HomeMy WebLinkAbout078-330-007N
-MILLER, .Bruce & Carolyn
2920 Oro GArden Ranch, Oroville G ti
95-0064 P ..
HINCKS, Suzanne Orovll
2920 Oro Garden Ranch Rd,
(gas: line-.repair/SFS
7 04-2534
HINCKS, CRAIG & SUSANNE
2920 ORO GRDN RANCH RD
OROVILLE
Cont: MOUNTAIN DEVELOPMENT
RE -ROOF 20 SQ
&Z -04-3619
HINKS, CRAIG
2920 ORO GARDEN RIS; OROVILLE
Cont: GENE DILL
NEW GARAGE/CARPORT -
1
I
i
07
Gti� c� �i
i� o c� �"�
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect. ,� �267 /
License Class : License Number:
Date: 12 O. S Contractor:/1&10,04AiA/ OCAJ617
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
permit to construct, alter, Improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to rile a
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's Stale License Law (Chapter 9 commencing with Section
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).):
❑ 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
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 Pfofessions Code. The Contractors' Slate 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.). ,
❑ I am Exempt under Article 3 of the Business and Professions Code
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penally of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -Insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is Issued.
❑ 1 have and will maintain workers' compensation Insurance, as
required by Section 3700 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:
Policy
id 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, I shall
forthwith comply with those provisions.
Date: ^ ' % . O
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
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.)
PERMIT NO.
BP043619
Issued Date: 02/28/2005 APN: 036-340-007-000
Site Address: 2920 -ORO GARDEN RANCH RD ORO
Map Index:
Description: ADD GAR(320) & CARPORT(400)
Owner: HINCKS CRAIG L & SUZANNE R
2920 ORO GARDEN RANCH RD
OROVILLE, CA
95966
Applicant: HINCKS CRAIG L & SUZANNE R
Contractor: MOUNTAIN DEVELOPMENT CO
GENE DILL
P O BOX 5732
OROVILLE, CA 95966
530-534-9722
License #: 216715
Architect:
Engineer:
Total Square Ft: 720 S.F.
Valuation: $14,080.00
Census Code:
C�
This permit Is hereby Issued under tapp%yhich fees have been paid.
licable provisions of the Butte County Code and/or
Resoluti n do work indi ated �e l
tt O�
By. Date:
PERM T EXPIRES ON: O
Address: I / / (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 ofa . (ficial 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:: k D;k72 ), 7- V�t / ' L Signature
Date:
❑ Owner
Contractor
❑ Agent for Owner
❑ Agent for Contractor
B. C. t3uiioing Hermit ul-lb-U4 pg i
BUTTE COUNTY p
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS oC
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"
OWNER
Last Name
first Na
Address
City
S
Z'
Phone
Fax
E-mail
I CONTRACTOR I
Name
Address
City
-Phone
E-mail
�10_p AP -W , I IMA wl?
For office use only:
ARCHITECT/ENGINEER
Name
e
Address
SA
City
Lot #
State
Zip
Phone
Address
Fax
E-mail
State License Number
�10_p AP -W , I IMA wl?
For office use only:
APPLICANT NAME
Name
1.
Address
M�
City
Lot #
State
Zip
Phone
Address
Fax
E-mail
�10_p AP -W , I IMA wl?
For office use only:
ZoningA,,qjq I Flood Zone 1>el I SRA Yes No
Occ.
Type Const.V
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
PERMIT
NO. h
BP
BIN #
LOCATION
AP#� ` /� .� /�I
/
Pr erty Address ^
City
Cross Street
WORKER'S COMPENSATION
Policy Number <---
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
-Nam
Address
OVER FOR SUBMITTAL REQUIREMENTS U
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2
Description or Scope of Work:
A4 013
G,4 ICA Ge -320
Sq. Footage
❑ Structure BuilFwithoul Permi s
❑ 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: Amount: Q.) �p�� Bldg
SRA
Receipt#;qJ�� `70 Sherff
n�9t,, �, SMIP
Date:
Other
REV 7-27-04
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 INK
❑
1.
Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paperl
❑
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 calcs 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).
—D —i3 Sanitationaa"te-plmr appj:ov_alfrom-tbe-Ea*-onmentaLHealtb-Deparfinent
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.
Workers 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.
i
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
Butte County Department of Development Services°OUTtF°
YVONNE CHRISTOPHER, DIRECTOR ' o o
0 0
7 County Center Drive °+;p °
Oroville, CA 95965 0 0
' (530) 538.7601 Telephone UN
(530) 538.7785 Facsimile
TO: WILLDAN
FROM: Scott Rutherford (530) 538-7160 ,
' srutherford(a)buttecounty.net
SUBJECT: Plans Transmittal For Review Per Contract
O I I DATE: 12/29L2004
Applicant: Hinks, Craig Permit 04-3619 t.
