressure treated. (UBC 2320.13) 4' Max. a- ' Max. I 36" Min. mLL11 U Top of SIDE VIEW 4' Max. Deck Min. 2x pressure treated ledger Min. 2 — 3/8" x ' lag bolts or screws. 4 - 16d nails or an approved post base connection If using precast piers, wet set precast pier into concrete footing Guardrail 1997 UBC.As Min. 4 x 4 post @ 5'- 0" o.c. Intermediate rails spacing shall prevent the. passage of a 4" diameter sphere. Top of 3/4" clearance Joist to the edge of 4a --the wood member joist Min. 2 - 1/2" dia. thru bolts reg6ired GUARDRAIL An approved post cap connection Girder or connect girder and post with 1/2" plywd gussett Post and 3 - 16d nails top &bottom T 6" Min. 12" x 12" Footing 1 8" Min. embedment TYPICAL PIER FOOTING W TYPICAL LEDGER If the deck/porch is 30" Pier posts greater or greater above the than 3 feet in height finish grade a guardrail is need to be diagonally required. braced between posts 4 - 16d nails or an approved post base connection If using precast piers, wet set precast pier into concrete footing Guardrail 1997 UBC.As Min. 4 x 4 post @ 5'- 0" o.c. Intermediate rails spacing shall prevent the. passage of a 4" diameter sphere. Top of 3/4" clearance Joist to the edge of 4a --the wood member joist Min. 2 - 1/2" dia. thru bolts reg6ired GUARDRAIL An approved post cap connection Girder or connect girder and post with 1/2" plywd gussett Post and 3 - 16d nails top &bottom T 6" Min. 12" x 12" Footing 1 8" Min. embedment TYPICAL PIER FOOTING W Page 1 of 1 Rutherford, Scott From: Schnurr, Curtis Sent: Friday, May 13, 2005 9:08 AM To: Rutherford, Scott Subject: refund for bp04O2687 Scott, I was told this refund was in your care. Client was in asking about the status. AP # 036-103-024 Curtis 05/19/2005 NOTES RESIDENTIAL PERMIT NO. �jCJ non cP,&U an(a 954 V -b 120 dQCLxi lQ R(2� 03OF&mp tI �-:QUa j JOB'FINALED (Date) Signature J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNK LO R (Plans) OK except #'s /I g -Setbacks -Easements -Flood -Slope 2 tg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /' Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel -Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation 14. / DateLAV_"__ Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s '-1-7�.-Water Htr.; Vent -Access -Combustion Air Baffle d,tt! ater Pipe; Test & Anchor -Nail Protection 1 . D.W.V.; Test Fittings & Anchor -Nail Protection "26 -Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date EL CTRICAL (Permit) OK except #'s Property Line Firewall & Openings 2,f. Fixture & Transformer Clearance -Ins. Protection Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits tairs; Width -Headroom -Rise -Run -Landing -Fire Protection 2 Elec. Receptacles Spacing -Lights & Switches at Doors Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Size Boxes & No. of Conductors Stapled iding-Nailing Veneer 2 Romex Installed Close to Edge of Studs & C.J. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access -Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Glazing Area -Glass Protection -Skylights -Plastic --29-2 Appliance Circuits in Kitchen & Conductor Size GFI Sh Walls; Nailin -Bolts --30-.-Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al Xrace Interio xterior ne _'U Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral ❑ Yes ❑ No Insulation -Walls -Ceilings 2. Service -Riser Conductors & Ground Main Disconnect Infiltration -Walls -Windows X33- Equip. Clearances Panels-Motors-Mech. Equip. Card B-1 Date Card B-1 73�lothes Closet Light -Shower Light -Spa Light B-1 Date Card B-1 Smoke Detector , Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 81. 3 . A.C. Ducts Insulation & Support 82. 3 /4ent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade _ 83. 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 88. 4Vills Proper Materials & Anchors 89. alls Studs -Nailing Spacing & Braces -Plates -Sound 90. 43 Bearing Walls over Girders & Floor Nailing 91. 4. Draft Stop in Walls (rat proof) Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 93. 46_.bleaders & Beams -Size & Bearing Date FRAMING (Continued) 4 an ers-Post Caps -Anchors -Connectors X. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. r�place Ties or Type A Flue -Fireplace Throat Clearance Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles y 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions '-68r age Fire Protection Framing -RC Channel . Property Line Firewall & Openings 4 Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits tairs; Width -Headroom -Rise -Run -Landing -Fire Protection 6 Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. iding-Nailing Veneer 68. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 69. Glazing Area -Glass Protection -Skylights -Plastic 70. Sh Walls; Nailin -Bolts 61. Xrace Interio xterior ne . Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date iCard B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes _ 83. llowing Instl ./Drive ❑ Yes ❑ No/Walks ❑ Yes ❑ No/Planters ❑ Yes ❑ No . Stucco wn-Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. brrections from Previous Inspections Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date L j p j Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: J=OK 0 Not OK NotNoApplic Readyable DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L 'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector - 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 7*' BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.neAdds PERMIT NO. BP043067 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 10/20/2004 APN• 036-103-024-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 2574 V-6 RD ORO Date: Contractor. Ma p Index: Description: RE ROOF COMP 14 SQUARES OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: PETRO SIMONI permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a ANA SIMONI signed statement that he or she is licensed pursuant to the provisions of, i/Oiif� "T"O `f` the Contractor's State License Law (Chapter 9 commencing with Section r V C� 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA. 95966 she is exempt therefrom and the basis for the alleged exemption. Any 530-5348446 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: PETRU SIMONI Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ lam Exempt under Article 3 of the Business and Professions Code Date: Owner: `'(' License #: WORKERS' COMPENSATION DECLARATION I 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 Architect: is issued. Engineer: ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier. Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: Policy a: 9"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 the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: p /I l Z Dl r)!� Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages s provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) This permit is hereby issued under the applicable provisions of the Butte County Cods anrvor Resolutions toF0116rk indicated above for whichfeeshave been paid. Q 'v Name: By: Date: ' -- `C7 Address: PERMIT EXPIRES N Date - ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name:/J�f'`/ / y/// e:1 ?4 ` Signature: Date: N16wner ❑ Contractor ❑ Agent for Owner 13 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" OWNER Last Name f irst Name �O Address 2 S b'l 6 City � 1C - LO State C, Zip q S Phones _ Fax E-mail APPLICANT NAME ARCHITECT/ENGINEER CONTRACTOR Name P7 r Sb iM 6?wI Addressog (( �/&" 91 L/ i City^47 le Lot # State Zip -Phon State License Number fa E-mail Uc. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City �Q7"l(p Address Zip / `S City LFta State Zip Phone Lot # Fax E-mail Date Approved: State License Number APPLICANT NAME Name lI n/// �b �702 �1� Address #16 City �Q7"l(p e, j9 Zip / `S Phone 3 H y( S LFta E-mail APPLICANT SIGNATURE X GP u For office use onl : o� Zoning Flood Zone SRA I Yes_ I No Occ. SRA Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: LOCATION PERMIT NO. BP O L/3 BIN # Ar* /moi /` . v^ -(p Property Address ZS% 6' H6 -el 1 City p,2o V/ 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 1-ivanro Description or Scope of Work: Sq. Footage ❑ 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. OVER FOR SUBMITTAL REQUIREMENTS L K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Date: /©/26/(Jr Other Total REV 7-27-04 o� Received by: Amount: Bldg SRA Receipt #: LlI o3Z Sheriff SMTP OVER FOR SUBMITTAL REQUIREMENTS L K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Date: /©/26/(Jr Other Total REV 7-27-04 a; SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INIC ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxesl ❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and talcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). 3._Sanitationand- ite plan-apptovaLfrom_the-EavlronmentaLHealth_Depadment. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 I BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION "PLEASE PRINT CLEARLY" APPLICANT SIGNATURE X WW19 For office use only: OWNER Last Name a irst Name �O Address Z 5 6' City 6919 / Zip StateC, Zp 5 Phones 6 Fax E-mail State License Number APPLICANT SIGNATURE X WW19 For office use only: CONTRACTOR Name n a Addressid q q �� 9b4& City,ph� ltv State ( e Zip —PhonS a E-mail Lic. # Class APPLICANT SIGNATURE X WW19 For office use only: ARCHITECT/ENGINEER Name Flood Zone SRA Yes No Address city P46 9 City State C, State Zip Phone Fax Fax E-mail Date Approved: State License Number APPLICANT SIGNATURE X WW19 For office use only: APPLICANT NAME Name Flood Zone SRA Yes No Addresls/�j,, city P46 9 Type Const. State C, Zip ��`S Phone,J -2 Page Fax E-mail APPLICANT SIGNATURE X WW19 For office use only: Zoning Flood Zone SRA Yes No Occ, Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: LOCATION PERMIT NO. BP O qW BIN # AP# U oalk Property Address ZS% 6') �o City Cross I LENDING AGENCY I Address Description or Scope of Work: t Sq. Footage ❑ 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. OVER FOR SUBMITTAL KEQUI,KLMLN I s K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Received by: Amount: ori Bldg SRA Receipt M. Sheriff '11 � oz SMIP Other Date: /C/)p (J, l V Total REV 7-27-04 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 PERMIT NO. BP043066 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 12/08/2004 APN• 036-103-024-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 2574 V-6 RD ORO Date: Contractor. Map Index: Description: ADD(624)COV(96)REMODEL(720) OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: SIMONI PETRO ETAL, ANNA SIMONI 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 pursuant to the provisions of 4484 V E AVE the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA. she is exempt therefrom and the basis for the alleged exemption. Any 95966 violation of Section 7031.5 by any applicant for a permit subjects the 530-534-8446 applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: SIMONI PETRO ETAL, ANNA SIMONI owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: O 1 am Exempt under Article 3 of the Business and Professions Code a��T L g:,1 Dat Owner: t W RKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for License #: workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. O I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Total Square Ft: 720 S. F. Policy #. 0 1 certify that in the performance of the work for which this permit is Valuation: $42,096.00 issued. I shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall .3 forthwith comply with those provisions. ���/// i v Date72 r d,0,0— -� r .� i0 Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of IrI2 0 compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit' hereb issue the plicabl provisions of the Butte County Cody ?nrUor I hereby affirm that there is a construction lending agency for the of the work for which this permit is issued (Sec 3097 Civ.) Resoluti s to do o is d abo for wh' fees have been paid. ! performance By: Date: Name: L Z r-- ® — Address: PER EXPIRES ON: U Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official forth or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Signature: Print Name: a ./ )q o 'y Signature: Date: 4 /2-112 / ,0 1A ,ZlOwner O Contractor ❑ Agent for Owner 13 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CIECO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REO UIRED AT TIME OFAPPLICATION "PLEASE PRINT CLEARLY" C✓� . /► Last Name rl `1y ust Name q . 1 Address '' � r' Address City State: Zip "S 6'E Phone. D r 6 Fax E -mal CONTRACTOR Name. � 1% to L'�/ Address C�_ City - Phone V StateL, i7' Zip jq 14. PhoneS3 _ 6 Fax E-mail Date Approved: Luc. # Class M ARCHITECTIENGINfER me lAddress., Gtr - City -1,5_1V StateP (•, Zp d� 5 C/ � Phone V Fax E-mail State License Number APPLICANT NAME Name h17111 Address 4( City Stated �,? 7 zip Phone — 9 ' Fax E-mail APPLICANT SIGNATURE X L22 f", rf N-"wf or office use onlyoning F.7 AP# ©34. 4 Property Add res � / (� Flood Zone Cross Street SRA rY!!A No WORKER'S COMPENSATION Type Const. Subdlvision Name Map Book Page Lot # Planner Date Approved: nAf=D CnD QII0II111TTA1 C?Pf1111PP: PMT_ PERMIT NO. BP oy6G LOCATION AP# ©34. 4 Property Add res � / (� City Cross Street WORKER'S COMPENSATION Policy Number Carrier ff hiring anyone other fhan license contractors, a certificate of worker's compensation must be shown at the time ofpermft issuance. LENDING AGENCY Name Address Description or Scope of Work: r� O -n m>,1�6z� 60- 11(96 kezvl�c7 Sq. Footage ❑ 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 IReceived by. Avfi Amount 14 10 - -5 / Bldg I 2/9 L/ $ SRA Receipt #: q / o I Shedff . I SMIP �O Other Date: /� /2_6/Total 5) 0 "i?i.RST'`.�-�.a;%.;;.Ys�+'3'.+,K';.:�="-.�':..,�"_.-`��-�;..r;?.'�,��--:a=��..�.-'�t--;'^:;._::,..��--,::_-..a.`L-.•-`�*,�.'+-T:,.�..:. �. �..._,-.1----;.�w..r�;r-•.�:;�,_✓�4_v COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET AA , OWNER: %/t _S/m &,(\/ I ASSESSOR PARCEL NUMBER Proposed Building Use:T1O_'i"l Oji A&7MMZ-�ounter Technician: (^ Date. Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. t�)�, 1. Site plans, 3 or 4 sets, signed by the preparer of the plans.. ' `",_/ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. 6. Energy compliance design and supporting documentation in duplicate. I �❑� 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form )'ACK 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. S L-S� ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan. review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... 20. Erosion Control Plan Required........................................................................ ........ 21_. es as shown on the attached Schedule of Fees Due Sheet .............................. / y of Chico Plumbing permit........................................................... j� 23. California Department of Fore try plan approval paid. Sent by: i1°..,�J 24. Planning approval (A) Use: �(B)Parking: (C) Parcel Check:_ t - Z -o_ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... 1�❑� 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization .................................. :.................................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ ,F4, 34. Manufactured home utility clearance............................................................... ❑ -35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction ........................ :................................................................ ❑ 37. ❑ Grant Deed, ❑ M.H. TitlelStatement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone -and' m -hold for pickup. "> > a o �r99r� ©7G 7 I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date. 1. Index permit application for the abo ' e s numbered: . n Plan Check Letter l �2. Additional items required X ' ��y� ontractor, designer, owner, was dvised of the above data by phone, ❑ mail, ❑ counter, Date: t ontractor, designer, ownerr/�w�af advised of the abov da a b ❑ phone, ❑ mail, ❑ cou ter by Date: Plans reviewed by: V3 Date: Plans approved by: Date : ? Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division (One form per Building) BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM School District CA)( Building Department No. A.P. Number U�o r) Jurisdiction: jCounty • Property Owner Property Location/Address Subdivision Lot No ........... oe . .......................................................................... Residential Development [ Sq. Footage No of Living Mobile Home Supp lemental to (Group R) Units Installation Conversion Permit # *(No foundation Inspection) .......................... . .............................. . ........... t ............... ..... Commercial/Industrial Building Department District Identification No. LMW KuSulumu Sq. rootage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Sq. Footage Now Addition (including Exterior `Roofed Areas) nom:. P�� r �� five Date 64%w _t le -e rn School District certifies that (Applicant) V G (Street Address) / (Phone Number) (City) (State) (Zip Code) I has complied with the requirements of Resolution No. representing School District 6 X* —square feet. by payment of $ 2926 $ FULL N - 4 - Paid by Check # Remarks: O'S Aa li. 0 3 n „L4 Date Notice: You may protest the Imposition of the fen IdenOW above by submitting a written protest to the District. In compliance with Government Code Soctlon 66020(a). within 90 days from the date fees are Oald. Failure to submit a timely written protest vAll'prohibit you from challenging the Imposition of the fen In any court action, N. subsequent to the School District Representative signing this - Butte County Schools Impact Fee Certiftation Form the School. Dls.bict Is nottilled by the applicable Local Planning Agency that this project Is being reviewed under the California Environmental Quality Act (CECft this project may be subject to additional school fen to fully mitigate. Its Impact on the school districrt schools. White (applicant), Yellow (building department), Pink (school district.) feeform.)ds 0 0/03ldmm COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER liwpr ,S /�'L.B�n/ �� A.P. # 4 3G ` /0 2 `� PROPROSED BUILDING USE hV- Q1 JP&v-1 DATE 161 2=016 L/ RECEIPT # DATE REC. 1. BUILDING PERMIT FEES --- Balance Due ..................... $ f2. --- Additional Fees Due........... $ Y__ � Revised Plan Checking Fee....SCHOOL DISTRICT FEES V� Lmlpaid at School District Office) (form available after Plan Check) PD''�'��'� 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ . Sq. Ftg. Amt. 5. RECREATION DISTRICT FEES + (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) 8. WATER TENDER FEES BATTALION # $200.00 (paid. at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... ' X = $ Sq. Ftg. Amt. 10. OTHER tt"07 At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT_DATEp 1212 Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the projector from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant , Pink -Owner (rev. 2/2003) 16, Butte County Department of Development Services YVONNE CHRISTOPHER, DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538.7601 Telephone (530) 538.7785 Facsimile ADMINISTRATION * BUILDING * GIS * PLANNING November 24, 2004 k Ana Simoni 4844 VE Avenue Oroville, CA 95966 Subject: Building Permit 04-3066, Addition and Remodel. Dear Mrs. Simon: The Butte County Department of Development Services, Planning Department, has reviewed the submitted Building Permit Application, and has found your application in compliance with the established planning criteria. .The site plan you submitted meets the setback requirements for your zone as well as applicable map or use permit conditions. The Permit Application has now been returned to their department, for consideration and action. .If attached, Please find a copy of any use permits, map notes and conditions for you property. We are providing this. for you information and future reference. Should you have any questions please feel free to contact me between the hours of 8:00 a.m. and 4:00 p.m. Monday through Friday at (530) 538-7603. Sinc r Y, J� Chris Tolley Assistant Planner Depart,ment of .P�'ublic Works o C o u n t ,y 0 Butte C LAND DEVELOPMENT DIVISION J. Michael Crump, DirectOr Storm Water Management Program O 7 County Center Drive -� Oroville. CA 95965 rig s (530) 538-7266 wpp`� M (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 7 ACR Project Description: Project Location and/or Parcel Number: O BY signing below, I, the project owner/owner's 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. I am aware that submitting false and/or inaccurate information or failure to apply for nd fo strict project Storm Water Permit from the State -of California Regional Water Quality Control Bo P ] that disturbs one acre of more of land may result in„revocation. of grading and/or other permits or other sanctions provided by, law. Signed: Title: Date: Less than' 1 Acre NPDES & SWPPP Compliance Certification .....__ vt-.� 1.Re..enmmP.nt PmPrayn Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to -avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. r 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement :4] 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: ' NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4_ I plan to provide portions of this work, but I have hired the following'person to coordinate, supervise, and provide the major work: NAME: ADDRESS: • CITY: PHONE: CONTRACTOR'S LICENSE NO. 5_ I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE .TYPE OF WORK SIGNED: PROPERTY OWNER:�.� SOCIAL SECURITY NUMBER: DATE: NOTE: This owner -Builder Verification is, required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit.. May 1995 2.26 Dear Property Owner: An application for a building permit has' been submitted in your name listing yourself as the builder of property improvements specified For your protection, you should be aware that as "owner -builder" you are the responsible party 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: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for -the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. 0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned Vie* C.B.O. Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. May 1995 2.27 OROVILLE-WYANDOTTE IRRIGATION DISTRICT 2310 Oro: Quincy Hwy. • P.O. Box 581 Oroville, CA 95965 • (53 533- 78 (v5492 ACCOUNTNAME,f-t /7 J)' / ", DATE F 3 O ADDRESS T V'- NAME Gtr V 1� CUSTOMER 1D. CITY rd 1/I ��P S ZIP '6.� ADDRESS `T�� T -5 4Cl PHONE JOB DESCRIPTION , �; CITY coq q6 91 6 STATE ZIP LOCATIONLl PROPERTY DESCRIPTION' ` M DISTRICT ACREAGE NO. OF DWELLINGS SERVED A/PNUMBER WORK REQUIRED YES O NO / 3� —/d. 3 y., EQUIPMENT USED LABOR / ITEM HOURS RATE TOTAL NAME HOURS RATE TOTALS METER LOCKED Y O N O BACKFLOW REQUIRED Y N O ' ; (IF YES, IS INSTALLATION DEVICE COMPLETED) Y O - (IF NO, DO NOT TURN ON WATER) PERSON CONTACTED IN BACKFLOW DEPT. SUB -TOTAL r ` PLUS OVERHEAD UMTS MATERIAL USED EACH TOTAL E UtPMENTTOTAL LABOR TOTAL METER NO. ,.,: Utility Billing Account History List User: lynne Printed: 10/08/2004 - 9:21 AM South Feather Water & Power_ Account Number: 011978 000 Reference Number: Billing_Cycle 3 Customer Name: Simoni, Anna Owner Name: Simoni, Anna Account Status: Active Customer Address: 4844 V -E Rd Service Address: 2574 V-6 Rd Connect Date: 08/03/2004 Oroville, CA 95966 _� , �,��� Home Phone: (530) 534-8446 Ext /�' (� Total Balance Due: 0.00 Business Phone: ( ) - Ext Route Number: 18 Sequence Number:. 001942 �� 9 Serial Number: 923105b >'f 1-11% "7&,P- 4���1G Date Type Amount Description Water BF BN DomCommunit Irrig Tax Penalty Sp Chg I Read Dt Reads Cons 108/03/2004 0 0 Total Balance Due: 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 UB - Account History List (10/08/2004 - 9:21 AM) Page 1 PF County of Butte Oroville, California GENERAL CLAIM CLAIMANT: Ana Simonl ADDRESS: q.ggq /E Avenue CITY & STATE: Oroville, CA 95966 nATF OF CI AIM- nA/17/n5 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Refund Claim - See attached calculation sheet APN: 036-103-024 Perm it,W;7 0�7 PAID RETAINED REFUND Development Services $ 714.87 $ 450.92 $ 263.95 SRA $ - $ - $ - Sheriff $ _ $ _ $ Other: $ $ _ $ TOTAL $ 714.87 $ 450.92 $ 263.95 ............................................... ............. ............................................... ............. ..................... . . .' ' ................................................ ................................................ R)f A3£ OWtV ............... ............... .............. .............................. .............. .............................. :ACCOUNT::::AM0UN-T- ............... ............... -::: . Development Services 440-001 4210500 $ 263.95 SRA 0100 4617240 $ - Sheriff 280 1011811 $ Other $ - TOTAL I I $ 263.951$ 263.95 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. Dated this day of 2005, at Calif.4. �%%� 7l9mo^�[ Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Check on the same. Dated this day of ; 2605, at Oroville Ca Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE RFI OW THIS I INF - AI InlTnR'S I ISF nNl Y DEPT & SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT. o�uTrFo Butte County Department of Development Services o O . o _ o www.buttecounty.netldds o�._ o o o 7 County Center Drive cOUN'�y oroville, CA 95965 (530) 538.7601 Telephone (530) 538.7785 Facsimile ADMINISTRATION * BUILDING * PLANNING 8/23/2005 Ana Simoni » 4844 VE Avenue Orovi.11e, CA 95966 RE: Permit No. 04-2687 APN#036-103-024. Owner: same On. 9/13/2004 a deposit was made in the amount' of $714.87, of which $450.92 was retained. The remaining fees will be reimbursed to you. Please sign, date, and return the enclosed claim form to ithis office. Once we receive the claim form, we will then process your refund in the amount of $263.95. `Should you have -any questions, please contact this'office Monday through Friday, 8:00 a.m. to 4:00 p.m., at 538-7601. Sincerely, Diane Lewellen Senior Account Clerk Administrative Division, enclosure 04-2687.1tr' l • r c�UTrFo Butte County Department of Development Services Building Division j O - V. O 7 County Center Drive 0- t4 ty Oroville, CA 95965 (530)'538-7541., REFUND REQUEST•APPLICATION REFUND POLICY - Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the fees, whose name is on the receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt. 2. The request must be made within two years from the date of fee payments on permits not issued, and two years from the date of permit issuance for permits issued -if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees paid to other County De artnients are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the receipt) and return to Development Services for payment processing. CLAIMANT'S NAME: ' r MAILING ADDRESS: PHONE: (3D)lL ASSESSOR'S PARCEL NO.: .: - :b , - a ✓ - [Please use one claim form per permit.) BLDG PERMIT NO.: U' RECEIPT NO.: Receipt No. 1 I Peceipt No. 2 Receipt No. 3 35 Signature K:/Forms/Refund Application 082203 t Date 7 REFUND CALCULATION SHEET CLAIMANT: Ana Simoni _ ADDRESS: 4866 VE Ave l.. CITY a STATE: Oroville, CA 95966 DATE OF CLAIM: -11/09/04 APN: 036-103-024 RECEIPT INFORMATION, NUMBER: 412516 • - - DATE: 09/132004 •' , ISSUED TO: Ana SimoN CHECK#: , y - AMOUNT: $714.87 • ., PERMIT #: 04-2687 ` Yes No Yea" *No Yea No PRIOR REFUNDS: •X L - 0 FEES VERIFIED X •- _ 4 REFUND BREAKDOWN - Title::::::iecooE::E:::rxani:lidiia .................................................................................... ii'AUD:SUSPii NER:GEY.103:. tfdNTilt1RH0E' ' '. Fund::::::: ' 00'10::.:.: ...... iiii.180 .... 800:::::::0:.. :az:jp'tii`i 00..::::.: i'iii-jI j.... r ;- r� De t:::::qq': P wli:::::::: ..... Oc0.0...... HRMiQRN.ii;(SMIP):ii i::fSHR}?i?'r'i•r''!?i?? . . X Accor : :::: a , " Cesh ::::::101001::::::::101:1822::::::4:: DETAILI PAID RETAIN REFUND :<o....... ;<::..... >><<<r`asr>€€€€»»»»>»><>><»>»>:>:>:<:::::<;>:<>>><:>>:>>::::>:>>::::>: e..10H. .......... F. . ..... ......... ......... ......... ......... ......................................................................... ....................................................... ................................................ r �. • FiG .... r..m PYari ......:::::::::::::: ro Check ...............0:00 .............. - 0.00::::::::::::::0.00 ....:.....::>:>:>::>:::::>:>s ii;i::3p:;;??ii%:i?:y<:;.;.;??:;.;???r:ii :::::0::<>:>:>:>: a:0:a:0:0:0:0:0: ' PlanCheck/Filin .::::: .0.25 27;50 .285.95 285.95 000 .::::::::::::0.00 ..........:.:.:...............:.......:.:.....:....::.::......... ,r Ins cticn ::::::::::::0:00 - 428.92 109.98111 318.94 8.94 ::: X::X-X-:z:: X X-:-x ::::i:.::i L ..F. ............................................................................................................................................... ................................................................. ................................. r Dc::::>::::>::::>::::>::>::>::::>::::>::>::>:::<:>:«:>::>::::>:<:;::::>::;:::<:>:::««:>:<z<z:;:::::::<2i::::>:::i:::>.::ii:<::<::::::::::i::i::::i::::i:::: >3 .HeR sL >::i::::>::::i::::><':«::><:::::> ................................. { i::i:::z:>:`::i::ii::>:::i::::::i::>::::i::::i::::is:::::::::i::::i::::i::::i::::i: 0.000.00>:><:?:>:: »:>'::>:::>'::>:::>::::>:::>:::>:>:: REFUNDPROCESS: FEE:::::::::::::::: 54:99 - 54.99 '-54.99 ::: i:::: =54.99 :3i: E3 i3 ................................................................. ................................................................. ................................................................. 6tJ([ �I►JG>7 kf�1i < ................................................................... .. 82 : :..,... >9 > ? ? ? : 5 .. . x td 8 ......... 263...x ............................................................................... > > .''• < a i > > :s J:HERM DRNG. ........ ............................................. .... ....._ _ 0.001 ..... w. O:Oo l ...........................<,:;.<: .. SMIB:......::::::::i:::: .........................................................................................................0,00 >:'>>::>;;::%::%>`i:<:i:::::i::;:;::;isi::::::::<::::::<::::i::i::i::i::i:............i:....:::i::is::i::i:::<:i::i::i::i::i::;:i>: ............................................:.:0.00 >:>:':::>::' > > > ::.:::::::::::::.::::.:::.::::. : ................ SFif ::: c::::ii::3:::3::is sis :3:::::i::::i;::::::i::;::;i: ii i:::::;::ii: :',';::;:::...... :i::`:::::::`O:bb ::i::::fi:: G:i :3:isi:::i: :< : :>: :: ::?:i#ii:33�:2<ii#:`•i#:`•5 3iii::ii:`•:'•iiiiiiiiiiii iiiiiiii`•i`•i`•:i'i':'•:<':'• ::;:i;i;ii;i;:::>..'::isi::::ii::ii::ii::ii::<33i3i`3i`:3iiiiiiiiii:%i 9QA................................................................................. i00. ' $ 714.87 $ 450.92 $ 263.95;$«<.;:< .;:;.;:.:.: ^i ii ::::::::::::: •: :::::::.:::::: 'c• APPROVAL • CHECK: $263.95 : Date Reviewed • 08/172005 DIFFERENCE: - • /%.Q - (Should be blank) � -Michaelna ng Manager ' BuildiMa � , _ . •• '. NOTES RESIDENTIAL PERMIT NO.� Arm a5 v- U SPECIAL. CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOS FINALED (Date) Signature Z tr I J=OK 0= Not OK - = Not Applicable . = Not Ready Date FRAMING (Continued) _ RESIDENTIAL Date UNDE OOR (Plans) OK except #'s Cling. Joist-Rftr. Ties-Purlin-Roll Bract-Truss-Shting.-Rtng. 1 o ' g-Setba s -Easements -F d -Slope, KA Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles tg., Main oils-Elec. Gr q /" Ftg. Depth . rn .-Ftg. Depth orches & Decks; Soils -Steel-/ /" Ftg. Depth Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions fro-Stemwalls, Main; Steel-Blockouts-Wrapped 53. 6. - Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 1 6a. Hold Downs and Special Anchors 56. 7. Slab, Steel -Wrapped, Siding -Nailing Veneer { 8. Piers -Fireplace Ftg.-Steel Glazing Area -Glass Protection -Skylights -Plastic 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 61. 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test Insulation -Walls -Ceilings 11. Water Pipe; Test-Anchors-Regulator-Seryice Test Date 12. Electric Underground Card B-1 Date Card B-1 , 13. Plenums & Ducts; Clearance -Material -Support -Ins. Ext. Steps -Door & Sidelight Protection -Landings ' 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies _ 66. 15. Access & Ventilation Bedroom Exiting 16. Insulation 69. Elec. Trim & Subpanel, Breaker Sizes &Labels - 70. Date _ 71. Card B-1 Date Card B-1 Date Card B-1 'Date Card B-1 Date PLUMBING (Permit) OK except #'s 74. 17. Water Htr.; Vent -Access -Combustion Air Baffle. Garage Fire Door; Swing -Landing -Closure 18. Water Pipe; Test & Anchor -Nail Protection _ 77. 19. D.W.V.; Test Fittings &'Anchor -Nail Protection' Plb.; Elec. & Mech. Equip. Listed for Location 20, Shower Pan; Test, First Floor -Tub Access Elec. Receptacles in Garage (F.F.I.)-Romex Protection 21. Test Tub & Shower, Second Floor -Tub Access 81. 22. Gas Pipe; Sixe & Anchors - Fdn. VBents & Crawl Hole Door Drainage &Wood -Earth 23. Fire Sprinkler; Test _ 83. Following Instld./Drive O Yes O No/Walks O Yes O No/Planters Cl Yes O No 84. Date 85. Card B-1 Date Card B-1 Date Card B-1 Date . Card B-1 Date ELECTRICAL (Permit) OK except #'s 88. 24. Fixture & Transformer Clearance -Ins. Protection Ventilation Throughout House 25. Elec. Receptacles Spacing -Lights & Switches at Doors 91. 26. Size Boxes & No. of Conductors Stapled Gas Test -Meters Tagged, Gas -Electric 27. Romex Installed Close to Edge of Studs & C.J. 94. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Address Posted 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI Date 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al Card B-1 Date Card B-1 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes O No Comments at Final: 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C: Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing t 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs' 46. Headers & Beams -Size & Bearing ff Tingle & Duplex) 's ��'' • ' - Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors - 48. Cling. Joist-Rftr. Ties-Purlin-Roll Bract-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 1 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer { :58.. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access s:! - 59. Glazing Area -Glass Protection -Skylights -Plastic 60. y Shear Walls; Nailing-Bolts1 61. Brace Interior/Exterior Wall Panels, f. 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows , Date Card B-1 Date Carld B-1 _ Date Card B-1 Date Card B-1 , Date FINAL (Plans) OK except #'s % 64. Ext. Steps -Door & Sidelight Protection -Landings ' 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes &Labels - 70. Stairs & Rails' _ 71. Fireplace or Stove, Clearance -Hearth: 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper -. _ 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.. _. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps , 82. Fdn. VBents & Crawl Hole Door Drainage &Wood -Earth . Clearance Looked under Floor -O Yes _ _ 83. Following Instld./Drive O Yes O No/Walks O Yes O No/Planters Cl Yes O No 84. Stucco Brown -Finish 85. -A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: = OK = Not OK = NotReadyable MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test-Wrap;-/ /" L'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance Card B-1 Date Card B-1 Date Dette Card B-1 Date Card B-1 Daft: Card B-1 Date Card B-1 Date' . MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 3 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10: Exits; Insp.-Sketch 11. Cert. of Occupancy Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s Card B-1 Date Card B-1 Date Cad B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 1. Zoning Requirements -Setbacks -Easements 5. 2. Footings; Size -Spacing -Marriage Line 6. 3. Blocking 7. Electric 4. Gas; MH Test -Demand -Valve Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 5. Electricity; MH Test 10. 6. Water; MH Test 11. Ext.; Steps -Doors -Landings 7. Water and Sewer Connected Braced Wall Panels B. Gas and Electricity Tagged Date 9. Exits Card B-1 Date Card B-1 10. License Decals 1. 11. Verify #'s with Office 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining Date 4. Card B-1 Date Card B-1 Date Elec.; Pool Lighting; 15 Volts-GFI Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes -Enclosures- Panel boards- Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 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 PERMIT NO. BP042687 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 09/13/2004 APN: 036-103-024-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 2574 V-6 RD ORO Date: Contractor. Ma p Index: Description: REROOF, ELE & SHEETROCK OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: SIMONI, ANA &PETRU permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a CICEU, MARIA & ION signed statement that he or she is licensed pursuant to the provisions of 4484 VE AVE the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or . OROVILLE, CA 95966 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5011 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: SIMONI, ANA & PETRU Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). [Date: ❑ 1 am Exempt under Article 3 of the Business and Professions Code Owner: License #: 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 Architect: is issued. Engineer: ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier. Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 Census Code: 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' compensation provisions of Section 3700 of the Labor Code, Ishall forthwith comply with those provisions. Date: fi l 0 �l W Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY' This permit is hereby issued under the agplicable provisions of the Bette County oda rUOr <Lhereby affirm that there is aconstruction Jending agency for the �. Resolutio _ ., do wprk indZ�w h fees have been paid. _ performance of the work for which this permit is issued (Sec 3097 Civ.) /j Name: By: Date: vv Address: PE IT EXPIRES ON: e ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of utte County to enter upon the above mentioned property for inspection purposes. 0 Print Name:ju/ % Signature:�v Date: *6�ner 13 Contractor ❑ Agent for Owner ❑ Agent for Contractor O.B.-1 OWNER EUILDER VERIFICATION Attention Property Owner. An "owner -builder' building pemut has been applied for in your name and bean -pour signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing anal issuing your building permit No building permit will be issued until this verification is received. Cl. I personally plan to provide the major labor and materials for constriction of the proposed- property improvement : 0❑ NO ❑ 2. I HAVE ❑ HAVE NOT 0 si ed an lication fo a gn app r building permit for the proposed wo& I have cont=acted with th " following p� n (firm) to provide the proposed construction: ADDRESS:G��/ �/ ���� CITY: PHONE: Gf.-. ( G CON'TRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have bired the following person.to coordinate, supervise, and provide the major worms NAME: ADDRESS: CTTYc CONTRACTOR'S LICENSE NO. IIl pride som$ ofherbuI-liave�oncted-eotiflwg �er�ons #s�rovidv the work indicated: '' ADDRESS, '> •,r TYPE, OF WORK SIGNED: . , s E • tL• D / i, / �✓ NOTA: This Owner Builder Verykadon is required by Section 11831 and 19832 of the California Health and Safety. Code. TTiis varication must be completed and returned to°our of ice before we are permitted to issue the verndt. O RBUILDERINFORMAT1r®N Dear Property Owner. wpmAn appli=diOR for a buff ft Pemait has been, submitted in your name listing yourself as the bmlder of property vemenfs Foryourprotea' you should be aware that as-owner-bufldee you aro the respaasible per, ofrecord on such a PewBuilding p=2h are not requ$ed to be sfgned by ProPMY owners unless they are personally perfo own work: If your work is being permed by someone other than untag their liability if that person applies for the Y°u�e , You may Protect Yourself from. possible ProP� permit is his or her name. yrs am wed by law to be licensed and bonded by the Stale of Califaiaia and to have a business cense from the city or counfp. They are also bylaw to put their license mmiber on all permits for which they Ifyou plan to be aware of the � o your oa for � the mon of various trades that You plan to subcontzart; you should Yom benefit and protection: a Ifyon employ or otherwise engagn my and other costs) is $300 or Perste other "an your fi=Ddiate family, and the work (mclu ling maieials more for the entre pmjeCt. and such persons are not licensed as contractors or lb 1 acbars, then You may be an Moyer. ♦ If you are an employer, You nmst register wi8i. the State and Federal Go subject to several ob V as as employer and yon are moons �dmg state and federal � OII AMY ms�aaace cos S, -Md tac withh oldia, federal social sectiIIty ; and uneiBployment .. � ♦ � �' bei W �� � 3� if you do not cry old'�e �biiga#ioas, and tiesen'sks Y serous sale, . ♦ For more specific n aboutob Y� Iigatioas under Federal Law, contract the mal RsVenne Service (and, ifyon wish, the U.S. Small BuSh]esg . . Stale Law, colitug the D )- For more c mon about your obligations under epartment of Benefit Payer and the Division of industrial Accidenfc. If the structure is intended £or sale, property owners Who are not licensed contractors are allowed to perform their cord tions. nalIy through their own employees, without a licensed contractor or subC`M&Wior, only under limited A frequent practice of tmticensed p=oma ProSssing to be W=actars is to secure an -owner builder" b Pew moony mmP� that the P vPmty owner is Providing his or her own labor and tnldmg plafoffiatioa property ° �Y am Petfarmaig &ea � �- c ommnnity or at 1070 N SftwA �Y be obtained by the State Incense Board is your Plem �� , GA. 95814. Omer Verification"onthereverseside of this EMM so that We can confiim that you are are of � Math= The building Pea# will not be issued agn the Verification is 'II'!- - � .I • I• Il v r• • I OTS• 21it Owt:er_Bur747l0rrlrnt0rt is required by Seeaa IB830 0die f CaTiforiziaHealBc =dSafety Cods Y . - ,. .• --, ...M,,....y,. - _ to-. _.--. ,, ti., , � , S F, COUNTYfOF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: t t'10 I t ASSESSOR PARCEL NUMBER e:5 3e. • I©3 . o2A Proposed Building Use: Counter Technician: Date: `� ' 13. 4>+ Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑n 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ '� 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. - ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other °TM Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 0, 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Bluffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... t, ❑ 20. Erosion Control Plan Required........................................................................ ........ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ . 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... T ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed°to owner) ..................... ❑ 32. Letter of Signature authorization ......................................:............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ -35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction.......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ P_� 38. Other: ❑ 39. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: 1. Index permit application for the above items numbered: 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Plans reviewed by: Date: Plans approved by: Structural reviewed by: Date: Structural approved by: Note transfer by: Date: Date: Yellow: Building Division Plan Check Letter Date: Date: - Date Date: / . Name Street Address City, State Zip Order No. RECORDING REQUESTED BY Bidwell Title & Escrow Company AND WHEN RECORDED MAIL TO Petru Simoni etal 4454 VE Avenue Oroville, CA 95966 00213999-001 2004-004431 4 Recorded Official Records County Of BUTTE CANDACE J. GRUBBS Recorder ROS64ARY DICKSON Assistant 09:00AM 22 -Jul -2004 I REC FEE, 16.00 I TAX 71.50 I t I' I 1 Cheryl I Rage 1 of 4 SPACE ABOVE THIS LINE FOR RECORDER'S USE Parcel No. 036-103-024 GRANT DEED THIS FORM FURNISHED BY BIDWELL TITLE & ESCROW COMPANY The Undersigned Grantor(s) Declares) Documentary Transfer Tax is $71 . 50 ❑ City/Town of ✓ computed on full value of interest or property conveyed, or ✓ UnincorNurated Area C] full value less value of liens o encumbrances remaining at the time of sale ❑ Monument Fee of $10.00 FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, John A. Morris Jr., AKA John A. Morris, a married man hereby GRANT(s) to Petru Simoni and Anna Simoni and Maria Ciceu and Ion Ciceu, husband and wife �)1,d/,Z,6 p'�V)yla Z ii�r,d�,/ 1,hA1,1WAAWAWAA1f16 all as joint tenants the following real property in the ❑ City of ✓ Unincorporated Area County of Butte, State of Califomia: SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF Document Date: July 14 2004 State of California Countyof ¢'c } SS. On -7//5--/0 1- , before me, the undersigned, a Notary Public in and for said County and State, personally appeared John A. Morris Jr. Personally known to me (or proved to me on the basis of satisfactory FOR NOTARY SEAL OR STAMP 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 r e„s``�.••••• `°.� JANIE CLARK upon behalf of which the person(s) acted, executed the instrument. O = ` o Comm. # 1312686 NOTARY PUBLIC CALIFORNIA Q WITNESS my hand d official seal. -2 0 BUTTE COUNTY - My Commisslon Explres Jul, 9, 2005 Signature_/Z 0 — TAk STATEMENTS TO: Same as Above BTEC/GRANTDEED PETRU SIMONI AND ANA SIMONI, HUSBAND AND WIFE AND ION CICEU AND MARIA CICEU ALL HEREBY CONSENT TO THE JOINT TENANCY CREATED IN THIS GRANT DEED. t � I Xjoz/ X Petru Simoni Ana Simoni X X . Ion Ciceu Maria Ciceu pBTRL S ]MOM AND tiND�A Sn"iOM HL;SBAND AND VV[F TH'DSIONN CIC DfiA' ?v(ARLA CICEU ALL HEREBY CONSENT "1'O THE JOINT IP—NCl CREATED II X AAna Simoni peau Simoiu & VA --- Maria Ciceu ion Ciceu .c Order No. 00213999-001 EXHIBIT A. THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: LOT 3, BLOCK 24, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MAP OF VILLA VERONA BUTTE COUNTY, CALIFORNIA", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, JANUARY 17, 1889. EXCEPTING THEREFROM THE WESTERLY 165 FEET. AP NO. 036-103-024 4 SITE PLAN REVIEW APPLICATION Date: AAoU- 2! . %06 AP# 62 Permit Number (if applicable) O G�� 30 64� Bin Number APPLICANT INFORMATION Parcel Size: Owners Name: A Owners Address: Telephone No.: Situs Address: Proposed Use: Residential ❑ New Single Family Residential Single Family Addition ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑. Temporary. Travel -Trailer. ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other " ❑ Septic ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): Single Family Remodel ❑ Commercial Remodel - Industrial Remodel ❑ Well ❑ Agricultural Buffer Form ❑ Applicable ❑ 'N/A DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved s ❑ Resolve Problems Prior to Approval Site Plan Stampe Approved By Date 11'Z.W ZaOy Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) Watershed Protection Overlay Zone (See attached standards and requirements) fijzkf Expansive Soils (Test for expansive soils and if verified proper foundation design required) SRA - (CDF to determine specific requirements) ® 100 -Year Flood Plain: (See attached) • Flood Zone: X • Flood Panel No.: b Fg S./) Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance -------=---------------------------------------------------------------------------------------------------------------------------- ❑ Detached Building Use Form- ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: A-- Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. N CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Zd, Side Side Street Rear 5' So Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. N CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 I r] Applicable Development Fees: Standard Fees Amount Formula ❑ Fire ❑ School* " ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other ---------------------------=---------------------------------------------------------------- Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By Deeds: Q Date of Creation: 6 Legal Access Provided: ❑ No, Yes Deed of Reference: 1-709 — 0 20 Legal Access Required ❑ N Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation: E-1 No ❑ Yes Comments: ' `7 ?_'--'7-3 ta.� (fin l I .. ® Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps'recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 P ❑ Subdivision Map/Parcel Map: Map Date of Recording: Lot: Book: Page: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible'for road maintenance, and stop sign maintenance. U Page 4 of 5 Z", x u a] Summary of Specific Requirements: • ~ This information provided in this summary is based on the application information and on the best available data at the time of review. CAUTTys\Building Permit Site Plan Reviewl.doc Page 5 of 5