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NOTES • J RESIDEN , A� 1 036-610-04303-3292 r PERMIT NO. ICnN, DOUG,_, 11 30 HEATHER CIR, OROVILLE CONT: OWNER NSF dyr- CJ L 4 -ti L P Z 1 C Qs40 �. FFICE COPY Address GAS Meter By Date ELECTRIC Meter By Date��" L s SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. r FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS t VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER _ ¢o of (^i Ro' Il 4o F -I��Q � OFFICE COPY Address -736 kAe-o�Vxm- c+., GAS v Meter By f/� Da_tJ ' Z� �b 14- ELECTRIC Meter By Date 3: JOB FINALED (Date) _ Signature J=OK o = NotOK - =Not Applicable Ap . = Not Ready RESIDENTIAL Date UND FLOOR (Plans) OK except #'s 0 0�- . Zo g -Setbacks -Easement Flood -Slope . Han rs-Post Ca s -Anchors -Connect 2.1 3 g. ain; Soils-Elec. Gr d.-/ " Ftg. Depth g., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth -Ming. Joist-Rftr. Ties- Purlin-Roll c. -Tr -Shting.-Rtng. 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth Stemwalls, Main; Steel-Blockouts-Wrapped SOr"Aftic 6 walls, Garage; Steel- Blockouts-Wra ed 51. Bdrm. Wi s or Exiting Do ill Ht. & Dirtyffsions 6 d'Downs and Special Anchors ge Fire Protection Framing -RC Channel 7.. , Steel -Wrapped I - ro rty Line Firewall & Openings Rr Pi -Fire lace Ftg.-Steel 2e)'ate- W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 10. Uf_Gas Pipe; Size Anchors -Yard Gas Piping; Size Test Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 1 .. ater Pipe; Test -Anchors -Regulator -Service Test -Si -ding -Nailing Veneer 12. Electric Underground Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance -Material -Support -Ins. 59. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date 114,-U Card B-1 Date Card B-1 Date j4, e), Card B-1 Date Card B-1 Dat -1 PLUMBIN (Permit) OK excent #'s bustion Air Baffle -T8. Water e; Test & An -Nail Protection 19. D. ..; Test Fitti nchor-Nail Pro ion 20. wer Pan; Tesf First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 2YGas Pipe; Sixe & Anchors 2 pnn Date CTaCard B-1 L)G Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Transformer i (Single & Duplex) 25!Elec jJeceptacles Spacing -Lights & Switches at Doors 26. �'Pexes & No. of Conductors Stapled 27. ome nstalled Close to Edge of Studs & C.J. 28. EqTip. Ground made up w/Mech Fasteners -Bond Gas & t� 29.-246p-lianc_e-Circuits in Kitchen & Concluctor-size-CA- 3q!!!Su Wire Size/ /ga. Cu or AI-A.C4.Wilie Size/_ /ga Cu LAI - 3 ange Circle/ /ga Cu or AI -Oven Circ. / /ga C or AI Insulated Neutral O Yes O No 3?/S ce-Riser Conductors & Ground Main Disconnect Equi . Clearances Panels-Motors-Mech. Equip. 3_4eOr,lothes Closet Light -Shower Light -Spa Light 0 Smoke Detector Date -t%-U, Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECH NICAL (Permit) OK except #'s ,46'A.gu'cts Insulation & Support u, -fent Fan, Exhaust ab ve insulation 38. Cqndensate D Overflow, Size rade 39. urnace-V Access -Comb. Ait-Return ent 115 Outl 1 t Attic Access Platform if Furnace in Attic Date -(g -6b Card B-1 L) Date Card B-1 Date Card B-1 Date Card B-1 Date FRAIVING`(Permit) OK except #'s Silj§_Proper Materials & Anchors 42. �lalf; tuds-Nailing Spacing & Braces -Plates -Sound 43. B i g Walls over Girders & Floor Nailing 44. Stop in Walls (rat proof) 45 tops, Furred Ceilings -Stairs -Chasers -Tubs 46-FFe1j5ers & Beams -Size & Bearing 66. Furnace Vents -clearance -Comb, Air-Connector- ln ge; Above Floor-Ducts-Mech. Protection Ge-Bomarfi-Exiting W.-G.F.I. & Bath Fixtures & Tub Access -Spa lec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 74,,� Fireplace or Stove, Clearance -Hearth 72. Elec. O ets at Wood Panel, Int. & Ext. 7 EW. & Appliance; Ground -Air -Gap -Cooking Clearance 7 . E�-c.Aatfets & Receptacles at Kit. Counter 7 Garage Fire Door; Swing -Landing -Closure 76. A ct in Garage -Damper 77'.' Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in rage; Above Floor-Mech. Protection b.; Elec. & Mech. Equip. Listed for Location 7.9. ec. Receptacles in Garage (F.F.I.)-Romex Protection . Insulation -Foam -Looked in Attic 81. ails & Deck Construction -Post Caps �To b . Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes 83. Following Instld./Drive 0 Yes 0 No/Walks O Yes O No/Planters O Yes O No 84. S Brown -Finish A.C. Unit Disconnect, Electrical -Plumbing ents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. _V {atg-rWell, Disconnect, Electrical, Plumbing Ext e ' Elec. Trim, G.F.I. Receptacle -Underground 8 en 'Nation Throughout House WOIG_[!�tection orrectio-- from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water &-Sewer Connected -C/O to Grade -HD Approval jk;?�nergy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: Date FRAM Continued) 4 . Han rs-Post Ca s -Anchors -Connect 48 -Ming. Joist-Rftr. Ties- Purlin-Roll c. -Tr -Shting.-Rtng. 49 SOr"Aftic Access; Size &Romex Protecti n -Draft Stop -Ins. Baffles 51. Bdrm. Wi s or Exiting Do ill Ht. & Dirtyffsions �j ge Fire Protection Framing -RC Channel 58 ro rty Line Firewall & Openings 54 xt. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5P. -Si -ding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Gig Area -Glass Prol ction,Skylights-Plastic jp (o -pr hear Walls; Na' i (/ 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 83. Infiltration -Walls -Windows Date `- R'p(� Card B-1 V� Date Card B-1 Date Card B-1 Date Card B-1 Date FINA!!fTains) OK except #'s K. Fx"teps-Door & Sidelight Protection -Landings . Smoke Detector l 66. Furnace Vents -clearance -Comb, Air-Connector- ln ge; Above Floor-Ducts-Mech. Protection Ge-Bomarfi-Exiting W.-G.F.I. & Bath Fixtures & Tub Access -Spa lec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 74,,� Fireplace or Stove, Clearance -Hearth 72. Elec. O ets at Wood Panel, Int. & Ext. 7 EW. & Appliance; Ground -Air -Gap -Cooking Clearance 7 . E�-c.Aatfets & Receptacles at Kit. Counter 7 Garage Fire Door; Swing -Landing -Closure 76. A ct in Garage -Damper 77'.' Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in rage; Above Floor-Mech. Protection b.; Elec. & Mech. Equip. Listed for Location 7.9. ec. Receptacles in Garage (F.F.I.)-Romex Protection . Insulation -Foam -Looked in Attic 81. ails & Deck Construction -Post Caps �To b . Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes 83. Following Instld./Drive 0 Yes 0 No/Walks O Yes O No/Planters O Yes O No 84. S Brown -Finish A.C. Unit Disconnect, Electrical -Plumbing ents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. _V {atg-rWell, Disconnect, Electrical, Plumbing Ext e ' Elec. Trim, G.F.I. Receptacle -Underground 8 en 'Nation Throughout House WOIG_[!�tection orrectio-- from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water &-Sewer Connected -C/O to Grade -HD Approval jk;?�nergy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: J=OK 0 = Not OK . = Not Readyable DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s k 1. Zoning Requirements -Setbacks -Easements Date 2. Soils; Special MH Support Sketch ILII[ 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) Footings; Size -Spacing -Marriage Line 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 3. 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or / /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance Electricity; MH Test 10. Roof; Shthg-Roofing 6. Water; MH Test Ext.; Steps -Doors -Landings Date 7. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line License Decals 3. Gas; MH Test -Demand -Valve -Connector' 11. 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector Card B-1 Date 7. Water and Sewer Connected -C/O to Grade -HD Approval . 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) - Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 1. Zoning Requirements -Setbacks -Easements 5. 2. Footings; Size -Spacing -Marriage Line 6. Carports; Windows -Doors 3. Blocking Electric - 4. Gas; MH Test -Demand -Valve 9. 5. Electricity; MH Test 10. Roof; Shthg-Roofing 6. Water; MH Test Ext.; Steps -Doors -Landings 7. Water and Sewer Connected 8. Gas and Electricity Tagged Card B-1 Date Card B-1 9. Exits Card B-1 Date Card B-1 Date 10. License Decals 1. Setbacks -Easements 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric - 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes -Enclosures- 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 st COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754V, PERMIT�NO. (Rev.12/961,.*d�', APPLICATION AND PERMIT ASSESSOR PARCEL U� W ' t I - `1 Z° a _ i, BUILDING PERMIT OWNER ;� TELEPHONE 7 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS, I X I � ''� t" ` .t f r "f (� `1 `-,C1-, s CONTRACTORS NAMETELEPHONE / j J t' CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 66 BUILDING AoSS, ( r - I • ( r (� .1 Energy Plan Checking Fee t $ •7 ' d $ PERMIT FEE $ LOTNO. ' SUBDNISIONSNAM U � . .PARCEL MAP I -, PARCEL PERMIT Fling Fee 20.00 �' USEOFSTRUCTURE ��" SF y Duplex ❑ Mobilehome ❑ Other I' SPECIFY Each Trap 11 7.00 Solar or heat um water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New 4Addition ❑ Remodel ❑ Unities ❑ Installation ❑ Other Describe Work: t t u -Mobile Gas piping system 1 - 5 outlets 15.00 ' Buildingsewer 15.00 U Home S G W 920.00 PERMIT FEE $ ., ..' ELECTRICAL PERMIT Fling ee 20.00 r" ,�,i r t r f-) 1 eoov oR'ss Main Service 2o.A OR LESS ., 23.00 a O LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.P License CIBSS LIC. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ,M 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 & offered for sale. ❑ I, as owner of the property, am exclusively con`tracting'with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWEWNG oCCUP. OR ( S. 3.50so-I FT. M�C-ou� I,°NRMID. ULT' TL RC OMNI @7.50 OWER APPARATUS 8 SINGLE OUTLET CIR. Ex, OCCu OUTLET OR FIXTURESB20 @ "00 0 Ex. Occup. oFimErs A�Io.°E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION I hereby affirm 6`nd40penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued: My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating F�/ y g — 4r"OD CoolingI. Hood 6.50 Ventilation) , PERMIT FEE $ • C,(� Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those royi'sions. l X _/�__���((` _ Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavatio saver 5'0" deep and demolition or construction of structures over 3 stories in height.-JJ1/ Mobile Home Installation Fee $ Energy Inspection Fee U Occ CONST. TYPE TOTAL FEE $ (D x HA2. D. FEE$ IM j V� F100D X CDP {/ PRC Ppm V HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which feeIs have been paid. 1 ` 1 ! vv By a Y ���f/ ; Date ll PERMIT EXPIRES ON Illdl- f fDele rReceiptNo. �.C'1 1 � 1 :�! (� WHITE-D.D.S.-B.D. — CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT i• jwr-t� GQCV..E LLG MOM NO mm CNN HEM.. �= IB790N OF M WALLATM i. ROOF AlMistlai BAsd NOW Tlddaom (ds) Thennd Re limism c a (R Va>W� 2 CELNG Beit or Type Begs 8rond NNW jdw ! 7hmkr en (in , - Thound Redstwm (R–kWw) Loose FN Type F9b Btond Nmres J+ohno Nigmr>Ite Caahoaobrls ivft wedweiOhtllt 8q- • b 5 tb, #fin Thkkness S .� 5 . Mm-wftdunWlpl 1 11 weWd per squm bdio adies 7hwMal Reddom (R VWW) 7�3$ 3 EXTERIOR WALL Aland Stand Name Thidoness (indtesl 3.5 i mmd RaeMia m (R-Vakej]��1 �c � Z�3 4. RAISED FIAOR 11elwid BBIM— Tmdmn ?— L SLAB FLOOR /PERIMETER Peib��eteran � tlee:t� FOUNDATION WALL BrandMons udge ThwMd (R•Vklkw) Blend Name Thetrra� ReeMMnoe �lle�es) Thk*nm Iindws) . Thwmel Pjwld=ae (R -V CM CiAm so fib"• c -) 3•Z'4. OG 1- Z- COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 (Rev.12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBERo 3W - d =G _ L ' �— BUILDING PERMIT OWNER TELEPHO E SO. FT. C. BUILDING VALUATION OWNER R10 CONTRACTOR'S NAME / TELEPHCt,NE CONTRACTOR'S MAILING ADDRESS 6 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $ 3ap 66 Plan Checkin Fee $ BUILDING ApD{IESS" CA C-4 r r.,)\/ I / Energy Plan Checking Fee $ ' O (C PERMIT FEE $ LOTNO. SUBDIVISIONS NAME5 C)- - CEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE r 4 A(` SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap ' 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 ' d0 TYPE OF WORK New Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Gas piping stem 1 - 5 outlets 15.00 '5 Building sewer 15.00 Q Mobile Home IS I GI WI @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 000V OR LESS 2DOA OR LESS 23.00 • tI LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business and Professions Code, ( g ) and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: JS 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a.certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 6 ACC. BUDS, SO 3.5¢x; NEW CONST. MULTI.OUTL ET NON•RE NS 97.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES B 00 AL �' Nis Ex. Occup. onx�e�OSA PPES16JOREA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating �/ �Ir� >, 5 — 4;-0 Cooling(- ip�, rj"ja►'� (j Hood 6.50 Ventilation Lt-sp PERMIT FEt $ 45-, 0!7 Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 50 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall fort ith comply wit those ro iAions. f�_ Z y O� X Date / Signat of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavatio ver 60" deep and demolition or construction of structures over 3 stories in height. / Mobile Home Installation Fee $ Energy Inspection Fee $ occ TOTAL FEE $ (9 CONST. �FE HAz. D. IM D cDF PARC PD D E This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which feei ave been paid. III B pa Off PERMIT EXPIRES ON ly C3 Defe Receipt No. ' WHITE-D.D.S.-B.D. C A SS S OR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF OF BUTTE-DEPARTMENTV �LENT-SERVICES-BUILDING DIVISION a 7 County Center Drive, Oroville; COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 SCHEDULE OF FEES DUE OWNER PROPOSED BUILDING USE 1. BUILDING PERMIT FEES Balance Due ....................... $ Additional Fees Due ................. $ Additional Fees Due ................. $ Revised Plan Checking Fee ...... .$ SCHOOL DISTRICT FEES J�3. (paid at District Office) (Available after Plan Check) SHERIFF FEES (paid at Building Division) Residential ...................... x $360.00 = $ Units Commercial (sq. ft.) ............... x $0.03 = $ Sq. ft. 4. URBAN AREA FEES (paid at Building Division) Residential ................... x = $ # Units Amt. Commercial (sq. ft.) ............ -x-=$ Sq. ft. Amt. 5. RECREATIONAL DISTRICT FEES (paid at District Office) (Available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES J $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER .,.DATE 03(v-Glb 043 RECEIPT # DATE REC. r 101 P -,1A At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. APPLICANT DATE 11 z 7 " 0J. Pursuant to Government Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 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 - Buiding Div. 2nd Copy - Applicant 3rd Copy - Owner * (Rev. 6100) BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District cyo-yBuilding Department No. A.P. Number 0341-L9 I a bkV!-,> Jurisdiction:. City rCounty Property Owner Property Location/A Subdivision Lot No. Residential Development Sq. Footage No of Living 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 documen--) Commercial/Industrial Now Addition Building Distri6tid-l-6-ritification No. Lot J L k- tz School District certifies that (Street Address) Sq. Footage (including Exterior Roofed Areas) Date k-k1te1%.— (Applicant) (Phone Number) u.? C.JA-- q (City) (state) (Zip Code) has complied with the requirements of Resolution No. 01 -3 —b `( by payment of $ 44-90 representing . . .........a oc square feet. 292 : $ FULL :;;-n $ A— School District Riipres6htative Date Paid by Check # Remarks: 13-3 to — (0 0'.( 3 Notloe: You may protest the Imposition of the fees Identified above by submitting a written protest to the Dlsfticl, In compliance with Government Code Section 66020(a), within 90 days from the date fen are paid. Failure to submit a timely written protest will'prohibit you from challenging the Imposition of the fees In any court action. if, subsequat to the School DWrk:t Representative signing this Su is County Schools Impact Fee Cwdftadon Form, the School District Is ONNd by the applicable Local Planning Agency that this project Is being reviewed under the California Environments! Quality Act (CEQA), this p aI r may be subject to additional school fees to fulty millgate.1b; Impact on the school dWbkft schools. White (applicant), Yellow (building department), Pink (school dis1rict) feeform.xis (10/03)dinm PERMIT NO.: 89-04 Lake Oroville Area Public Utility. District 1960 Elgin Street OROVILLE, CALIFORNIA 95966 533-2000 DISTRICT APPROVAL AND VERIFICATION OF INSPECTION BUILDING SEWERS This verification form must be submitted to the Butte County Department of Public Works Building Department prior to issuance of a building or occupancy permit, whichever is applicable. Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by Lake Oroville Area Public Utility District, must be submitted to Butte County. Date: Applicant: Applicant Address: Applicant Phone No.: November 23, 2004 Doug Kahn 875 S. Barrett Rd. Yuba City CA 95991 674-2153 Property Locations(s): 30 Heather circle, broville CA 95966 A. P. No.(s): Fees due: Copley Acres Lot 16 036-61-0-043 All fees paid as of 11/23/04 Application for service approved: ' LAA 6OVILLE AREA PUBLIC UTILITY DISTRICT Inspection(s) made and successful test(s) observed: Location: Lake Oroville Area Public Utility District release to close permit: Date: By: Date: a COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - 7 County Center Drive *Oroville, California 95965 • Telephone ev.12/96) APPLICATION AND PERMIT .4SSESSORPARCELNUMB �O ZONING � g1�y{pyE 1 ^ C Ti✓71G7/L S`YI P CONTRACTOR'S NAME IG DIVISION 4 75 41 jqp ►ILDING PERMIT CONSTRUCTION LENDER PERMIT FEE Fireplace { p X ap 5h 1 D LENDER'S MAILING ADDRESS Total Valuation Is Fling Fee 20.00 ARCHITECT OR ENGINEER LICENSE No. Flirt Fee $ 20.00 Permit Fee $ Main Service 200A To I 000 ARCNTTECT OR ENGINEERS MAUNG ADDRESS Plan CheckingFee $ SULDWG ADDRESSF Energy Plan Checking Fee $ $ C-apL_ 144.egs sum PERMIT FEE $ LOTNo. / _ SUBDNISIONSNAME v� m� p� Q /J� j`/ PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap �' 7.00 USEOFSTRUCTURE i �� A �— ,,Er"o'Duplex ❑ Mobilehome ❑ Other SF SP�� Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK15.00 New,Z_"Addition ❑ Rem E3 ❑ Utilities ❑ Installation ❑ Other ❑ Il Describe Work: r Gas piping stem 1 - 5 outlets '� Building sewer 15.00 1 f Mobile Home S G W @20.00 I V 1-7.9'5 ANi0U1VT RECEIVED $ g �,hGin PA DATE RECEIVED vpo� RECEIPT ##L�'q PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ =c CONST. TYPE TO AL EE $ NAZ ID. FEES I WAV INEUCAD I CDF IXAqEL IS -SUE This permit is hereby issued u6der the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By PERMIT EXPIRES ON Date PERMIT FEE { p X ap 5h 1 D ELECTRICAL PERMIT Fling Fee 20.00 Main Service o.AAooaL=5 5S 23.00 PERMIT. FEE PAID .. SRA SHERIFF OTHER roll $9,Y9�NRES.D. $ �- $ $ Main Service 200A To I 000 46.00 NEW CONST. DWELLM OCCUR 3.5Q0. OR ADONS. a ACC. MDS. NEW CONS . MULSFOUTLEr @7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. 20 OUTLET OR FIXTURES @ I.50 EX. Occup. B+Lt. ® .so Ex. Occup. o TSID.OTJL 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Wise. Wiring 23.00 PERMIT FEE $ �' ,MECHANIqAL, PEJLMIT Fling Fee 20.00 Heating I S Cooling 15� 15 t Hood 6.50 (p�' I V 1-7.9'5 ANi0U1VT RECEIVED $ g �,hGin PA DATE RECEIVED vpo� RECEIPT ##L�'q PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ =c CONST. TYPE TO AL EE $ NAZ ID. FEES I WAV INEUCAD I CDF IXAqEL IS -SUE This permit is hereby issued u6der the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By PERMIT EXPIRES ON Date O.B.-1 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. G) personally plan to provide the major labor and materials for construction of the proposed operty improvement: YES 0 NO 0 2. HAVEIR HAVE NOT 0 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: CTIY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major woric NAME: ADDRESS: may: 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 NOTE. Thu Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification trust be completed and returned to our office before we are permitted to issue the pentni4 OVER OWNER BUIt.DER INFORMATION Dear Property Owner. 0.B-. An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner der" YOU are the responsible party of record on such a permit Building perm are not required to 6e signed by property owners unless they are personally perfom ing their own work If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required bylaw to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (Including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, wod= compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not cavy out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific infomration about your obligations under Federal Law, contract the Intemal Revenue Service (and, if you wish. the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit; erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is ret ar ed. ly> N I C. Vi ira, C.B.O. er, Building Inspection NOTE: This Owner -Builder InfomKdon is required by Seddon 19830 of the California Health mrd Safely Code OVER March 16, 2004 Mr. Michael Vieira County of Butte 7 County Center Drive Oroville, CA 95965-3397 Phone: (530) 538-7541 Fax: (530) 538-2140 Re: Plan Review: Kahn SFD Address: 30 Heather Circle Dear Mr. Vieira: County of Butte- FINAL REVIEW Jurisdiction Application No.: 03-3292 LP2A Job No. 203015-113 Linhart Petersen Powers Associates (LP2A) has completed a final review of the following documents: 1. Plans: Two (2) copies revised Plan Sheets 1 through 8 Title/Cover Sheet not dated by Sroka's Design and Drafting and two (2) copies 11 "x17" Site Plan undated. 2. Structural Calculations: Two (2) copies (cover + 2 pages) dated January 27, 2004 by Carl Anderson, P.E., Anderson Engineering Consultants. 3. Title 24 Energy Compliance Documentation: Two (2) revised copies dated January 21, 2004 by Sroka's Design and Drafting. 4. Prefabricated Roof Truss Calculations: Two (2) copies dated October 09, 2003 by Homewood Truss. These documents were reviewed only for their conformance to the 2001 California Building, Plumbing, Mechanical, and Electrical Codes. We have no further plan review comments. Therefore, we are recommending approval of the above noted items with the following conditions: 1. Compliance with SRA - CDF requirements (form stapled to plan -sets) 2. Redline revisions as noted on plans The above documents now bearing the "LP2A Plan Review Approval" stamp on all appropriate sheets are enclosed. Please let us know if you have any questions. Thank you. Sincerely, LINHART PETERSEN POWERS ASSOCIATES Robert T. Berna I.C.B.O. Plans Examiner RTB/CLJ/RNE:ag Richard N. Essenwanger I.C.B.O. Plans Examiner Enclosures: LINHART PETERSEN POWERS ASSOCIATES 7610 Auburn Boulevard • Citrus Heights, CA 95610 (916) 725-4200 • FAX (916) 725-8242 • Toll Free (877) 235-0653 Butte County Department ofDevelopmentServlces YVONNE CHRISTOPHER, DIRECTOR N 7 County Center Drive Oroville, CA 95965 (530) 538.7601 Telephone N (530) 538.7785 Facsimile M Q TO: FROM: ' M SUBJECT: O DATE: LP2A Michael Vieira (530) 538-7159 mvieira(a-buttecounty.net Plans Transmittal For Review Per Contract 1:1424J. M t"jp Applicant: IKhan,Doug Project Type: INSF 100% Plan Check Fees $ 468.00 Energy Calc Fees $ 23.00 $ 491.00 Permit 03-3292 APN: 036-610-043 70% $ 327.60 $ 16.10 $ 343.70 LP2A Fee $ 343.70 Copies Attached: Qty Chk AApplication Site Plan Review FEMA Elevation Certificate Building Plans - Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other ^ii •AP: to 036 610 0"43 DATES y ,10/24/3 t: 01/00/00 01/00/00 01/00/00 Doug OUTlt t County fButte :o G4/Hda�o 7 OWNER 4 G'' 4 Khan: can G r Phone 673 2153 t k o 0 s es at a stX , e '° e a ert� az Phone x 7 t V+i DEPARTMENT OF a` N i' MAIL ' Phone ° a_' 875 S Barrett7Road BE'— x ... t7, DEVELOPMENT SERVICES ADDRESS:Yuba Building Division t ,: Ci ,, la ;x ", 'I'd95993„„ ;, ,.^. „„ ,, xWia 'ex° Owner °Vyil.i gm t ieG , I '' Phone let k et 7 rs 7 County Center Drive CONTRACTOR tt 7 ,t f s c' 7 F eft a G to k G a a t t Phone t r a Oroville,' CA 96965 O .., . . - t t. e� xP't 6zxv:xxxx. : .r,S xx x7 Ft p.k.x..r x x.xxi.xa.xx."-; Email x . es t t •(530)638-7541. , F7 t n 7 t t s G e' Phone { t G _. ARCHITECT OR ENGINEER ex 7 7.0 I t tt 4 4? yt 2 t- t t et 7§ N t t j tl i R Gx EjG, G E !`9 eF LicNoe tat o:e'.4 spERMITNUMBER• - .. 03, 3292 a x apt s a t t. f7 teGf t t t ” �x e , FeF _,FFF , ,x.c>. F. x xxx;-.t xx„Fx.. ,, ,xx:xx;Y .xx,: Email ,a ,a7 -x kx x x.,x,x x,t, x ... .., � � SITE � 4 d k 30 Heather CtF. � t tk F k Y rcletet. , € Phone .. . .. APPLIC'ATION AND PERMIT t 7 ) a, t 9 ' " I , tt t tt f. er x f t a a s ' ADDRESS F x' Email a T+ t k 7 4k USE 1 Ftt4a s Px Fier, _ t ex Other i 7 x t a xt'a I'7 7 _ 4 , t 3 a 4 t 4 4 �' , s ttt m o o F f,t a 64 is t G t 7 i 4# 7tF e t "Ge t. t t t t A' t tt eft z tx.i .k xxevtxx",ttltert, :..F.:L..u_ .. __:ixF.., C•xxuxx-_ _...... .. ;. k. .. ___'.d3..:.. :.. xxwx__ _..t .ek_:.'..._.:.t „xltxt"�StY�::t:et_...:. TYPE OF °:New G Addn Rmdl t Utlts Instln., -` t a t t t t7 - G a 4 E t 4�i k WORK 7. 7 9 y 4 o n r f a i€ t t Other:; a i t n Y e T q - Int t 4e G k 3 tff. km G u. dCF.C:..55:...., _u y_Y3:v____ .. ,....__: DESCRIPTION NSF r S t -Hip Y, e.. _ t, s tt „ 7x � e t4f7 t t yc t44444tt.tt:t 4 -: G;ek:tttt;ere.;7t7tt-'ftteGr,et:". 3 :. . z o s t �. �t5� �.. t €tv'� t i : I. �4 t�...v_?Lk ;zx k4 .G,t _._e..tt i' i .� . .._,:_ _ _N1:.__i,fillkt k _1.:._,H .__� __: _.l im J. .._ E_ _CE.:.:._'i,.t 3 �__h�_..'c �:_0._YE�!_�_S � .. _�_I.._.�_ t , F x 5 .,fix � `�..�.. ,:f ae S= � fi� •r a,--- '3 t � S.7 LICENSED.CONTRACTOR 'ARATIONs 55 y z o _.., .t , x._v±✓ a3.:.. „kYxH 'i" ._..,.._ dSZX .aeY .l. wv,.o- ,, vU..�F`.e'. s&:w 5L .fu;,.�, ..,...... _.0 X�e_^` Yi I hereby affirm under: penality of perjury that I am licensed under provisions of Chapter,9 (commencing with Section,7000) of Division 3 of the Business and Professions Code; and my license is in Tull force and effect �",x,v t 3 �4 d4t - F :5 x _fro-,iC y:. t # H ., ,. License Class F"%%` ,f"k�,, .7,4 . l ". _.._ -Yt. License No . xxgw„t G k, m ; t . ...FSG t t , 4 F _., i'' '°'.4' xe-� 4-,* 'k�e^' •i�'''%Y'i � -.% { xk j 'y, _ ^"3_a_.."s” vSx.a,. y 'A 'F+xv aYf,-i-} '�.X'W 4'•: 3{v _ fiirY 4 y ivl. :....., y £,i!.`14. k !'LA's '�'T Y: 3'.FS'fi DECL�`QRATION tea,.. OWNER.BUI..LDER hereby affirm under penality of perjury that I am exempt from the Contractor's State License Caw for the folio wing"reason: o 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. p I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ' ' I am exempt under Sec. ` 4H t" G GS -Business and'Professions Code'for this reason: ® x �� s s sx et ¢ .. n t t 4 i t�G 4 4. G G h t t r t 7'c € G 7 '_. t_x _: n __N -P, _xs.._. __ _:.... ?<__ .. _ : ' __ _ ...: _ t6._..n_F x ,F . ? .s... _ � i1 ,ez ._:§ F_ _ ... - Y . f_ . ° - i G ' s, .._. 4 es _ . P,y .. Y ': v"U '•:C C-. WOf2KERS' COMPENSATIQN DECtLARATION4 _,. _-' '..! I hereb affirm under ens of perjurydne of the followin 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: I have and will maintain workers' comperisation,insurance, as required.by Section 3700„of the, Labor Code, for the performarice•of the work forwhich this permit is issued. My workers' compensation insurance carrier and policy number are:, . �FIflr' 7 @ t 4'� t9 ta]y e14 kms' vxGG -t t_'G G "S'i Camey SH5 s G ex; G 5 xxu. x a.x Gk G x xGexk t. :G exx & S x. x x kt .x.- :Gxax t_MMUM sx Ga,xxG,x - ,5 gff 7 9 cG F q t'eY `kfu G + ° .i;: Gxx,axx„lax Policy Number ,x:7tff.e77 x,mn,x ,' xxx.xxx t Ixxxxxx4xxx,:., e xxkf?n:aa.:xzG xxx 4 x;xe 3@ t.xl I(This section need not be completed if the ermitis for one hundred dollars $100 or less .'' 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' D compensation laws of California, anda gree that; if I should. become subject to the worker's compensation provision's of Section 3700 of the Labor Code, I shall forthwith . comply with those provisions., WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF,COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE INTEREST, AND ATTORNEY'S FEES. CONSTRU,CTIONrLENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of work for which this permit w issued a t d, AME. t.', "C tguif ” t c .' :. e'"�e eeitx t,ux.xx.� -. Lenders Name: tx,...._ ,,. ,+., c..._?,.. G.,s......r.x7.Es._1,.,....,.xxxx.G=s.s;:: ., t GG Gt Lt t 7x4 - 1 .G G G ty 74 7 'xF t G '. xG 9 { t90. k yx k , Lenders Address: a ;. _, r, ., :..,.... ar.. a s ........ ..... G _.,. , .9, .,..; tGr .,., .. ?., ..3axcG.,..s, certify that have read this application and state that the above information`is"correct. I�agree to comply with all city and county ordinances and state laws relating.to building construction; and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection,.. -: purposes. Signature of Applicant Date : '..°Yk.HOwner ..... Contractor Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of'structures over 3 stories in height. This permit Is hereby Issued under the applicable provisions of the •Butte County Code and/or Resolutions to do work Indicated above for which fees have been paid.: , e Date _PERMIT EXPIRES.ON: By Date ..Page 1 of 3 N AP NO.: 036-610-043 DATES: 10/24/03 af N Ci M OWNER: Khan SITE ADDRESS: 30 Phone: Heather Circle 673-2153 Oroville C Zoning A-R Acres 0.47 Name/Date Copley Acres 08-01-63 Flood X Map/Book 30 38/40 70/72 Block Lot 16 Panel 0985D Snow Load Other $/8/2003 SRA Yes VALUATION CODE SQ FT $/SQ FT VALUATION Residential/ Guest House/Heated Fun Room R 2000 $54.00 $ 108,000.00 Business/Office U 768 $18.00 $ 13,824.00 Covered Cov 42 $13.00 $ 546.00 Storage/Commercial $ _ $ - Re-Roof X SQ $ 60.00 Calculatesquares 20 ft x 30ft = 60 sf = 6 squares Fireplace A (Zero Clr): Masonry: $ - TOTAL VALUATION $ 122,370.00 BUILDING PERMIT FEES - QTY FEES FILING FEE 1 $ 20.00 $ 20.00 Permit Fee - Full 1 Permit Fee -1/2 (MH)1. $ 720.00 Plan Check @ 65% Permit Fee 1 $ 468.00 Plan Check Minimum/Mobile Home State Approved Plan $ 23.00 $ - Plan Check MASTER PLANS ONLY -- $ - Revised Plan Check $ 46.00 $ - Energy Inspection Fee 1 $ 46.00 $ 46.00 Energy Plan Check Commercial 4000+: $ - Residential 1 To Master: 1 $ 23.00 Mobile Home Installation Inspection $ 100.00 $ - $ - __ _ $ - TOTAL BUILDING,*PERMIT FEES $ 1,277.00 PLUMBING PERMIT FILING FEE 1 $ 20.00 $ 20.00 Each Trap 11 $ 7.00 $ 77.00 Solar or heat pump water heater $ 23.00 $ - Water piping 1 $ 15.00 $ 15.00 Each gas water heater or vent 1 $ 15.00 $ 15.00 Gas piping system 1-5 Outlets 1 5+'Outlets $15/$3 $ 15.00 Building Sewer 1 $ 15.00 $ 15.00 Mobile Home Utilities Sewer: I I Water: I Gas: 1 $ 20.00 $ - TOTAL PLUMBING.PERMIT FEES $ 157.00 N, AP f4b.: Mums 036-610-043 DATES: 10/24/03 - gg r.,.xx; ate...:., x.>z xx.xxxx,x .�x. N OWNER: Khan - Phone: 673-2153 Ci SITE ADDRESS:30 Heather Circle' Oroville Via-- ..�.ks,., � -�.�a'.�.;.:.�k E,, ...-r.i`.>ss. ,--S,b'' -. G•,..n FILING FEE .... � 1 $ 20.00 $ 20.00« 600V or less/200A or less, �k 1 .$ 23.00 $ 23.00 Main Service 200+A to 1000A $ 46.00 '$ _ New Construction or Addns ; Dwelling Occupied &Accessory Bldgs _ x 2768 x�x.x ` $ " 0.035 $ 96:88 New Construction Multi -Outlet Branch Circuits '-` ° ° $ 7.50 Power'Apparatus & Single Outlet,Cir: »... °' F k;g $ - Non -Residential 1-20- $ 1.00 Outlets Fixtures $ Existing Occupied or 20+ ` F $ , 0.50 $ _ Fixed Appliances or Outlets (Res) ea:�'°� $ 5.00 $ .x xx.. Temporary Service $ 23.00 $ Mobile Home Facilities $ 20.00 $ Miscellaneous $ 23.00 $ .Wiring _ Pre -Inspection (existing MH, existing site)x $ 23.00 $ _. yya;`,y . Pool Electric; a, .. ,.4 ' °' $ 30:00Mg. k 7� h8 +r C $ 0A_fl ! 97S A C C k� :. S _4..• "`� 7 x i :x. k.:kr7x�+t:Y n^M,x:;`�_., xah.: .;.xa, K v:Ixn xxxx x )<` x.Nx ! xV,.n x:nx.axrx : x axxn.. + :xx .rkx xxxa;.xx.v; .x '{MINN.-Cx iu:.xixx x.vxxxxur FxuxxxxKx xax 'xxzx.x C ny 4 CS i_ yy� � "5:, G rm ?; N k i& i k 8i S ..� 2 ' S 4 v P A & %. '� �' xavx.vx x,Cx.Av:x ...naxxCx+l. •x...xx,:.vuux.xxx: uSv av,c.t.'Ixx@ ..rnuxxxx:e 'f. x.xxxx xxxx 8 xxvaxx.x:x S xx:xxxussx .. xx.rxxxxx xuxrExxxx3 xxxx r` :.. �" x..xaxxx xssxa r,xxxxx x,. �'3xxVx. :xxux.xxxx'$ "r - " f "'/ '?'h`u4 TOTAL ELE(C�ZTRICAL PERMITTIFEES$,F f'' F 1`3988 a ,« t n'f4b..� x: a.:vsay. w.ww ,v:w6..a�: E..+«..iw:aut2',rt :vx="3w, ,..:."k n a�f(,x''ivei'ni r.� .. ai. >*!f n �...'J,a-6v - .a<az.; S; �'±:�f 4 Y' t ieE/f 'C "I 4v«I '. -M" ": dM ri A€ ={,RYS tv 5 t.,;ra':y MECHANICAL PERMIT iia- .. yw dx( `.. fb(�i a> gi` %.F4{fTi.{ i .K.. F, e= E {L i.: .U' k' E ,-A k r _- r._... ,.. ...x,. _..,.,. ... x,.� -rzv.atl._� k f :ix., nr:. .5 &'2.2, ea.,.,.-za..�,-n asK'a�i�A,<sx x,. >.F..�iF.a. ;w.r<:_ -.. s:..t;a d;PiHx......�.t_'2k':.x. yp _ vA ;-=�K!.<v ,:r.'••a:"`' �a-E .z 'f.l '`fir^ FILING FEE -mg $. 20.00 20.00xx Up to and including' 100,000 BTU H. °'1 $ 15.00 $' 15.00 Heating Greater than 100;000 BTU Tum ''' $ 20.00 $ .. - < Up to 3' HP and 100,000 BTU ...fi_....., 1' ,$- 15.00 $ 15.00 Cooling 3+ to"15 HP and Over 100,000. -BTU ° ;xx l $ 25.00 $ 25.00 Evaporative Cooleyr $ 15.00 $MRH Extend Ducts in Additions �. x..:x.... $ 15.00 $ Hoods 1 $ 6.50• $ 6.50 Ventilation' 3 $ 4.50 $ 13.50 ... Gas Fireplace Na�., $ 15.00 $ . _. i_ 9 g4 . - 5 71 9 +"`pyo, I's _..; f� - �.€l .. ...."kk `ksnE.5 r ff ,MECHANICAL PERMIT�FEES$ E "f x 95 OOz. r�$w3 � � � "! f ��3 �x t ..,��P,\.� f.--�'.r3��'e..x..e.u.. ;.e."h•Yn•.Yfta re?v.. ._ ._._ _'. a...�93; r. ..... Nrk. T�<.-x. �.Ex�.c ."-�Cnl�. r?a w:. a � ..'AN•i�>r v�oL�:rcy.:F•z .� . v �:.Nf ,N5*.... x�I BUILDING PERMIT-FEESx� :..., n_ , Occupancy: #; " Construction ' ' F ISSUED ;. j i 4 . y. �, xx HAZ FEES IMP.'" FLOOD CDF PRCL -,PD HD NN - _ M:N F L- f ? F 4 -f1 - e !3:px.? NO.: 036-610-043 DATES: 1 10/24/03 Notes: INER: Khan - Phone: 673-2153 30 Heather Circle Oroville nlRFRA 'ATE RESPONSIBILITY AREA SRA BALANCE SRA Per Structure I 1 13 89.00 1 S 89.00 DUE SRA FEES $ 89.00 a ,o SHERIFF Sheriff Residential Per SF Livin Unil 1 1 $360.00 1 $ 360.00 TOTAL SHERIFF FEES $ 360.00 TOTAL NCSP FEES $ - Filing Fees DRAINAGE 50.00 Thermalito Residential Per LMna Unit I S510.00 $ REQUIRED MINIMUM PAYMENT OF FEES $ 660.00 Commercial Per Ordmance 3304 TOTAL BUILDING PERMIT FEES 1,668.88 $$ TOTAL DRAINAGE FEES $ STREET IMPROVEMENTS $0.03 rOWES $ 2,117.85 $ - $ PAID PAID PAID PAID Commercial Per Each single LMna Unil S 1982.00 Chico Urban Area Commercial Service structures Per Sq. Ft. $ 2.22 $ Commercial Industrial structures Per Sq. Ft. S 1.02 $ Residential Per Each Single 1 -King Unit S 595.00 $ Thermalho Urban Area Commercial Office Per Acre S 11924.E S Industrial I Light I Per Atte 1 $5962.40 $ TOTAL STREET IMPROVEMENT FEES $ WATER TENDER Water Tender Per Parcel IS 200.00 S TOTAL WATER TENDER FEES $ NORTH CHICO SPECIFIC PLAN NCSP Residential I SR - 1 Per DU S 3,315.000 $ Industria[/Commercial Office Per SF s 2.32 $ ,. _.-__. I x »ata nnn S TOTAL NCSP FEES $ - Filing Fees $ 50.00 TOTAL IMPACT FEES $ 360.00 391127 10/24/03 PA Doug Khan 1.103 $. 2,117.85 - - $ 2,117.85 $ $ $ $ 360.00 $ $ $ Collected by Deeveloefopmeent n OTHER FEES: REQUIRED MINIMUM PAYMENT OF FEES $ 660.00 PROOF OF PAYMFENT REQUIRED FOR FEES BELOW services TOTAL BUILDING PERMIT FEES 1,668.88 0.03 s - 1,668.85 _ SCHOOL DISTRICTS - Proof of Pa ment Onl TOTAL ALL FEES $ 2,117.88 $0.03 rOWES $ 2,117.85 $ - $ PAID PAID PAID PAID MINIMUM PAYMENT OF FEES BUILDING Filing Fees $ 50.00 Receipt No. Receipt Date Staff Initials Receipt Name Check Number Check Amount Cash TOTAL PAID 391127 10/24/03 PA Doug Khan 1.103 $. 2,117.85 - - $ 2,117.85 $ $ $ IPlan Check Fees $ 491.00 SUBTOTAL BLDG $. 571.00 SRA FEES $ 89.00 REQUIRED MINIMUM PAYMENT OF FEES $ 660.00 PROOF OF PAYMFENT REQUIRED FOR FEES BELOW RECREATION DISTRICTS -Proof of Pa mens Onl Chico Area Residengal Per Livin Unit S 1,189.00 1 $ ❑ Durham Residential Per Sq. Ft. 1 $ 1.041$ 1 ❑ Is _1 ❑ SCHOOL DISTRICTS - Proof of Pa ment Onl OrovilleElementary -091 Residential1 2,000 1 2.141$ 4,280.00 1 ❑ " CHECK ('ro9 CHECKLIST FOR SHIPPING PLANS TO LP2A The following items must be included when shipping plans to LP2A for plan check: ICover Sheet Copy of Site Plan Review Form with important items highlighted. (i.e. map conditions, site elevation if snow load area, fire sprinklers, flood zone, requirements for engineered foundations, etc.) ' (2) sets of plans with plot plans. (1 plot plan stamped and signed by CDF if in SRA. Both sets of plans must be signed and stamped by the engineer or architect of record for commercial construction or engineered structures.) (2) sets of structural calculations.. (Commercial or engineered structures) p(2) sets of energy calculations. (2) sets of truss calculations. (Designed for appropriate snow load.) (2) wet stamped flood elevation certificates. (If within a flood hazard zone.) (2) copies of SRA requirements. (If in SRA.) Copy of geotechnical report recommendations. (If a geotechnical report is referenced on the parcel map or subdivision map.) (2) copies of Residential/Commercial Construction Requirements. (Blue sheets) Residential/eonmte °eiat Plan Review Guide. Butte County Air Quality Management District Rule 207 Form. (If a fireplace or wood burning device is shown on the plans.) Code analysis for commercial construction. (Must be included on the plans.) Permit history for commercial construction. (i.e. copy of file "jacket".) • Enter date shipped to LP2A in "Access" a Place assembled plans and documents in shipping bags provided by LP2A • Prepare shipping label • Call LP2A for pickup Sent by: Date sent: K 499-- p36• L,10 - 0C/3 CHECKLIST FOR SHIPPING PLANS TO LP2A The following items must be included when shipping plans to LP2A for plan check: ICover Sheet Copy of Site Plan Review Form with important items highlighted. (i.e. map conditions, site elevation if snow load area, fire sprinklers, flood zone, requirements for engineered foundations, etc.) ' (2) sets of plans with plot plans. (1 plot plan stamped and signed by CDF if in SRA. Both sets of plans must be signed and stamped by the engineer'or architect of record for commercial construction or engineered structures.) (2) sets of structural calculations.. (Commercial or engineered structures) (2) sets of energy calculations,) (2) sets of truss calculations. (Designed for appropriate snow load.) (2) wet stamped flood elevation certificates. (If within a flood hazard zone.) (2) copies of SRA requirements. (If in SRA) Copy of geotechnical report recommendations. (If a geotechnical report is referenced on the parcel map or subdivision map.) (2) copies of Residential/Commercial Construction Requirements. (Blue sheets) ResidentiaVE� Plan Review Guide. Butte County Air Quality Management District Rule 207 Form. (If a fireplace or wood burning device is shown on the plans.) Code analysis for commercial construction. (Must be included on the plans.) Permit history for commercial construction. (i.e. copy of file "jacket".) • Enter date shipped to LP2A in "Access" Place assembled plans and documents in shipping bags provided by LP2A • Prepare shipping label • Call LP2A for pickup Sent by: Date sent: SITE PLAN REVIEW APPLICATION Date: 0--;-) AP# D a t- (:;./0— O y 3 Permit Number (if applicable) - 32� Z Bin Number A b APPLICANT INFORMATION Parcel Size: A (L OwnersName: ` f/ H A i) , b09 &- Owners Address: aia 2P,_C-- T 121 , CA '95993 Telephone No.: 16 2, S — 215 Situs Address: 3 O H E)g7T H Ci fz c L_6_ Proposed Use: Residential A New Single Family Residential ❑ Single Family Addition ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ 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 Site Plan Stamped Approved BY LP Date ) 0—so Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY !e 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: X • Flood Panel No.: 0 G) D s Index Date: Li ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance --------------------------------------------------------------------------------------------------------------- ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: A — Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front S 6 0--/L- Side 5 Side Street Rear 'Z .C";' 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 1. i Applicable Development Fees: 1 Standard Fees Amount Formula ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other ---------------------------------------------- Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By Q Deeds: 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 ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 IS Subdivision Map/Parcel Map: Gp Map Date of Recording: �— 6 Lot: ❑ Use Permit/Minor Use Permit Permit Number: /,Z zC Book: Date of Approval: _ Page: 3 z Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Attached ga None ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. ❑ U Page 4 of 5 z•. s J�5 .00 q�t P" I CD cn OD, OD 'OD %- o o gip, 0 te.C)o co C-4 0. © � -oo�`' `f' oma, � 0. .0 to :Zt '39 THE C'l 0 � Q)C 0 C) CD C4 04 4 o ILI 04 '50 0 00 q r✓ CDF FIRE SAFE REQUIREMENTS z36-6Ia43 0:9-32-9 , AP# PEFMT # NAME Under authority of PRC 4290, the following checked items are required by the Butte County Fire Department and are made a part of this permit. These requirements are minimums and will be superseded by Butte County local regulations which equal or exceed these standards. Field inspections will be made by the Butte County Building Department for compliance. [X] 1272.00 Maintenance of Defensible Space. To ensure continued maintenance of properties in conformance with these standards and measures and to assure continued availability, access and utilization of the defensible space provide for in these standards, annual maintenance must be provided for by the land owner. Driveway Standards [X] 1273.02 Surface. All driveway surfaces and structures (bridges, culverts and other appurtenant structures which supplement the roadway bed or shoulders) shall provide unobstructed access to conventional drive vehicles. Including sedans and fire apparatus weighing up to 40,000 pounds. [X] 1273.03 Grade. Not to exceed 16 percent unless paved. 1273.04 Driveway Radius [X] 1. No roadway shall have a horizontal inside radius of curvature of less than 50 feet and additional surface width of feet shall be added to curves of 50-100 feet radius; 2 feet to those from 100- 200 feet. [X] 2. The length of vertical curves in roadways exclusive of gutters, ditches and drainage structures designed to hold or divert water shall be not less than 100 feet. [X] 1273.05 Turnarounds. If required, will have a minimum turning radius of 40 feet from the center of the road. [X] 1273.06 Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 foot taper on each end. [X] 1273.10 Width. All driveways shall provide a minimum 10 foot traffic lane and unobstructed vertical clearance of 15 feet along its entire length. Page 1 of 3 -& 10 L0 D'� - 3 z 2- /<' 4/J) Do4 AP# PERMIT# NAME [X] 1273.10 Turnouts. Driveways exceeding 150 feet in length,. but less than 800 feet in length, shall provide a turnout near the midpoint of the driveway. Where a driveway exceeds 800 feet, turnouts shall be provided no more than 400 feet apart. [X] 1273.10 Turnaround. A turnaround shall be provided at all building sites on driveways over 300 feet in length and shall be within 50 feet of the building. 1273.11 Gates [X] 1. Gate entrances shall be at least two feet wider than the roadway it serves. [X] 2. The gates must be located at least 30 feet from the roadway and shall open to allow a vehicle to stop without obstructing traffic on that roadway. [X] 3. Where a one-way road with a single traffic lane provides entrance, a 50 foot turning radius shall be used. Fuel Modification 1276.01 Setback for Structure Defensible Space [ ] 1. All parcels 1 acre and larger shall provide a minimum 30 foot setback for buildings and accessory buildings from all property lines and/or the center of the road. 2. For parcels less than 1 acre, local jurisdiction shall provide for the same practical effect. See other requirements on page 3. 1276.02 Disposal of Vegetation and Fuels. Disposal, including chipping, burying, burning or removal to a landfill site approved by the local jurisdiction, of flammable vegetation and fuels caused by site development and construction, road and driveway construction and fuel modification shalt be completed prior to completion of road construction or final inspection of a building permit. Page 2 of 3 'o AN PERMIT # Other Requirements [j If Building Setback is 15 to 30 Feet: Class A or B roof and Enclosed Eaves k ,j &c 1 AME If Building Setback is Less Than 15 Feet- Class A or B Roof with Enclosed Eaves and: Choose any 2 of the following: - Metal or no doors on the side toward property line with insufficient setback - Interior automatic fire sprinkler system per NFPA 13D - Glass area not to exceed 10 % of wall area toward property line with insufficient setback - Siding from the following list: Stucco — 3 coat Hardi- Board or Plank Masonry Masonry veneer r Metal Other Butte County Fire Department approved materials iJ 3 (�-/,0 03 Date Signature Page 3 of 3 National Pollutant Discharge Elimination System (NPDES) Phase II & SWPPP Non -Certification for Project # for Butte County Storm Water Permit Compliance By signing below, I, the project architect/engineer of record, indicate that I am aware that a construction project that disturbs more than 1 acre of land requires a Construction Storm Water Permit from the State Water Resources Control Board. I, additionally, understand that it is the project owner's/owner's agent's responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP) and a fee of $700.00 to the State Water Resources Control Board to obtain such a permit. I, further, certify that this project will not disturb more than 1 acre of land. I have also reviewed the Best Management Practices Handbooks, California Storm Water Quality Task Force, Sacramento, CA. I certify that appropriate BMPs will be implemented to effectively minimize the negative impacts of this project's construction activities on storm water quality. I acknowledge that it is my obligation to make the project owner and contractor aware that the selected BMPs must be installed, monitored, and maintained to ensure their effectiveness. If, at any time, site conditions and/or observations by a County official warrant reevaluation and revisions of the chosen BNIPs, the appropriate changes will be made without unnecessary delay. I am aware that failure to properly implement and maintain the BMPs necessary to prevent the discharge of pollutants from this project during construction could result in significant penalties and/or delays. Signed: Title: Date: By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs more than 1 acre of land requires a Construction Storm Water Permit from the State Water Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP) and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit, if my project disturbs more than 1 acre of land. I, further, certify that this project will not disturb more than 1 acre of land. This document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified individuals properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons directly responsible for gathering the information, I certify, to the best of my knowledge and belief, that the information submitted is true, accurate, and complete. Signed: Title: Date: /M -Z u -O NPDES & SWPPP Non -Compliance Certification Draft Butte County Stormwater Plan AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 CORY:zof Document Recorded 24 -Qct -2003 2003-0074605 Has not been compared with original BUTTE COUNTY RECORDER AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Date / U Z Z - o,3 State of California County of On ..O. 9-003 before F-� 4&1 0 �'LLG personally appeared S.k'ka-,, a► -A EhKore --Personally known to me (or proved to nA on the basis of satisfactory evidence) to be the persons) whose name(s),Ware subscribed to the within instrument and acknowledged to me that 4m49he/they executed the same in hisAt r/their authorized capacity(ies), and that by4+64ier/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my and and official seal. DUANE F. HALEY r ♦� s Signature— > COMM. # 1425735 Z a I: �. �• NOTARY PUBLIC - CALIFORNIA Z svrTER COUNTY . 1) MY Conon Expires JUN 21, 2007 A.P. # D36 . 610 -Ov-vob Order No. BU -204013-3 CB Description The land referred to herein is situated in the State of California, County of Butte, and is described as follows: LOT 16, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "COPLEY ACRES SUBDIVISION', WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 1, 1963, IN BOOK 30 OF MAPS, AT PAGE(S) 38, 39 AND 40. APN 036-610-043-000 SITE PLAN REVIEW APPLICATION Date: ' zq- n AP# () 3 /0 r 6/ 0— O L Permit Number (if applicable) Z Bin Number APPLICANT INFORMATION Parcel Size: ' A L Owners Name: J Owners Address: 2 a F� 2P_G: (TT Y2_b _ y, C, CA 9 5 9 9 3 Telephone No.: % S-2-)55 Situs Address: H EA-rH EY2- C1 2C L_6 Proposed Use: Residential J1 New Single Family Residential ❑ Single Family Addition ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ 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 Site Plan Stamped Approved BY Date 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: X • Flood Panel No.: o G) &5 Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: h — 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 S6 0--/L- --L- Side Side 5 Side Street Rear 'Z 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 ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) Formula * 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 II Deeds: 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: E] No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 _ ma Subdivision Man/Parcel Mme: co PC.7 Map Date of Recording: 1— 6 Lot: ❑ Use Permit/Minor Use Permit Permit Number: p,Ae(?-Es -!�v-(�> Book: SC) Date of Approval: Page: 3 A D Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Attached 0 None ❑ 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. a Page 4 of 5 -1. 40?- + tv do. o , �; desC.—c� .pQ� lul .vim, o �� .a:s N cp0 9 p �� 9� •tri _� �% 0 �� .�, _o s 130 �� � } "��, •, / �,� tib \ \ *Q 0" N � A � "Q�,-� � � "�,• � QCs �,0� " O TO 04 us loo vc o 30 ��. � g0 : "• 040 � SNE zt