Project Type: Car ort/Gara e:` APN: 036-340-00.7
100% 70%
Plan Check Fees $ 373.93 ` $ 261.75
$ 373.93 $ 261.75
WILLDAN Fee $ .261.75
Copies Attached: Qty
Chk
Application
Site Plan Review
FEMA Elevation Certificate
Building Plans
Truss Calculations
Energy Calculations
Structural Calculations
Residential Plan Review Guide
Residential Construction Requirements
Other '
Other
COUNTY�OF BUr5 TE -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�'�f
OWNER:I i4s, 1 %II f ASSESSOR PARCEL NUMBER
Proposed Building Use:(j Counter Technician: Date:
Items required in order to aplply fora hermit. All bkxks 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.
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
17. 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable.
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 ........................................... ........
❑ Erosion Control Plan Required ......................................... .............................. ........
ees as shown on the attached Schedule of Fees Due Sheet ..............................
O City of Chico Plumbing permit........................................................................
_:ZEF7 2L California Department of Forestry plan approval Ppaid. Sent by:
fanning approval (A) Use: 0 r-- (B)Parking: (C) Parcel Check: 05'
❑ 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 ..........................................
❑ 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. $
❑ 38. Other:
❑ 39. Other:
When issued Telephone - ( and hold for pickup.
I have been informed of the above items s and a uirements for obtaining a building permit.
i
Applicant: � ,� Date:
1. Index perrril pylic ron� orbo e iem`umbered: l Plan Check Letter
C
itiQ�,al items requiredctor,.tlesigner, owner, was advised of the above data by phone, ❑ mail, ❑ counter, by Date: i 9 ctor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Plans reviewed by: Date: Plans approved by: Date : -
Structural reviewed by: Date: Structural approved by: ' Date:
Note transfer by: Date: S
Yellow: Building Division
Sw Plan Anech-4_
Flow Ran Aizzc"d—�-
Saw to 8.0.
TO: Building Department
FROM:, Environmental Health
SUBJECT: Sanitation'Clearance
Owner Location AP#
Plan Approved for: Sewage Dispos Water Sup I Pubfic-"-, Private Well
,p Y:
Clearance for dwelling.. Other
Hold final for:
,Final clearance O.K. for,
NOTE:
Environmental Health Specialist
8/96
/0-0� -2�)q
Date
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
PROPROSED BUILDING USE 0a nonlAg ramp_,,
V- 1. BUILDING PERMIT FEES
�J.
--- Balance Due ..................... $ 4 2 i
--- Additional Fees Due........... $
--- Revised Plan Checking Fee.... $
2. SCHOOL DISTRICT FEES
(paid at. School District Office) (form available after Plan Check)
3. SHERIFF FEES (paid at Building Division)
Residential..........:. X $360.00 =$
Units
Commercial (sq. ftg.).... X $0.03 = $
Sq.Ftg
A.P. # U(d m' /
DATE
RECEIPT # DATE REC.
2.2,71b16s
.1
C
4. URBAN AREA FEES (paid at Building Division)
Residential (per unit)..... X
# Units Amt.
Commercial (Sq. Ftg.).... X = $
Sq. Ftg. Amt.
,
I
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)
T
r .
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. Fig. Amt.
10. OTHER k5iY1 I 0!
lJ 0 Is
�1 I/
N � / ,
=(,F�--�
At time of permit applica • n, I was advised the above fees are required to be paid prior to issuance of the permit. These fees
may be changed during a plan the r e s.
_
APPLICAN
U
DATE
Pursuant to Govemment 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. 2/2003)
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
OWNER:
Ora,/01ASSESSOR PARCEL NUMBER�•
17.
Fire Sprinklers
)e!-1:�
18.
Proposed
Building Use` C Counter Technician: Date:
Items required
Soils Report and/or Engineered Foundation required.
in order to apply for a permit. All b s MUST be checked OR marked NA in order to apply.
20.
1.
Site plans, 3 or 4 sets, signed by the preparer of the plans.
21.
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.
❑
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
28.
Pre -Inspection for required:
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
30.
Worker's Compensation Carrier and Policy Number.
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.
4 t�
12.
Letter of intent for non-residential buildings.
�5
13.
Detached Accessory Building Form filled out by the owner.
❑
14.
Hazardous Material Form.
J -
15.
Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable.
. ❑
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 clearance and site plan approval from the Ag Commissioner's office
❑
19.
Soils Report and/or Engineered Foundation required.
❑
20.
Erosion Control Plan Required.
-P-"
21.
Fees as shown on the attached Schedule of Fees Due Sheet.
❑
22.
City of Chico Plumbing permit.
12`�.
23.
California Department of Forestry plan approval Laid.
24.
Planning approval for (A) Use: (B)Parking: (C) Parcel Check:
0
25.
Contact Land Development about _ Improvements, _Drainage.
0
26.
NPDES Form
27.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
28.
Pre -Inspection for required:
❑
29.
Contractor's license information. (Number, Name Style, Classification).
❑
30.
Worker's Compensation Carrier and Policy Number.
❑
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. $
❑
38.
Other:
❑
39.
Other:
When issued Telephone �' " and hold for pickup.
I have been informe he above i nd a irements for obtaining a building permit.
Applicant. Date: /2IV Glol-w -_
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.
Original -Applicant
0 TTS Department of Public Works
o
° C o' u n t Y o f B u t t e
1 0 o J, Michael Crump, Director LAND DEVELOPMENT DIVISION
® Storm Water Management Program
c�UNI � / 7 County Center Drive
A�ville, CA 95965
tic WOR�9 Oro(530) 38.7266
(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 9 ACRE
J
Project Description:
Project Location and/or Parcel Number: / clJct" �314w) (4
By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTTJRB
1 acre or more -.of land and that 1, 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 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 1 w.
Signed:
Title: / D12
Date:.
Less than I Acre NPDES & SWPPP Compliance Certification
Butte County Storm Water Management Program .
Revised 5/24/04
Tl _s
W I LLDAN
Serving Public Agencies
February 22, 2005
Scott Rutherford
Butte County Building Department
7 County Center Drive
Oroville, CA 95965
(530) 538-7169
(530) 538-2140 FAX
SUBJECT: COUNTY OF BUTTE PLAN REVIEW APPROVAL
117. C Street
Marysville, California 95901
530/749.2373 fax 530/749.2199
www.willdan.com
Willdan Project No:
14353-1315
Jurisdiction Job No:
04-3619
Assessor's Parcel No:
036-340-007
Description:
Hinks Carport
Dear Mr. Rutherford:
Willdan has completed a plan review of submitted plans and documents for the above referenced project
and recommends your approval with the conditions noted on the 2nd page of this letter. The, plans and
documents provided for this review that have been found in compliance with the applicable codes are:
➢ Plans: Two (2) copies sheet 1 not dated, not signed
The plans have been stamped with the Willdan approval stamp and dated the date of this letter.
On the pages to follow is the identification of the codes and standards, applicable to the project, a code
analysis, conditions -of -approval and identification of any deferred submittals.
W 9 LLDAN
'Serving Public Agencies
APPLICABLE CODES
Unless noted otherwise, all comments are based on requirements of 'the 2001 California Building
Standards Code found in the California Code of Regulations, Title 24: '
• Part 2, known as the California Building Code and abbreviated herein as "CBC"
• Part 3, known as the California Electrical Code and abbreviated herein as "CEC"
• Part 4, known as the California Mechanical Code and abbreviated herein as "CMC"
• Part 5, known as the California Plumbing Code and abbreviated herein as "CPC"
• Part 6, known as the California Energy Code, and Energy Commission Standards, and
abbreviated herein as "CECS"
CODE ANALYSIS
Ourplan' review revealed the following information regarding the occupancy designation, type of
construction, and other pertinent features. This information is consistent with that shown on the'plans and
the permit application.
Type of
Type of
Sprinklers Stories
4" Floor
2"d Floor
Total Sq Ft
Occupancy
Construction
Sq Ft
Sq Ft
R-3 Carport'
V -N No 1.
400
NA 400
U-1 Garage
V -N No 1
320
NA 320 ...
CONDITIONS OF APPROVAL
L. Approval is contingent upon the review, requirements and approval of other departments
and/or agencies.that have jurisdiction over this project.
2. Revisions and/or notes as red -lined on the plans.
DEFERRED SUBMITTALS
Our plan review reveals no deferred submittals noted at this time.
SPECIAL INSPECTION NEEDS
Opt plan review reveals no�,special inspection -needs pursuant to CBC 1701.
Sincerely,
Isaac Kuster Gordon.Wright, P.E.
Plans Examiner Plan Check Engineer
Cc:,.. 'Alice'Mefford, E-mail: a'mefford@buttecounty.net
Craig Hinks, 2920 Oro Garden Ranch. Road, Oroville,'CA 95966
Pave 2oft County cif Butte Permit .Number 04-3619
Willdan'P.roiect Number 1.4'353-.1315
4Q
SITE PIAN REVIEW APPLICATION
Date: .a2y`.-#.,� _ 3/0 7 f
Permit Number (if applicable)
APPLICANT INFORMATION Parcel Size:* l ac1tt
Owners Name:
Owners Address: d 010 GiiO 11i✓L� �U'. � %���
Telephone No. f3 3- h 3 r
Situs Address:
Proposed 'Use:
Residential
❑ New Single Family Residential
Single Family Addition ❑ Single Family Remodel
Mobile Home
Residential Accessory o�
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie) .1
F] Temporary Travel Trailer +
❑ Multi -family
Non-residential h
❑ New Commercial -
❑ Commercial Addition ❑ Commercial Remodel
❑ New Industrial
❑ Industrial' Addition ❑ Industrial. Remodel
Other
❑ Septic ❑ Well
❑ Agricultural Exempt Building
❑ .Other:
Brief Explanation (if necessary): '
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SERVICES INFORMATION (For Staff Use)
Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
IN'Site Plan Stan Ped Approved
By Date OS
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) �
E] Expansive Soils (Test for expansive soils and if verified proper foundation design required)�Ji'L�
® SRA - (CDF to determine specific requirements) ��
❑ 100 -Year Flood Plain: (See attaclied)
• Flood Zone: X
• Flood Panel No.: OGDO 7C/�Q i -D Index Date: %�'11e) d
❑ Sacramento River Reclamation District (Approval must be obtained from thd 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- -2
G P- LDS
Applicable Building Setbacks:
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
30
Side
,
Side Street
Rear
S�
301
oZ0
Height
Waterway
N/A
N/A
N/A
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Applicable Development'Fees:
_
Standard Fees Amount :., , . Formula
Fire
School*
❑ Parks/Recreation t °
❑ Roads
Sheriff
❑ Drainage
NCSP/CSA 87 ,
❑ .Chico Urban Area' Road
❑ Thermalito Impact
❑ Other
------_--------
Subdivision Map Special Fees ,
t ❑ Water Tender y
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: ;
s ;
Date of Creation: Legal Access Provided: ❑ No ❑ Yes
Deed of Reference: Legal Access Required -❑ No ❑ Yes.
Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: '
Complies with County Standards for Deed Creation:❑ No ❑ Yes
Comments:
Parcel Deemed to be legal.
❑ Verify Legal Parcel ❑Verify Legal Access ❑Provide Deed of Creation
❑ Obtain a Certificate of Compliance 3
EJ.'Obtain a Merger ❑ Obtain a Lot Line Adjustment
El Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17L of Maps Page 23).
❑ Construct road to; ❑ Meet Parcel size'required by:zone,
❑ Meet current Environmental Health Department requirements '
Page 3 of 5
In. Subdivision May/Parcel Map:
Map Date of Recording: &/(�
Lot: 3
❑ Use PermiVMinor Use Permit
Permit Number:
Book: �. / Page: —"- O .2-51
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 roa
100
Page 4 of 5
h
P
':.•':.,_. 1.
-
oZOOOV
V 16 CZ0
N l9
v°a EQ>u°- TZ oZm°o!
tiwrtco�
\j` t� EZ m °tOtS T F O d use
Nom.>UQ °_ `O o L N'[U i 00zz 10 J U"-
u17ioEO o•� L oar -'°' O 3 s V 6Q01 =1 m$ NL
nv.��i
m0LL
�°cu:uu a+ `QN,TE
moo v-� md°. OT 'E.
a mZ�° T T LLWF Nw >
�Y, LFII
oEQL`0o -UZ c K�01 c Z 2,3
, JS
a`c OOVV �oc'v $ o Z�� u ° VO—)000 LL y m -C
�-
V N �" LO+°� T NL z O Z N L V
•LL b>U� �W E^'. p(jOT A O� j
f Z m p
C 13
u
U c 170LL �_a1
cDu�o° tNivrE4 Q ?J 3
O>Z
p
cs 7+n .fes m0 -i .�pu
c v •a -o p++ V
�Ea a3 o��oa v' c•. Gov
c ev�D L al T a u i.0 oL�
mom
`t mSDe Q-0yT°TV
+`-V V `g, o uML
V C
c V
Q± 6 p aD nC I V+--QIO'Ic-
Z 1vU,40
>LO°N
Z mu-�VQ-
^uol aoE oyo9 • ��+o
L' I - S `a
ro.? • ac _ TE
LC'-+- O Biuv
a GZD OO 0 �-�-.V
1'f of ovl.« ,ate u0�3. °m ox
o.
r bpm
Qom'; V l l L C CL
VE L O p CU. .P. z� V �t VNN._. �U_O L
+L•TiVO -T2. U-.- °YL L• Q QOOQ �Q ��
v+uv
vaHo moo==`SEN a V cwc, oh t
+$E 3buDa�� ��a \� �� v+:usu u� 3a L Qa g
O �t a i
UO.ew71aD ON 4ky`
t�4 'Iu+p�NL J10n as �UJaU WN
uuO
CO c>'�NV.:,c EDU
]fE p'� ud YJ .0 L C
(\\dry',
Nm�-aa �jevoE 1 i�°�L N -CO �U O
Qo Nv ND���+r 2U m Zi-°aU •%C'NT �'
W—..0. Qa uD •.i4v D°ILu t
mp,P� 7Pg+.
uZEa Q,L,$tl•c • Eax�i' �}.= v
;;F-;;F-i.o
U> uv+c01Suu LL
0 JZ �i cc"+"Li a
• U�yQo u4 DDV C� .'-. NX SOm OU C
C �VGV
Z vN`bv
aN�O N+UL VDb N ..Nu-=3tC
WOco6 c U.000 N+dam Um i +G].N O V
• nub VVV°UU° -m"O rQ ND OSP„ O[+6
IZn4 -,v
A-E '4
(�cr q°oo'b 3: oTo }v ° wZac° ar c 9Ma
u0� UEW�u °u'^
yZV°
.2 3,2=2 � Z ua3aE o A
\
O�° °;Sa - z o o al7ccu m DLmF.
31
f<Oo` a�vc�rt u Qac
NVVED t m0° LQINN pF '`IVB•°. n
CUl m �LYY U°V V V "pL
D� �4'vc ou oay.'c'`mac_ L
°c cac o°Cco4vx'` >'�.zTD U N �a la
ma vEoEc i Lu°_a pyo E
of3.a3vi.o"eo� 3.°.Sc°c°o°�Doo .cvE°ia�T0E. K O Vo Oc�OcaVi+Du 'D . y9LaoDi�UacUQ +. Q`�-uVaZZsL9
o3
UiOu]�yN
\ cOI
w° w
zaVcL
Q, o
Stoll u
rc
N
N
' 296 •� \
$ - - 797 \ 287
o L
c
r se e•u' �a 1 \�
S 20�se.
I` �• a\ 'dam,/ Sao 1Z;.
n �
b•a
"$ 0.96 Ac.: a' .. 3•'
X.
- 308 307
.4
k'
I °�°za:7o•H. �. \\
'k' \/ 9 jar
_ A I _ O ma' �1: • \
Q
-
0.91 Ac. L
.�
1
\\� -
`d7
•
1+°;WE 57-267.24
i
l
/
S c 1.29
/ a
mol
%
P.
275-0.
1.23 Ac.
• $/ ..
£
'� :td
Gfr4
•e •'
ee 3'y/ 326.25'
$ex••
!°
EAST
„
.AS'>
° L�t�
•"afi.os
�-
Poriion Loi 296
.-iu'7°d.?i.^.>;�,..
ILI
4,32
3t
F �9/'.M1S�/ 'osier
•
r'o-"�/
`��
GARDEN RANCHOS
-�
° >�
UNIT HS I
BEING A SUBDIVISION OF A PORTION
••?b•
9P - '
OF LOT 298.OROVILLE WYANDOTTE
FRUIT LANDS UNIT N9 6
306
,
• -
°
'� \
�;
\p X91
'
FOR
J.F.A%0J.CM5ABERY '• OROV ILLS CAL.
"
..i
BY
mAY-195 ALE I' 13
MAY - 1952 SCALE I°•100'
/
o!• for chis survey ig the cenf<er/ne
oP or a -Gag
of ,PVI/le •Gorden Ranch Road os s own on
9heei N? 3 0!' oroville W nd0lfc f ui Lands N?6
-
..
. -
-
-
- 314' fl. pipe set oto// /af earners except where
9ymba/ 6 %ndico res 6°A I5' Cexre fe monument .
5.42 Ac. S Nei
-
MAP50OK/7 PAGES .28L d Shcei 2 of 2 Sheets
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.netWds
PERMIT NO.
BP042534
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: 08/30/2004 APN: 036-340-007-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: Lice a Number ) GO��
Site Address: 2920 ORO GARDEN RANCH RD ORO
Date: Q� Contracto
Map Index:
Description: REROOF(20 SQ)
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
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: HINCKS CRAIG L & SUZANNE R
to its issuance, also requires the applicant for such permit to file a
2920 ORO GARDEN RANCH RD
signed statement that he or she is licensed pursuant to the provisions of
OROVILLE CA
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
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 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: MOUNTAIN DEVELOPMENT CO
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,
GENE DILL
provided that such improvements are not intended or offered for
p O BOX 5732
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
OROVILLE, CA 95966
proving that he or she did not build or improve for the purpose of
530-534-9722
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
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
Contractor: MOUNTAIN DEVELOPMENT CO
ursuant to the Contractors' State License Law.).
7;/,Ipam
Exempt under Article 3 of the Business and Professions Code
GENE DILL
P O BOX 5732
Date: Owner:
OROVILLE, CA 95966
530-534-9722
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
License #: 216715
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
❑ 1 have and will maintain workers' compensation insurance, as
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 carder and policy number are:
Carrier:
Total Square Ft: 0 S. F.
Policy #:
1 certify that in the performance of the work for which this permit is
Valuation' $0.00
issued. I shall not employ any person in any manner so as to
become
Census Code:
subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
^ '-7
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date: — Q
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 plicable provisions of the Butte County Cods ?nrVor
I hereby affirm that there is a construction lending agency for the -
Resolutio do� work indi t abov, r ich fees have been paid. a
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
BY �Date: VVV lJ
PERMIT EXPIRES ON: CJS
Address:
(Dkite)
❑ 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 dw 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 anyAAial 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: �7(1 L l Signature:
Date:
❑ Owner K Contractor 0 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
First Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT NAME
CONTRACTOR
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
Lic. #
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
X
For office use only:
Zoning
Prgperlty Address
Flood Zone
Cross Street
SRA
Yes
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
PERMIT
NO.
BP x,5'3
BIN #
LOCATION
AP# O�
Prgperlty Address
City
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
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2
Description or Scope of Work:
c), c
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: '_� Amount: 0. 0 0 Bldg
Receipt #: (1x137
Date: 3a`6q
Sheriff
SMIP
Total
REV 7-27-04
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 1N INK.
❑ 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 calcs 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).
❑ 13. Sanitation and site plan approval from the Environmental Health Department.
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
netunds can oniy 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
COUNTY OF BUTTE - DEPARTMENT OF d!iVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 4rPERM!TIo.
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER 036-34--007
ZONING
1 11
BUILDING PERMIT
OWNER M =ANNE HINCKS
TEL533-6389 EPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS 2920 ORO GARDEN RMICH OROVILLE
CONTRACTOR'S NAME 0W
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $
20,00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
2420 ORO GARDEN RANCH
PERMIT FEE $
OROVILLE
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater {
23.00
LOT NO.
SUBDIVISION'SNAME
PARCEL MAP
Water piping
15.00
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF ❑X Duplex ❑ Mobilehome O Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00 +
Building sewer
15.00
Mobile Home S G W
@20.00
r TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities 15 Installation ❑ Other O
�/j�
Describe Work: GAS LINE � /\.k .P1 ! k-,
PERMIT FEE $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( BOOV OR LESS )
200A OR LESS
23.00
Main Service ( 200A TO IOOOA )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( 8 ACC. BLDS. )
3.50 FTSO..
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
❑ 1 am a licensed underrovisions of Chapter 9, Division 3 of the Business and
P P
Professions Code and my license is in full force and effect.
(cense No. Classification
UZ I, as the owner, 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)
❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ 1 am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
NON-RESID. ( BRANCH CIRCUITS )
@7.50
( POW ER APPARATUS )
BSINGLEOUTLETCIR.
Ex. Occup. ( OUTLET OR FIXTURES )
20 @ 1.00
BAL. so
Ex. Occup FIXED APPS. OR
(OW
UTLETS IRESID.I EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
�ertificate of Consent to Self -insure.
l� I hall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Contractor
I certifythat I have read this application and state that the above information is correct.
I agree to comply to all Butte County Ordinances and California State Laws relating to
building construction, and hereby authorize representatives of the County of Butte to
enter upon the above mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against all
liabilities, judgments, costs, and expenses which may in any way accrue against said
County in consequence of the granting of this permit. f�
• /1•vt Date !' 1 5
f
Signature�'of Applicant -`� Owner ❑Contractor C3 Agent
An OSHA permit is required`for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
1
Mobile,Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 35.00
HAZ.
D. FEES
IMP
FLOOD
CDF
PARCEL PO
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
iridicated above for which fees have been paid.
q
BY s . c/, / .% , c_ Date
!
PERMITEXPIRE4N '
!Dere)
Receipt No. 170966
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PEVEL"OPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PE MIT o.
- APPLICATION AND PERMIT 0 -
ASSESSOR PARCEL NUMBER 036-34-007
ZONING
BUILDING PERMIT
OWNER -
SKM SUZANNE HINCKS
TELEPHONE
533-6389
SQ, FT, OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
2920 ORO GARDEN RANCH OROVILLE
CONTRACTOR'S NAME OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $
20.00
Permit Fee S
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee S
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESSPERMIT
2920 ORO GARDEN RANCH
FEE $
OROVILLE
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15,00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF Ox Duplex O Mobilehome ❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00 15.00
Building sewer
15.00
Mobile Home S G W
@20.00
TYPE OF WORK
New O Addition O Remodel O Utilities NInstallation O Other ElPERMIT
p ♦
Describe Work: GAS LINE #@PW
FEE $
35.00
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( BOOV OR LESS )
200A OR LESS
23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & ACC. BLDS. )
3.50 SO, FT,
CONTRACTORS LICENSE LAW(%POWER
I declare under penalty of perjury (check One)
❑ 1 am a licensed underp p rovisions of Chapter 9, Division 3 of the Business and
fessions Code and my license is in full force and effect.
nse No. Classification
ZIrias' the owner, or my employeeswith wages as their sole compensation, will do
the work, and the structure is not intended or offered for sale. (Sec 7044)
❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ lam exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
.NON-RESID. ( BRANCH CIRCUITS )
@7.50
APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
20 (7 1.00
BAL. .50
Ex. Occup. ( OUTLETS IRESID.)OEA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Dept. of Development Services,
B Ilding Division a Certificate of Workmen's Compensation Insurance or a
ertificate of Consent to Self -insure.
I shall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Contractor
I certify that I have read this application and state that the above information is correct.
I agree to comply to all Butte County Ordinances and California State Laws relating to
building construction, and hereby authorize representatives of the County of Butte to
enter upon the above mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against all
liabilities, judgments, costs, and expenses which may in any way accrue against said
Coun in consequence of the granting of this permit.'
PDate �'� 7-
Signature f Applicant -`A Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
ocC
CONST. TYPE
TOTAL FEE $ 35.00
HAZ-
1 D. FEES
IMP
I FLOOD
I CDF
PARCEL I PD
7D
ISSUE
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated abo a for which fees have been
PERMITEXPIRESON
lD tel
provisions
to do work
paid.
e
Receipt No. 170966
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
- COUNTY OF BUTTE
Dgpartmenf of Development Services
Building_ Division
Oroville: 7 County Center Dr., Oroville CA 95965 Ph: 916-538-7541
Chico: 1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751
4
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 materials for construction of the proposed property" improvement
(yes or no)
2. r (have/have not) signed an application for a,building permit for the proposed work.
3. I have contracted withthe following person (firm) to provide the proposed construction:
Name
Address City
Phone Contractor's License No.
4. 1 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
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 1983.1 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. .
r J��ea,�y+r-".obi �:' � '° .yS � h9-.�,v-tuS:�3f'��'?S �a.'YY't�,�is�r' a a' .«. i ..,, e �r-V r . gt'k,.��_„x �,,,�
. � �` o I
t
.. f . ..
' �
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT N0..
7 County Center Drive - Orovllle, California 95965 - Telephone: 916.'538-7541 �_,� _ y 3
APPLICATION AND PERMITrR
36-34-7
—5—WN—TorBRUCE
ZONING
A R
BUILDING PERMIT
& CAROLYN MILLER %510)
TELEPHONE 250--7494
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
742— HAMILTON PLEASAh"r HILL 94823
CONTRACTOR'S NAME
M ER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is
LENDER'S MAILING ADDRESS
Filing Fee
$ 15.00
Permit Fee
$ 25.
ARCHITECT OR ENGINEER
:LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING
f
2920RES5 ORO GARDEN RANCH OROVILLE
Permit tee
$ 40.50
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
1 5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each pas water heater or vent
7.00
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home S G W
@ 15.00
TYPE OF WORK
New Ir Addition Lj Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work:— __ _REROOF 12:12 PITCH) _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600V OR LESS
200A OR LESS
18.50
Main service 200A TO t000A)
_
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check. one):
❑ 1 am licensed under provisions Of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License .Jo. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended oroffered
for sale. (Sec. 7044)
E] 1, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason i
NEW CONST. ( DWELLING OCCUP.&)
OR AODNS. 1 ACC. BLDGS.
NEW CONSTR. ULTI.OUTLET
NON•RESID, BRANCH CIRC ITS
_37.50
3.54sq.ft.
@ 5 00
POWER APPARATUS &)
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
20 754
FIXED APLNS.
Ex. Occup. OUTLETS P(RESID )REA.)
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. bVirin 9
15.00
Permit Fee
$
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
FiIingFee 15.00
Heating
Cooling
g
Hood
6.50
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X Date
Si natuA -
re of Applicant
g pp OwnerQ Contractor❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct -
ion of structures over stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ CONST TYPE
TOTAL FEES 40.50
HAz
1 0FEES
IMP
I FLOOD
I CDF
PARCEL
PO
HD
ISSUE
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated above for which fees
,61RECYOR OF PUBLIC
By f..
PERMIT EXPIRES Date fv
ZZ
applicable provi-
resolutions to do
have been paid.
WORKS
Date c� q
Receipt No. J��V�
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD-APPL I CANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Orovllle, California 95965 - Telephone: 916,'536.7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER -,�
36-34-7
ZONING
A R
BUILDING PER
OWNERTELEPHONE
BRUCE & CAROLYN MILLER ,510)
510
2.56-7494
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
742— HAMILTON PLEASANT HILL 94823
CONTRACTOR'S NAME
OWRTER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
Permit Fee
—
$ 25, NO
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS ORO GARDEN RANCH OROVILLE
2 22
Permit tee
$ 40.50
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF ® Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home S I G I IN I
@ 15.00
TYPE OF WORK
New � Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: RERO)ZF_12-12 PTTCH) _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600V OR LESS
200A OR LESS
18.50
Main service 200A TO IOOOA,
_
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License Ao. Classification
I, as the owner, or my employees with wages as their sole compen-
. sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. ( DWELLING OCCUPM
OR ADDNS. ACC, BLDGS. I
3.6$sq.ft.
NEW CON5TR ULT[ -OUTLET
NON.RESID- BRANCH CIRCL IITS I
@ 5.00
(POWER APPARATUS &)
I SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
2) V 76d
FIXED APPLNS. OR
EX. Occup. OUTLETS IRESI0.I EA.)
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. byirin g
15.00
Permit Fee
$
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
F� I shall not employ any person in any manner so as to become subject
�l to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you becomesubject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Cooling
g
Hood
6.50
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
agains aid County in consequence of the granting of this permit.
X t Wl:, LI 2 D g'Z
i Date
Signature of Applicant — Owner Contractor ❑ Agent ❑
An OSHAwork
permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $ 40.50
rlAz
DFEES
IMP
FLOOD
CDf
PARCEL
PD
HD
ISSUE
This permit is hereby issued under the
sions of the Butte County Code and/or
indicated abo a for which fees
I OR OF PUBLIC
By _A!%Eg
PEftlt EXPIRES Date
applicable provi-
;
resolutions to do
have been paid.
WORKS
ate
[
Receipt No.���y��
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
I
X
COUNTY OF BUT - DEPARTMENT OF"PUBLIC WORKS -BUILDING DIVISION
7 COUNTY E TER DRIVE - OROVIt El, CALIFORNIA 95965 - TELEPHONE: 916/538-7541
o, } PERMIT APPLICATION DATA SHEET
Permit No.
OWNER a/Zf t- A. P. No. 3o�—JV-0 ff
Proposed Building Use Building Inspector 20, O Date
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
X^ DATE RECEIVED "APPROVED
x 1. All items have been submitted.
2. Plot plans in duplicate/triplicate, signed by preparer of plans ........
3. Complete plans in duplicate/triplicate, signed by preparer. of plans . .
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form ...................................... .
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions.......................................................
10. Fees of $ ........................
11. Chico Urban Area fees paid .......................................
12. Park fees paid ....................................................
13. School District fees paid ..............
14. Sanitation approval from Health Department
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements may be required.. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for required Pre-Inspec. request to
Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation,I,nsurance ..................
23. Owner -Builder Verification (Given tooeVer ❑, Mail to owner 0) .....
24. Recorded copy of Agricultural Acknowledgment Statement .........
S
25. Letter`of signature authorization ...................................
26.
27.
When you issue the permit, process as follows: Mail to owner. `~ Mail to contractor.
Telephone and hold for pickup at &R,Q' office. Deliver w/inspector.
Other �7 �1 ,
Applicant&,"^'� Q' Vv1 T,61, Date U 2p eTZ
Copy of Haz-Mat form sent Health Dept. Fire Dept. air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
v
Contractor, designer, owner, was advised of above required data by_phone---naiI—counter by .date
Contractor, designer, owner, was advised of above required data by—phone _mall—counter by date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy—DPW
COUNTY OF -BUTTE -.Department of Public Works
7 CBunty Center Drive, Oroville, CA 95965' Phone: 916-538-7541
b
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 materials for construction of
the proposed.property improvement (yes or no) t S
2: I (have/have not) v . ,signed.an application for a building permit
for the..proposed~work. -.
-I-have contracted with the following person (firm) to provide the'•proposed
construction:
Name
• Address City
Phone Contractors License -No.
A-. - I plan to, provide portions of this 'work, but I have hired -the. following. person: i.
to'coordinate, supervise,.and provide the major work:
Name
Address City
Phone Contractors License No.
hwill provide some of the work butt have contracted (hired) the following
persons to provide the"wo.rk indicated:
Name Address Phone- Type of Work
Signed:
Property Owner' ZRAA,� yvn
So:9:1 AT ml. a
Date, of 'L_
NOTE: This Owner -Builder- Verification is sent to you.as required by Sections 19831•and
. 19832- -of the.- Cal-ifornia Health -and Safety Code. w
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Orovllle, California 95965 - Tolophono U119 538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
—3y—
ZONING
R
BUILDING PERMIT
OWNER `
LA
TEL PHONE
SO. FT. OCC. BUILDING
VALUATION
OWNER'S MAILING ADDRESS
L
CONTRACTOR'5� NAME A �.
W I�
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation • 5
LENDER'S MAILING ADDRESS
Filing Fee
15,00
Permit Fee
$ -5- 4-u
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
°�.9zd ,�rtej
O f O Grp(,t - I La G
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
5.001
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SFLe Duplex❑ MobilehomeF-1 Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
1 15.001
Mobile Home SIG W
@ 15.00
TYPE OF WORK
New`_ Addition;_; RemodeIL Utilities Cl Installation[ Ot er119
Describe work:
Q 006i 2 ° /Z L
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 200AORLESS
18.50
Main service 20(A TO 1000A,
1 37.501
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
71 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License ;4o. Classification
U 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
I, as the owner, am exclusively contracting with licensed contract
ors. (Sec. 7044)
[I 1 am exempt under Sec. Business and Professions Code
for this reason
.JEW CONST. / DWELLING OCCUP.&\
OR ADONS. l ACC. BLDGS. /
3.5C sq.ft.
NEN CONSTR. " ULTI.OUT LET
NON.P.ESiO.
@ 5.00
f13RANCHCIR0 ER ATUS &t
SINGLE OUTLET C:R. /
Ex. Occup(DUTL�TS OR FIXTURES
zo 754
RA64544
Ex. Occup. OUTL TS FiXED I REISICOIRE .�.�
I 3.00 i
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
g
15.00
Permit Fee
$
—
WORKMEN'S COMPENSATION INSURANCE
I deciare under penalty of perjury (check one):
F-1 The permit is for $100.00 (valuation) or less.
U I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
�
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Cooling
Hood
6.50
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X Date
signoture of Applicant — Owner C Contractor Ir_. Agent ❑
An OSHA permit is required For excavations over 5'0" deep and demolition or construct -
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee $
OCC CONSTTYPE TOTAL FEES /l%
i IHAZ I0 FEES I IMP FLOOD COF PAFCEL
I PD Ho
I ISSUE
This permit is hereby issued under the
Bions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By ._
PERMIT EXPIRES Date
applicable provi-
resolutions to d0
have been paid.
WORKS
Date
i
I
Receipt No. /
NNITE-O.P.'N.• YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT I