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078-340-011
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AND WHEN RECORDED MAIL TO:. Recorded I REC FEE 10.00 BUTTE COUNTY BUILDING DIVISION Official Records . I CONFORM 1.0® ' 7 COUNTY CENTER DRIVE Count yy Of I COPIES ' 2.50 OROVILLE, CA 95965 � - CANDACEUJTEGRUBBS I . - Recorder ROSEMARY DICKSON Assistant I Kathyh 02:25PM 09 -Sep -2004 I Page l of 2 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agriculturaLpurposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, - including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations . including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be. prepared to accept such inconvenienceor discomfort from normal, necessary farm operations. r y/. All that real property situate in the County of Butte, State of California; described.as follows: . . Date I ^ ( "-' d� PROPERTY OWNERS: State of California ) { County On before me, t personally appeared /`9i�.Zf.:�! L . L�pP2. personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies); and that by his/her/theirsignature(s) on the instrument, the person($) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and officia s Al Signature Seal: ...ted RICHARD FEUERSTEIN D * Commission #1299529 r` { Q_ Notary Public California _ ,F Bun County A. dMy Comm. Exp. APR: 13, 2005 oftrr.k ^`ux Preliminary Report Order No. BU -1463292 MAM Description The land referred to herein is situated in the State of California, County of Butte, and is described as follows: ALL THAT PORTION OF LOT 300, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "OFFICIAL MAP OF OROVII.LE-WYANDOTTE FRUIT LANDS UNIT NO. 6", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MARCH 8, 1929, IN BOOK 10 OF MAPS, AT PAGE(S) 3A, 4A, AND SA DESCRIBED AS FOLLOWS: COMMENCING AT THE MOST SOUTHERLY 'CORNER OF SAID LOT 300, SAID POINT BEING LOCATED IN THE CENTERLINE OF EDGEMONT DRIVE, AS SHOWN ON SAID MAP; THENCE FROM SAID POINT OF COMMENCEMENT, ALONG THE WESTERLY LINE OF SAID LOT 300 AND ALONG THE CENTERLINE OF SAID EDGEMONT DRIVE, NORTH 120 41' WEST, 135 FEET; THENCE PARALLEL TO THE SOUTHERLY LINE OF SAID LOT 300, NORTH 520 32' EAST, 140 FEET; THENCE PARALLEL TO THE WE LINE OF SAID LOT 300, SOUTH 12° 41' EAST; 135 FEET, TO A POINT ON THE SOUTHERLY LINE OF SAID LOT 300; THENCE ALONG THE SOUTHERLY LINE OF SAID LOT 300, SOUTH 52° 32' WEST, 140 FEET TO THE POINT OF BEGINNING. r APN 036-450-011-000 y� 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.neAdds PERMIT NO. BP041850 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: 09/21/2004 APN: 036-450-011-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 135 EDGEMONT DR ORO Date: Contractor. Map Index: Description: NSF(1269)GAR(504) COV(180) 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: SIEVER -LOPEZ DEVRA L permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a P O BOX 5016 signed statement that he or she is licensed pursuant to the provisions of CHICO, 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 95927-5016 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).): A1, 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: SIEVER-LOPEZ DEVRA L 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.). ❑ I am Article 3 of the Business and Profess' ns Code �Exeem�pttuundder Date: 9—rc c—=VCOwner: License #: WORKERS' COMPE ATION DECLAR ION 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: PURSELL, FRANK JAMES ❑ 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: Carver: Total Square Ft: 1953 S.F. Valuation: $97,461.00 Census Code: Policy #: 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: Applicant: WARNING: a'Iure to secure work rs' compensation coverage is unlawful, and shall subject a( employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of Q/ / �/] `� compensation, damages as provided for in Section 3706 of the Labor f�' code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the appl" .able proVisions of the Butte "County dP. a or I hereby affirm that there is a construction lending agency for the Resolu n o de work in i ated a Ib hich fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) �( 2/ U Name: B •III Date: IT EXPIRES ON: Our Date Address: ❑ 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 form or document of Butte County. I hereby thorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: ��4�L2r!/CE /i tf%i�� Signature: Date: 0 Owner ❑ ContractorAgent for Owner 0 Agent for Contractor BUTTE COUNTY ` DEPARTMENT OF DEVELOPMENT ISE ICES BUILDING PERMIT APPLICATnO AND SUBMITTAL REQUIREME 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 -2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF AP "PLEASE PRINT CLEARLY" OWNER Last Name�z6 irst Nae r '447T ` Address RD 1:36yL CityDQo Jid� State Zipq5�6s Phon � � ��S�L� Fax E-mail APPLICANT NAME CONTRACTOR Name City VL Address Zip 5 v City Fax State Zip Phone Map Book Fax E-mail Phone Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name J' City VL State /J� G Zip 5 v Address �- Fax E-mail &D 7 t DO, CU J51e Cf 10 City D Map Book Stat , Zip �� Phone Date Approved: Fax E-mail State License Number APPLICANT NAME Name iziewey—`9 Cr AddressD&n Gencs� City VL State /J� G Zip 5 v Phone Fax E-mail &D 7 t DO, CU APPLICANT SIGNATURE X For 2tice u e only: Zoning IAL I Flood Zone I X I SRA Policy Number No Occ. Type Const, Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT 6LR V66 BP I BIN# .4 8 1 LOCATION AP# 034? _ qSQ -_ll Property Address 3s City Cross Street ` f9�JGc� Gt 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: e Sq. Footage, r/,�2&-�, &Q>" A,DJ4 C& ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): OVER FOR SUBMITTAL REQUIREMENTS U K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 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 1 —19 `CR6 Bldg SRA Receipt M Sheriff t /�J 5 l SMIP Date:(,(they 13 �'WT o-tal REV 6-76-04 SUB The following drawingAand s for a permit. INCOMPL` LEGIBLE AND IN INK. TAL REQUIREMENTS as must be submitted to the Building Division in order to apply ALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! OR 3 Sets Engineered plans (if required) with wet signature on plan`s AND 2 sets of stamped and signed calculations. ❑ 1 3' 2 Engineered truss details and layouts (if required) (NO FAXES!). _ ❑ 4. Letter from Engineer or Architect for truss design review -.1 115. 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. , 115. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from -the Environmental Health Department. v ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). - N' 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. (A ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). " ❑ 4. Letter from Engineer or Architect for truss design review. Al \ � ❑ 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 calci fimriphcate,,(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 KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 Butte County Department of Development Services YVONNE CHRISTOPHER, DIRECTOR °�uTtF°° o o O 7 County Center Drive • o o ' o o Oroville, CA 95965 (530) 538.7601 TelephoneLO (530).538.7785 Facsimile 100 TO: WILLDAN , • ' FROM: Scott Rutherford _ (530) 538-7160 CIO S srutherford@buttecounty.net SUBJECT: Plans Transmittal For'Review Per Contract O DATE: y 6/29/2004 ` Applicant: Lo ez, Martin Permit 04-1850 Project Type: NSF APN: 1036-450-011—. . } 100% Y 70% i Plan Check Fees ; $ 943:72, � $ -660.60 $ 943.72 $ 660.60 WILLDAN Fee°, $ 660.60 Copies Attached: Qty Chk ' Application . Site Plan Review FEMA Elevation Certificate Building' Plans Truss Calculations • Energy Calculations Y Structural Calculations . Residential Plan Review Guide Residential Construction Requirements ' Other Other .: 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: Lb ASSESSOR PARCEL NUMBER (J �`�' • 'Ty / Proposed Building Use: Counter Technici Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order 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! 45 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 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........................................................................ L ....... 21 ees as shown on the attached Schedule of Fees Due Sheet .............................. 22. City of Chico Plumbing permit ............................. ......................... .,.... � 23. California Department of Forestry plan approval a paid. Sent by: 24. Planning approval (A) Use: *(B)Parking: (C) Parcel Check:_/ - - -„ 25. Contact Land Development about _ Improvements, _ Drainage ......................... NPDESForm.........................................................................L . O IP157ncroachment Permit for driveway from the Public Works Dept. ............. ❑ . Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ Worker's Compensation Carrier and Policy Number..*...................................... 31. Owner -Builder Verification (_ Given to owner,ailed to owner) ..................... Letter of Signature authorization......................................:............................. IV - 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 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.- 0 ther:❑ 39. Other: When issued Telephone nd p I have been informed of the above items and requirements for obtaining a building permit. Applicant: / Qate? 6-�2 ty --e 1. Index perItspreaur icate above jf ms numbered: t Plan Check Letter 2. Additiona/ hh Contractor,designer owne as advised of the above data by phone, ❑ mail, ❑ counte , by Date: V 4. Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, b Date: Plans reviewed by: Date: Plans approved by: I I I I I I Date Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Mt,� Date: >5 Yellow: Building Division E.H. USE ONLY Plot Plan Anoched V-1 - — . Roar Plan Attached voll /YA Sent to S.D. TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance A IE- Z- 116— �E�e-rk7 Q,4.j 7 - Owner W Location AP# Plan Approved for: Sewage Disposal Water Supply: Public Vo' Private, Well Clearance for v" dwelling. 'Other ISIL=4610e-o=�2 -P AFAI H o I d f i n a I f o r: ze- S Irlp- Cd- C.17, .1 1 d 6 �s 7116M Final clearance O.K. for: NOTE: Environmental Health 8/96 NO I N t7k=A Date. 4 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 y PROPROSED BUILDING USE ' t 1. BUILDING PERMIT FEES --- Balance Due ..................... $ 1-7 9. LN --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... ' $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) HERIFF FEES (paid at B lding Division) Residential............ X $360.00 its Commercial (sq. ftg.)..... - X $0.03' _ $ - Sq.Ftg. A.P. #`P DATE `` a i RECEIPT # DATE C: 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Fig. 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) fi-7. SRA FIRE INSPECTION AND PLAN CHECK FEE W&O-(paid at Building Division) 8. WATER TENDER FEES BATTALIONp#1 ' $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 .=$ Ftg. Amt. ly OTHER - Y " V`J Tot' a9��a At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT DATE Pursuant to Govemm t Code Section 66020,,fou 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) S L O BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District Building Department No. tt�� � t A.P. Number l/�tO' �l — (( Jurisdiction: City, �/County Property Owner Property Location/A Subdivision Lot No. Residential Development L—�J Q .........................:._.................................. :..................................... Q Q Sq. Footage No of Uving Mobile Home- Addition/ Supplemental to (Group R) Units Installation Conversion Permit # .'(No foundation inspection) Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial Q Q Sq. Footage New Addition (Including Exterior Roofed Areas) Building Department Representative Date District Identification. No. School District certifies that `s Lyo e- Z (Aoplicant) (Street Address) C4(Phone Number) �112 t" r (City) w (State) (i P code) Sb has complied with the requirements of Resolution No. by payment of $ a r representing j 1110 i square feet. 2926 i FULL MRIGATION = School District Representative Date Paid by Check # Remarks: Nodc You rosy protest the Imposition of the fess Identified above by submitting a written protest to the District, In Compliance with Government Cods Section 66020(x), within 90 days from tiro date fees are paid. Failure to submit a timely written protest wlll'prohtbk you from challenging the Imposition of the fees In any court action. if, subsequent to the School District Representative signing this Butte County Stools Impact Fee Certification Form, the School District Is rhotllbd by the applicable Local Planning Agency that this project Is being reviewed under the California Environments! Quality Act (CEGA). this project may be subject to additional school fees to fully mltipste. its Impact on the school dlat kit schools. White (applicant), Yellow (building department), Pink (school district) feeform.xis (10/03)drrim r'•"" COPY of .Document Recorded " 09 -Sep -2004 2004-0055118 1 AND WHEN RECORDED MAIL TO: ' Has not been compared with original. BUT-mCOUNTY BUILDING DIVISION . 7 COUNTY CENTER DRIVE BUTTE COUNTY RECORDER OROVILLE, CA 95965 ' AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be. recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to ,herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, • smoke, noise,. and Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept'such inconvenience or discomfort from normal; necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: , Date / — d� PROPERTY OWNERS: L44 State of California ) County of,ga7/ z& ) On e2— �— before me; personally appeared /is��f,;,� 'L L�,o Z, personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the'within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the persons) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and officia s al: Signature Seal: RICHARD FEUERSTC-IN Commission #1299529 V Notary Public-Calitomia A.P. # (�36- �/So " 6 �� Butte County f ' My Comm. Exp. APR. 13, 2005 W µ. . y Preliminary Report Order No. BU -1463292 MAM ` Description' . The land referred to herein is situated in the State of California, County of Butte, and is described as follows: ALL THAT PORTION OF LOT 300, AS SHOWN ON THAT CERTAIN MAP ENTTTLED, "OFFICIAL MAP OF OROVILLE-WYANDOTTE FRUIT LANDS UNIT NO. 6", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, -ON MARCH 8, 1929, IN BOOK 10 OF MAPS, AT PAGE(S) 3A, 4A, AND 5A DESCRIBED AS FOLLOWS: COMMENCING AT_THE MOST SOUTHERLY -CORNER OF SAID LOT 300, SAID POINT BEING c.= LOCATED IN THE CENTERLINE OF EDGEMONT DRIVE, AS"SHOWN ON SAID MAP; THENCE FROM -SAID POINT OF COMMENCEMENT, ALONG THE WESTERLY LINE OF SAIDLOT 300 AND ALONG THE CENTERLINE OF SAID EDGEMONT DRIVE, NORTH 12° 41' WEST, 135 FEET; THENCE PARALLEL TO THE SOUTHERLY LINE OF SAID LOT 300, NORTH 52° 32' EAST, 140 - FEET; THENCE PARALLEL TO THE WESTERLY LINE OF SAID LOT 300, SOUTH 120 41' EAST, 135 FEET, TO A POINT ON THE SOUTHERLY LINE OF SAID LOT 300; THENCE ALONG THE SOUTHERLY LINE OF SAID LOT 300, SOUTH 520 32' WEST, 140 FEET TO,THE .POINT OF'"' BEGINNING. APN. 036-450-011-000 Y t Page 4 OWNER -BUILDER VER`ICATION Attention Property Owner. An "owner -builder' building pemut has been applied for in your name and bearing your signature. Please complete and return this,infonnation at your earliesi opportunity to avoid unnecessary delay: . iri processing -and issuing your building permit No building permit will be issued. until this verification is received. I. I personally plan io provide t4e major labor and materials for,constructian of the proposed property improvement: YES NO 0'' , 2: I HAVE HAVE NOT ❑ signed an applioafion for a building permit for the proposed work. I have contracted with the following person (firm) toprovide`the proposed corisnv:ction: = NAh;• - •� ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, butI have hired the following person to coordinate, supervise, andprovide the major work. NAMMh ADDRESS: CITY: PHONE: CONTRACTOR'&_I KNSE NO. . STI]l�rade sours ofhe mar -k buil Iiaue con#racted-)he� fog�ersons #-geode the work indicated: NAM - ADDRESS'' PHONE `TYPE' OR WORK GNED• PROPERTYOWNER: DATE: NOTA: This Owner -Builder YerY?i lon is required by Section 19831 and 19532 of the CagOrnla Health and Safety Code. Yhis_ veri�zcadon must. be completed and returned to our office before we are va7idt€ed to irrcp fAP,nP"";t Dear Property Owner �. specified. a P has been y� g y elf as flee builder of pro Mly Foryourproteodon, yon should be aware that as `°ownCV4M dee you are the responm•ble party ofrecord on such a Pew Buffi ft p= are not requu,ed to be signed by PmP 3' owners unless are own work -If your wadc is being perform by someone oil SamPnaaS► P°gigue iiabiTiiy if that person applies for the yoorsel , you may Prot yotaself from. possible ProperpeM* in his or her name. Contactlicense frommor by law to be licensed and bonded by the safe ogc �at;tr,,,,;a and to have a business apply. the �y Th'7 am also required by law to put their license number on all perm for which they IfYDU Plan 10 do be aware of the fD"Owiagyom on your benefit and protection; with the mon of various trades that yon plan to subcontract; you should a Ifyon employ or otherwise eqpp and. Od2ar costs) is $300 or more � � �� � y� �� �'' � � wD* Cm aerials subactx�rs, then You may be an Pf°J and such persons are not licensed as cogs or ♦ If you are an em loM you must register WA the State and Fed=1 Gov=nneats as as l subject to sevezal obli p&ns hmh dbg state and federal �P and You are incom$ tax witbhc ♦ Terre =be ea�tzon . dimbiiy i�ae costs, and memploym� � t With �� to w �s� �3'h m ry out these Obligations, and terse rids are especially serous ♦ For more specific MfMMnVon abottt ¢you Wish, "' U.S. Smai1 Bu=mf Ad obiigatioas under Federal l aW, coact the i mai Revenue Seavice land, State taw, caniact the D For mare s�OOM& moa about your obligations under ePartment ofBeneflt paymenfs and the Division of industrial A.ocid=tL if Ste gmztme is i tn&d for sale, P vPM9 ownem who are not licensed am allowed to perfDna thzjr Fork P��y or their own employ, without a licensed conditiaas. caWractnr�or , only under limited A frequent practice of tmiicensed persons proms W be �aCtM is to secmre an a P n Y =Pb* Seat Ste propeaty owner is providiag his or ben own labor and owner bu2ldea" building permits are not required to be signed by owners B infomation about = obtained �' an P�g their owa work may. camnm uiiy or at 1020 N Stree, Sam GA. 95814. yrs S�aie Board is your Please complete the low= Buikh r Ycmficafioe on Ste reverse side of this foam so that we can are aware of tfisse matters, The building p� WM not be issued QU the verifi con5rm find you cation is returned„ OT This Orvrter-SurTderlr orrnadan is required yy Sedan I383D of &e Calffornfa Heart =d Safdy Code dl%.Trvwv% SITE PLAN REVIEW APPLICATION Date: 3/, ZC0, AP# K Permit Number (if applicable) Bin Number APPLICANT INFORMATION ' Parcel Size: Owners Name:.. Owners Address: A L). f 7o 5d Telephone No.. J �'t%' 3 71� 5-�� • - Situs Address:".t 7 le 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 r ❑ New Commercial, R. Commercial Addition , ❑ New Industrial ❑ Industrial Addition, ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel , .Other ❑ Septic ❑ Well ❑ Agricultural Exempt Building ❑`Agricultural Buffer Form ❑ Applicable ❑ 'N/A ❑ 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 ❑ Sits ' an Stamped pproved BY: Date ` 2C5f 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) ❑ 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: V • Flood Panel No.: elfe, !L 0 Index Date: fes/ Zvi- 2Gaa ❑ 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: 42- Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2of5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side Side Street Rear Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2of5 ' ® Parcel Deemed to be legal ❑. Verify Legal Parcel ❑Verify Legal Access i ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger • , r ❑ 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 Applicable Development Fees: ; Standard Fees Amountp Formula • ❑ Fire ❑ School* ❑ Parks/Recfeation r ' ❑ Roads ❑ Sheriff : ❑ Drainage - ❑ NCSP/CSA 87 . ❑ Chico UrbanArea — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ' ❑ Other Subdivision Map Special Fees- ❑ Water TenderP - ❑ Road Improvement F-1North' Oioville Area ' ❑ Other (per map) - * Check with schooldistrict to'verify actual fee if pre -'application review:' A final determination will be made at the time of the building permit: , t' : Parcel Created By r Deeds:t ` �3 I'll Date of Creation:., • Access Provided: ❑ NoM Yes Deed of Reference: r727- -�6.5� - �. rLegal •Legal"Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: < ❑ No,E] Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes•. `... Comments: ' ® Parcel Deemed to be legal ❑. Verify Legal Parcel ❑Verify Legal Access i ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger • , r ❑ 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 Subdivision Man/Parcel Map: Map Date of Recording: Lot: Book: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Page: 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. Page 4 of 5 r. F . y El El • y - - • e Summary of Specific. Requirements: , : F ` This information provided in this summary, is based on the application information and on the best available data at the time of review. CALarrys\Building Permit Site Plan Reviewl.doc ` "Page 5of5 J"IM PURSELL ' Page 1 Date: '5/21/04 CIVIL ENGINEER.., RCE 60924 Job Number: 104-05-1001- Job Name: Lopez Assessor Parcel No. 036-450-011 Analysis: 2001 CBC Dead Loads Live loads Roof Comp 6.0 ' 1/2" O.S.B. 1.7 Framing .. 5.0 Insulation 1.0 1/2" Gyp 2_3 16.0 psf.: 16 psf. Wall Horz. Siding .2:0 3/8" O.S.B. 1.5 Framing 3.0 EYP " Insulation . 1.0"P 10.0 psf; 4 a Floor NO G 600 Flooring 4.5�° 3/4" plywood 2.5 �Tas CIVIL Insulation 1.0 P cAu���', 1/2 gyp 2.2 I-joists " 1_8 12.0. psf. 40 psf. Garage Floor Concrete 50 psf 40 psf. Lateral loads ..Wind P = Ce Cq q I where, } . Exposure B Ce = 0.62 @ 15 feet Cq = 0.3 in/ 0.9 out windward roof q _ .14.5 psf @ 75 mph 0.67 @ 20 feet 0.7 out leeward roof 1 = 1 0.72 @ 25 feet 0.8 in windward-wall 0.76 @ 30 feet 0.5 out"leeward wall " . ,Seismic: V = 2.5 Ca'I W / 1.4 R. Ca =0.36, I = 1, R = 5.5 / 4.5 Soil Bearing Lateral Sliding Lateral bearing " 1500 psf Coeff.=0.35. 200 psf/ft. `. 3(3H) 4� ?i �` �� �'�'�, �'�x Y� � �.� �•.5 �/b`'1'� � . • . DC7 At �^'��^t!.� � L"iL•`! SSS .� � �. l �.��. pjv �,�s1 G(V %'o' B � ��;�M,,=-,b Lopez Page 3 Lateral Analysis Improtance Factor 1 = 1 .Walls BO . _. Wind Seismic Roof: Windward Leeward q I 'P Roof Weight: (Coef.) (Coef.x A + Coef. x A) (675) (lbs) Pitch = Rise:Run Pitch Factor P(30)=' 0.76 0.3 0 0.7 0 16.4: 1 _ 0 5 :: 12 = 1.08 P(25)= ° 0.72 0.3 0 0.7 0 ''. 16.4: 1 _ 0 .(Pitch factor)x(Area)x(Wt.(psf)) = Wt.(Ib) P(20)= -. , 0.67 0.3 0 ". 0.7 : 0 16.4' 1 = 0- .1.08 x 1310 x 16 = .22707 . - P(15)= 0.62 0.3 70. 0.7 . 70 16.4' 1 = 712-. Wall Weight: (Area)x(Wt.(Psf)) = Wt.(Ib) 480 x 10 = 4800 Wall: Windward Leeward q I P (Coef.) (Coef. A + Coef. x A) (@75) (lbs) Ca = 0.36 Total Wt.(Ib) P(30)= 0.76 0.8 • 0 0.5 0 . 16.4 -1- = 0 R .= 5.5 W = 27507 P(25)= . 0.72 0.8 0 0.5 0 . 16.4 1 = 0 " (wood) P(20)= . 0.67 .0.8 0. 0.5 0 16.4 1 0 'Base Shear (lb) P(15)=. 0.62 "0.8 174 0.5 174 16.4 1 = 2300 V = (2.5 x Ca x I x W)/(1.4 x R) = 3215 P (Total) _ 3012: . SEISMIC GOVERNS 1 I/,c�/,�1Cl+. �g /s?: r,-:;_�^U U_S• g_.,. �� � ,Lams; @.. G �o.c. F-C�e (2 �,� C"►.�� (Il"vll)`J,r`I;.p.5L� `TZc�sZ5 . �3Ss y �Qp,FtTME/�T . O �uTTF ®epartrnen� .off Publ"ic ;W®rks ° o ° '� C o.. u n t y, o f B u t t_', e ° ° J. Michael \ Crum Director , t ° o � R• LAND DEVELOPMENT DIVISION , Al CO 1y Storm Water Management Program h N y 7 County Center Drive �e6C WORD Oroville, CA 95965 ' (530)538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement BLESS THAN 9 ACRE1 Project Description: 1 `e- A F Project Location and/or Parcel Number: 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 g 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 fora 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. r 1 Signed: Title: Date: IL e Less than 1 Acre NPDES & SWPPP Compliance Certification' Butte County Storm water Management Program Revised 5/24/04 To: Butte County Building Dept. .13 County Center Dr: Oroville, Ca, 95965 From: Martin L. Lopez - P.O. Box. # 2 Oroville, Ca, 95965 530-370-4548 Cell . 530-541-3911 Work . Re: Authorization to sign construction permits and documents by': Clarence H. Lobo 158 Edgemont Dr. Oroville; Ca, 95966 To whom it may concern;-. Please allow this letter to .serve as my authorization for Clarence H: Lobo tosign in my absence any and all construction related documents and permits for me, Martin L. Lopez in regards to the construction of my residence at 135Edgeniont.Dr., Oroville, .Ca, 95966 'kespectfully, X Martin L.. Lopez ar State of Nevada .. County of Douglas Signed and sworn to (or affirmed) before me on by L- "Fee KANE DAVIS ;ANI, DAMS Notary PWAi%Suu of Ne Nouuy Petiiic,8i eat ev Appoi�ent Ne 83-LS5� 1-5 - APpointmeM �3-�SS� 1-� My Appt Expire Jan. 1, 200 My Apps. Fxfimhn. 'I, 2008 r�WILLDAN , Serving Agencies September 2, 2004 Scott Rutherford Butte County Building Department 7 County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX 117 C Street Marysville, California 95901 t s 530/749.2373 fax 530/749.2199 www.willdan.com SUBJECT: COUNTY OF BUTTE PLAN REVIEW, APPROVED . Willdan Project No: 14353-1004 Jurisdiction Job No: 04-1850 Assessor's Parcel No: 036-450-011 ' Description: Lopez Residence Dear Mr. Rutherford: Willdan has completed a plan review of submitted plans and documents for the above referenced project and recommends your approval. The plans and documents provided for this review that have been found in compliance with the applicable codes are: 1. Plans: Two (2) copies sheets T through 5 dated 10/20/01 by James Pursell, P.E. 2. Structural Calculations: - Two (2) copies dated 5/28/04 by Jim Pursell 3. Energy Calculations: Two (2)'copies date 10/21/01 by Barry Rubanoff 4. Truss Calculations` Two (2) copies dated 5/19/04 by Robert. C. Anderson 5. Truss Approval Letter: Two (2) copies dated 10/18/02 by James Pursell, P.E. The plans have been stamped with the Willdan approval stamp and dated the date of this letter. According to our previous letters relating to this project, the superseded plans and documents will be discarded within 10 days unless we receive other instructions. On the pages to follow is the identification of the codes and standards applicable to the project, a code analysis, and identification of any deferred submittals. 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" J S 1- F }1ij .... WILLDAN t _ 4 Serving Public Agencies . 1 + � i •, , • 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" 1 a s r.- CODE ANALYSIS• ; 1 Our plan review revealed the following information regarding,the occupanc.ydesignation, "type of =: construction, and other pertinent features. This information is consistent with that shown n the Flans andpermit: Type of Type of i 4i Sprinklers , 1s`Floor 2° Floor Stories .1: a .. Total Sq Ft Occu anc - Construction S Ft S Ft _ R-3 V-N No , , 1, 1269 1269 U1 V-N ; . No-. I �... 1 ". i' ..' 504 ar.:' ' 504 Covered V-N s No •l '' 1 180 180 Porch SPECIAL INSPECTION- NEEDS Our plan review reveals no special. inspection needs pursuant to CBC 1701. DEFERRED SUBMITTALS } .. - Our plan review reveals no deferred submittals, noted at this time. s Sincerely, loo Rick Essenwanger Ricardo Gu an, S.E. r Plans Examiner 1" Plan Check Engineer ` CC: Alice Mefford at Butte.County Email. ainefford@buttecounty.net f Jim Pursell, 5 Madrone Avenue Suite B,•'Oroville, CA 95966; FAX (530) 534-0902 { Clarence Lobo, 158 Edgemont Dr,•Oroville, CA 05066,',E-mail: isot(a,yahoo.com , Martin Lopez, PO Box 2,,0roville, CA 95965 r t i • -t NOTES. 47, RESIDENTIAL PERMIT NO. — 036-456 bi- 018 4-50 LOPEZ 135 EDGEMONT, OROVILLE Cont: OWNER NEW SINGLE FAMILY � J ��0 �6 zy ' gg 77(o SPECIAL CONDITIONS -,,',,- CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER Qq- 16-0 t:> r J`7 OFFICE COPY Address 13.5 t-OGEMOM Eb (Zbu [ LLL w % GAS Meter By CARL Date ELECTRI - + Meter By Date b n _C9 t+'JOB FINALED (Date) ', Signature J=OK 0 = Not OK . = otReadyable i 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 t 8. Utilitv Clearance Date Card B-1 Date Card B-1 Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s Card B-1 Date _. Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line kV 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 Card B-1 Date Card B=1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 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 Elec.; Receptacles and Lighting, Distance-GFI 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 P-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 kV yI 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. Elect; Enclosures; Conduit Entries -Terminals -Listed 7. Elect; 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 J=bK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDaERFLOOR (Plans) OK except #'s .2' g., Main; Soils-Elec. G.Md.-"1, /" Ftg. Depth g., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth ,Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth §Wmwalls, Main; Steel- Blockouts-Wrapped mwalls, Garage; Steel-Blockouts-Wrapped Hold Downs and Special Anchors 7. W II-Fitt-Test-J*ay C/O -Sewer Test it 10. Gasgipe; Size Anchors -Yard Gas Piping; Size Test ri 11. PiDe: Test-Anchors-Reaulator-Service Test 12. Electric Underground 13. Plenums cts;.Clear ateri Support -Ins. 07 14. Gir s -Sill ch olts-Joi - e -Cri es f 15. Acc & Ve tion 16. Insulation Date J Card B-1Date Card B-1 Date Card B-1 Date Card B-1 Pate P BING (Per OK except #'s 1 Aa,,Ler Htr.; nt- ccess-Combustion Air Baffle 8. r Pipe -rest & Anchor -Nail Protection 15?5.W.V.: Test Fittinas & Anchor -Nail Protection 2Q-3hbwer Pan; Test, First Floor -Tub Access 21. Te u & Shower, Second Floor -Tub Access 2j? " as Pipe; Sixe & Anchors 22!FIP✓SSprinkler; Test Date ewCard B-1 G Date Card B-1 Date I ' Card B-1 Date Card B-1 Date ELECT CAL (Permit) OK except #'s 2µ,o0rqYkdr_e & Transformer Clearance -Ins. Protection hts & Switches at Doors Boxes & No. of Conductors 2Y96mex Installed Close to Edge of Studs & C.J. 2 F�uip. Ground made up w/Mech Fasteners-BondLG & Wa� 290"2 Appliance Circuits in Kitchen & Conductor Size GFI --@@-S Med Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or At /� 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or At 6r Insulated Neutral O Yes O No 32 -Service -Riser Conductors & Ground Main Disconnect „32 -Equip. Clearances Panels-Motors-Mech. Equip. 34. es Closet Light -Shower Light -Spa Light 36'Smoke Detector Date Vop 4 -4 ling. Joist-Rftr. Ties -Pur n- Brac.-Truss-Shting.-Rtng. Fireplace Ties or Type ue- 'replace Throat Clearance X36. Attic -Access: Siz ection-Draft Stop -Ins. Baffles 5;4dyn. Windows or Exiting Doors -Sill Ht. & Dime. Bions 2arage Fire Protection Framing 3. Prooertv Line Firewall & ODenlnas 54. Ext. Doors -One X -Check Garage 3rd Story, 2 Exits 55. irs; Width -Headroom -Rise -Run -Landing -Fire Protection Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 'Y57. Siding -Nailing Veneer -� 58. eco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59`d!.rea-Glass Protection -Skylights -Plastic 6 hear Walls; Nailipef-Bolts 6 . Brace Interior/Exterior.Wrall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls- indows Date Z a,/ Card B-1 / .,,enZ Date Card B-1 Date Card B-1' ate Card B-1 Date FINAL (Plans) 2 -pt #'s 64. Ext s oor & Sidelight Prot. ction-La gs 65. -Smoke Detector Qa_Par-nace s -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 6 room Exiting 6&_G -F. .-& Bath Fixt b Acce - pa 69._]Elec-1 tm & S _ Anel, Breaker Si Labe 72. Elec. OuttSts at Wood-Rghel. Int. & Ext. 73. Kit. ttEE.:L- plian round -Air- ooking Clearance 74. Elec utlets &�cept es at ' . Counter-_ 75. Garae6Foor: Swina- ina-Clo re 76".C. Duct in Garage -Damper 77. r. Htr.; Vents -Clearance -Comb. Air Connector -P. . . in G ge; Above Floor-Mech. Protection 7 b.; led-& Mech. Equip. Liste fcf Location ec. Receptacles in Ga a (F.F.I.)-Romex Protection 80. ulation-Foam-Looked in -Attic- 8 uard Rails & Deck Oenst u tion -Post Caps 8 n. VBents & Crawl Hole Door Drainage & Wood -Earth _ Clearance Looked under Door 8 owina Instld./Drive es o/Walks O Yes /Planters O Yes .�31vo A.C. Unit 86. Vents-Above-Roof,'Plba-Ai)Dliance-FirepleEe-Clearance to Ooeninos Of. Water Well, Disconnect, Electrical, Plumbing 8 . xt Trim, G.F.I. Receptacle -Underground 8 -Ventilation Throughout House 90 ass Protection 9rrectignsm Previous Inspections / 1 (.pl-of- 92' Ga�Xsj- (eters Tagged, Gas -Electric i lW,00.b n_JYj,, ga. ate wer Connected -C/O to Gra - rova 94'-En,ejgy Compliance Certificate -Other Certificates i Address Posted Date ( • A (4S Card B-1 Date Card B-1. +; ` Date Card B-1 Date Card B-1 Date 1223,6SCard B-1 U3 Date Card B-1 Comments at Final: Date b Date " 0-v Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s A .Ducts Insulation & Support 37/Ve0kFan, Exhaust above insulation 38. ondensate Drain & Overflow, Size & Grade 39. rnace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet Date Date 40. ' /t- X Attic Access & Platform if Furnace in Attic Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date FRA ING (Permit) OK except #'s 4 Sills Proper Materials & Anchors 42 IIs Studs -Nailing Spacing & Braces -Plates -Sound 43 aring Walls over Girders & Floor Nailing 4 raft Stop in Walls (rat proof) .. 45/Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 4 Headers & Beams -Size & Bearing :. Date Vop 4 -4 ling. Joist-Rftr. Ties -Pur n- Brac.-Truss-Shting.-Rtng. Fireplace Ties or Type ue- 'replace Throat Clearance X36. Attic -Access: Siz ection-Draft Stop -Ins. Baffles 5;4dyn. Windows or Exiting Doors -Sill Ht. & Dime. Bions 2arage Fire Protection Framing 3. Prooertv Line Firewall & ODenlnas 54. Ext. Doors -One X -Check Garage 3rd Story, 2 Exits 55. irs; Width -Headroom -Rise -Run -Landing -Fire Protection Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 'Y57. Siding -Nailing Veneer -� 58. eco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59`d!.rea-Glass Protection -Skylights -Plastic 6 hear Walls; Nailipef-Bolts 6 . Brace Interior/Exterior.Wrall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls- indows Date Z a,/ Card B-1 / .,,enZ Date Card B-1 Date Card B-1' ate Card B-1 Date FINAL (Plans) 2 -pt #'s 64. Ext s oor & Sidelight Prot. ction-La gs 65. -Smoke Detector Qa_Par-nace s -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 6 room Exiting 6&_G -F. .-& Bath Fixt b Acce - pa 69._]Elec-1 tm & S _ Anel, Breaker Si Labe 72. Elec. OuttSts at Wood-Rghel. Int. & Ext. 73. Kit. ttEE.:L- plian round -Air- ooking Clearance 74. Elec utlets &�cept es at ' . Counter-_ 75. Garae6Foor: Swina- ina-Clo re 76".C. Duct in Garage -Damper 77. r. Htr.; Vents -Clearance -Comb. Air Connector -P. . . in G ge; Above Floor-Mech. Protection 7 b.; led-& Mech. Equip. Liste fcf Location ec. Receptacles in Ga a (F.F.I.)-Romex Protection 80. ulation-Foam-Looked in -Attic- 8 uard Rails & Deck Oenst u tion -Post Caps 8 n. VBents & Crawl Hole Door Drainage & Wood -Earth _ Clearance Looked under Door 8 owina Instld./Drive es o/Walks O Yes /Planters O Yes .�31vo A.C. Unit 86. Vents-Above-Roof,'Plba-Ai)Dliance-FirepleEe-Clearance to Ooeninos Of. Water Well, Disconnect, Electrical, Plumbing 8 . xt Trim, G.F.I. Receptacle -Underground 8 -Ventilation Throughout House 90 ass Protection 9rrectignsm Previous Inspections / 1 (.pl-of- 92' Ga�Xsj- (eters Tagged, Gas -Electric i lW,00.b n_JYj,, ga. ate wer Connected -C/O to Gra - rova 94'-En,ejgy Compliance Certificate -Other Certificates i Address Posted Date ( • A (4S Card B-1 Date Card B-1. +; ` Date Card B-1 Date Card B-1 Date 1223,6SCard B-1 U3 Date Card B-1 Comments at Final: SITE PLAN .. ...................... .. ...... .. .... .... .... .... ...... .. ...... ................ .... .. .. .. .. .. ............ .. .. .. .. .. .. .. .......................................... .. .. .. .. .. .. .. ........................ r► ................................................................ .. . .. �. ............................................ ..... ..IL.. ......... --.� _ ._ w- _ - .....- .... .. ..... 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F c .. .. .: ... .. .. ... ..................... .:....:...:. .:.. ......... ........ :..... :...... i' ... .. .. ...�... is ter--/: ................... ?.7 r: .. ........... .. .. .. .Jl.11...........: .. ... .. .. .. ....................... ... .. .. .. ............................ .. .. .. ................ ................ ......................+.... .. ......................... ................. .. ............. .. .. .. ... .......................................... ................. .. .. �.... ... C.� — — ._................................................................._........................... Assessors Parcel Number Do 121 - Q 0 0 - Q © El Scale: 1 Owner Name /�9,� i ��►/ �, DREZ Address / Phone No. Site Location / S ED �� o�/ ?" Dn e2&��d1� Contact: 'Name �'L.ar� :�a � /ao Phone _ 77 3 5 2 Y om,, FOR OFFICE USE ONLY PROVIDE FOR ALL ADJACENT PARCELS Zoning: SIZE (AC): General Plan Desig: ZONING: Size, Acres GEN PLAN: 4.0(r - - USES: