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069-170-008
11„r ti• L IH._�1�`gift1 ♦ �. Q IT 069-170-008 05-2426 ' HIRSCHY, TERRY a+ _ ROCKY BAR LN., ROVI E CONT MIKE COOK ON NSE(N-STR01-18) ,JF fi1 M c y 1k ✓ y t{�-.e 3 c. ac i a Go ;r, 'Wi - jk �n n f ° �` •; > 7 +1'ty�- ' w 1 ` r-F r 41 .s. .� l V } C County of Butte Oroville, CaliforniaFJTa:E GENERAL CLAIM 02035 CLAIMANT: Terry Hirschy ®n '� �'s Dr vELOPYTKNT ADDRESS: 4155 Ishi Trial SERVICES CITY & STATE: Oroville, CA 95965 MAIC nc rl Amn. 11 /1d/nr ' SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY AMOUNT Refund Claim - See attached calculation sheet APN: 069-170-008 Permit No.: 05-2426 PAID RETAINED REFUND Development Services $ 744.72 $ 689.73 $ 109.98 THERM DRNG $ $ - $ - SMIP $ $ $ SHR $ - $ $ - SRA $ 95.00 $ $ 95.00 TOTAL $ 744.72 $ 689.73 $ 204.98 ............ ............. ............ .............. :::::::::::::::::::::::: :.. ..... k': ...... ............................................. .............................. ............................................. ...... REAKDOWN;:::::::::::: ..... .. .............. BUDGES :::::ACCEi ........... ............... ............. .............. J1VT . ............. .............. ............. :::AMOUNT:; 101001 DVLPMNT SVC 440-001 4210500 $ 109.98 1011822 THERM DRNG 1800 280 $ 1011430 SMIP 1001 280 $ - 1011811 SHR 1800 280 $ - 101001 SRA 0100 4617240 $ 95.00 TOTAL $ 204.98 $ 204.98 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. c Dated this day of 117, 2005, at Calif. Sign a of Claimant I, the undersigned, hereby certify that, to the best of my knovdedge, the services or articles specified above have been performed or delivered and that there is a Budget Appropriation r Speck Board Approval (Check one) for the me. Dated this �rJ day of v ✓ ` 2005, at Oroville Calif. v Del �a partment Head or Authorized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT &SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB_ GROSS AMT. o�uTTFo Butte County Department of Development Services 0 0 0 o www.buttecounty.netldds 0 = •.- o 0 7 County Center Drive cOUN'�y Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile ADMINISTRATION * BUILDING * PLANNING 11/1.4/2005 Terry Hirschy . 4155 Ishi Trail .Oroville, CA 95965 RE: Permit No. 05-2426 APN#069-170-008 Owner: SAME On 9/9/2005, a deposit was made in the amount of $839.72, of which $689.73 was retained. Please sign, date, and return the enclosed claim form to this office. Once we receive the claim form, we will then process your refund in the amount of $204.98: Should you have any questions, please. contact this office Monday through Friday, 8:00 a.m. to 4:00 p.m., at 538-7601. Sincerely, " l Diane Lewelleri Account Clerk, Senior Administrative Division enclosure 05-2426.1tr County of Butte Oroville, California GENERAL CLAIM CLAIMANT: Terry Hirsch ADDRESS: 4155 Ishi Trial DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY CITY & STATE: Oroville, CA 95965 Refund Claim - See attached calculation sheet APN: 069-170-008 DATE nF CI AIM- 11/14/n.s SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY AMOUNT Refund Claim - See attached calculation sheet APN: 069-170-008 Permit No.: 05-2426 PAID RETAINED REFUND Develo ment Services $ 744.72 $ 689.73 $ 109.98 THERM DRNG $ - $ - $ - SMIP $ $ _ $ SHR $ _ $ _ $ _ SRA $ 95.00 $ - $ 95.00 TOTAL $ 744.72 $ 689.73 $ 204.98 ::::::iEALDO.?VN::::::::`:::::$[JTrGE T;:;:::AGCOUNT::::i'iN10UN:T: 101001 DVLPMNT SVC 440-001 4210500 $ 109.98 %* ::o::::•:•: 1011822 THERM DRNG 1800 280 $ - .......•.•.. ' 1011430 SMIP 1001 280 $ - 1011811 SHR 1800 280 $ - 101001 SRA 0100 4617240 $ 95.00 TOTAL 1 1 $ 204.98 $ 204.98 i, cne unaersignea, aeciare unser penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. Dated this day of 2005, at Calif. Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Check one) for the same. Dated this day of , 2005, at Oroville Calif. Department Head or Authorized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE -AUDITOR'S USE ONLY .PT & SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT. CITY & STATE: DATE OF CLAIM: NUMBER: DATE: ISSUED TO: CHECK #: AMOUNT: PERMIT #: PRIOR REFUNDS: FEES VERIFIED DETAIL BLDG I Time 109.98 REFUND PROCESS FEE BUILDING TOTAL THERM DRNG SMIP SHR ; ._. APPROVAL Date Reviewed Scott Rutherford Chief Building Inspector HEET Terry Hirsch 4155 Ishi Trial Oroville, CA 95965 11/14/05 APN: 069-170-008 RECEIPT INFORMATION 435570 09/09/05 Terry Hirschy 1101 $839.72 05-2426 Yes Ni x x REFUND No BLDG THRM DRNG AUD SUSP HER`DEV FE fIRel, . 0010 1800 1001 9800 0100>, 440-001 rHRM DRN (SMIP) � (SHR) ) (SRA) i �"" a:�, •. Accnt Cash 4210500 101001 280 1011822 280 1011430 , '-280 c '14617240'- 101,1811f r, 4617240`: 1,1010011,4,; 1 =x PAID RETAIN REFUND 744.72 .......... .......... ..................... .......... .......... .......... .......... .......... :.:.:.:.:::::: ::::::::: ":;:;:;::;::;:;: .......... :::::::::: .......... :::::::::: . .......... ......... .......... .........: .......... .......... ::::::::: ......... 0.00 0.00 :::::::::::::::::::::::::::::::::::::::::::' :::::::::::::::::::::::::::::::::::::::::::::::% ............................... ::::::::::::::::::::::::: ............................... 634.74 634.74 0.00 0.00 109.98 109.98 109.98 0.00 0.00 0.00 0.00 54.99 0.00 0.00 ::::::::::::: 74472 680:73 ':. 100:08 . 109.98 .......... ............................... .......... .......................................... 0.00 0.00 0.00 0.00 !......... I ,y. a1Y� - w.. <<.\. �a N9 T3• � � [�t� t1 Q.�O � : �� Zh 1`t � 4. 4._.vZ+! 1 x CL.`.' �. � �0� 95 00 `'° 95.06 9500 $ 839.72 $ 689.73 $ 204.98 $ 109.98 ti' :$' 9500, s.i CHECK: $204.98 11/14/2005 DIFFERENCE: $0.00 (Should be blank) REFUND CALCULATION SHEET CLAIMANT: Terry Hirschy ' ADDRESS: 4155 Ishi Trial CITY & STATE: Oroville, CA 95965 DATE OF CLAIM: 10/24/05 APN: 069-170-008 RECEIPT INFORMATION NUMBER: 435570 DATE: 09/09/05 ISSUED TO: Terry Hirsch CHECK #: 1101 AMOUNT: $839.72 PERMIT #: 05-2426 Yes No Yes No Yes No PRIOR REFUNDS: x FEES VERIFIED x REFUND BREAKDOWN Title BLDG THRM DRNG AUD SUSP SHERDEVFEE 'FIRE,' - FIRE,: Fund Fund 0010 1800 1001 1800 0100. Dept 440-001 rHRM DRN (SMIP) (SHR) »` ,, ` *(SRA) Accnt 421050D 280 280 280 4617240! Cashl 101001 1011822 1011430 x1011811 4.ibiooitl DETAIL PAID RETAIN REFUND BLDG Time 109.98 744.72. ::::::::::::::::::::::::::::::::::::::.:.::: ::: ::.::: Filin from Plan Check 0.00 0.00 0.00 »»»: > :: »iiii>: ii?:: i>i: is ii::: ??: Plan Check/Filing 0.25 27.50 634.74 634.74 0.00 0.00:: Inspection 0.00 109.98 109.98 109.98 :::::::: : ::::::::::::: : BLDG FEES OTHER BLDG 0.00 0.00 ::::: :.:::: 0.00 0.00 :::::::::::::.::.::::::::::::::.:::::::::::' . REFUND PROCESS FEE 54.99 54.99 0.00 0.00 :::::::::::::::::::::::::::::.::::::::•:: .......... ............................... .......... .......... : .......... .......... BUILDING TOTAL 744.72 689.73 109.98 109.98,`«::' .......... .......................................... ......... .......... >::: >: »::< .......... .......... ::::: >:::: .......... .......... : »:::::: .......... ..................... >;>;;: »::< ::: >: »>:: .......... :: >:::: >: THERM DRNG 0.00 0.00 :::.::::::::: SMIP 0.00 0.00:::::::' SHR.......... 0.00 + _ 0.00 SRA ,, 95.00 .95.00 95.00 $ 839.72 $ 689.73 $ 204.98 $ 109.98 ' $ - $ - $ '$ '95.00; APPROVAL,�/' CHECK: $204.98 Date Reviewed ��/-Ivl/7 10/24/2005 DIFFERENCE: $0.00 Scott Rutherford (Should be blank) Chief Building Inspector y4 . , f o�vTTFo Butte County Department of Development Services C o Building Division O O s: 7 County Center Drive O C0UN'�y Oroville, CA 95965 (530)538-7541 REFUND REQUEST APPLICATION REFUND POLICY - Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the fees, whose name is on the receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt. 2. The request must be made within two years from the date of fee payments on permits not issued, and two years from the date of permit issuance for permits issued -if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees paid to other County Departments are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the receipt) and return to Development Services for paVment processing. CLAIMANT'S NAME:1:Y'...:... MAILING ADDRESS: PHONE: Check those fees which,A =Building Permit Fees Other (specify): _ (Plans for cancelled permits will be disposed of within 10 working days upon submission of a Request for Refund. If you want the plans, you may pick them up prior to that time. Signature K:/Forms/7111nd Application Z203 Date .W, �L a. .,�atw� & �. y, '"',�. y -:c•• ••„,IT -77. is ..& pment Se .ices - r , k Monday, October, 24' 2005 , c De a w s' wE `BUILE3ING` DIVISION Ver 1`0` s iR - � 'S . � fN 1. r -. - —. f,' M , r. , '� f •C ... _ S'Y tt •••, Counter Tammie I Person Fund 10 (Bldg Permits) I $744.72 SRA Fees (Fire) -- B$46/$43 $95.00 I 4 Payment Date 09/09/2005 I SHR Fees (Sheriff) B$25/$335 $0.00 Permit Number05-2426 I Copies/Document Sales $0.00 Receipt Number 435570 I CUA (Chico Urban Area) B$25 $0.00 Check Number or Cash 1101 I TUA (Therm. Urban Area) B$25/$570 $0.00 Parcel Number 069-170-008 Water Tender Btln #= $200 $0.00 Applicant TERRY HIRSCHY I West Chico Fire Station - $75 $0.00 Witness Fees B/All $0.00 Received From SAME Recorders Fees (N.O.C) B$246/$54 r $0.00 Thermalito Drainage $510 $0.00 Total Received$839:72 0 Oroville Area Traffic $75 Total Fees To Collect $839:72 I NSF (Non Sufficient Funds) $25 • Notice of Violation B$150/$150 NCSP Trails System $0.00 NCSP Roads/Bridges - $0.00 % %� -7q L(. 7 Z /3 1. NCSP Storm Drainage NCSP Fire Station $0.00 $0.00 ' NCSP Parks $0.00 7 Value Type $0.00 _� L Gly ! 16✓2-'`f :�nS I PERMIT : i - Bin f�:` _ AP N • • LAST NAME FIRST NAME CONTRACTOR MIKE COOK• CITY/CTY STREET NO _STREET NAME ROCKY BAR LN. C Tyl •' • USE ® TYPE RKS 25 char. max VALUATION FLOOD _ FEES PAID RECEIPT APPLIED • FEES 2 RECEIPT 2 ISSUED FINALED PLAN CHECK ACT1VlTY Plan Chk-9: Chkd By -9: Return Str Chk-1: -� Plan Chk�2: Chkd By�2: _ Return,2:,, Str�- Plan Chk-3: Chkd By -3: _ Approved: W11,61ARTY411112 Str Appr: I • Comments: 255 char. max 9/9/05 SRA FEES PID 204.98#435570 9/22/05 refund request, file given to Gwyn. 101001 101001 1011298. 10.1001'' copies 435568 r 052426 435.570„ 744.72 - $` ' ,---�"9.5.00. ``052428 J 435571 $-55-00` 052427 435572 $ 1,195.24 $ 95.00 052159 435573 $ 329.94 $ 17.76 052429 435574 $ 329.94 $ 95.00 ' 052430. 435575 $ 23.98 $ 95.00 052431 435575 $ 109.98 052432 435576 $ 82.45 copies 435577 052433 435578 $ 219.96 052434 435579 $ 29.94 $ 95.00 051794 435580 $ 458.04 $ 10.21 052435 435581 $ 467.42 copies 435582 052281 435583 $ 329.94 $ 15.29 052437 435584 $ 285.95 041899 435585 $ 109.98 052133 435586 $ 810.60 5.93 v040449 435,587 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR rNSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REO UIRED AT TIME OF APPLICATION Website: www.buttecounty.netldds u",`rPLEASE PRINT CLEARLY`-` ADo OWNER CONTRACTOR Last Name //- Cti� First Name_ .�-errs 7_ / Address _/'1z7_0/ �Y"� Address cityew V . L State State , ZipfIrI — Phone 5,72 Fax 5 3Z� �oy7� C E-mail E-mail APPLICANT NAME CONTRACTOR Name � coo Address Address City City State , Zip Phone Phone Fax E-mail E-mail Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name CityoV� ` State Address Phone 532 City E-mail State Zip Phone Page Fax E-mail Date Approved: State License Number APPLICANT NAME Na Address CityoV� ` State Zip 6� Phone 532 Fax 532 y72- E-mail APPLICANT SIGNATURE For Dfficp4se only: Zoning r AP# &6q_1 Flood Zone Property Addr s SRA j4a No OCC. Type Const. a 1 (V Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. 05-a1iz(, BIN # Description or Scope of Work: a. '� O` Sq. Footage s ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must'be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. 40ye Received by Amount: Receipt #:.4.1 1-j 3SV7 C;g ill Date: V_ q_a5 '7// Bldg ` SRA Sheriff SMIP Other LOCATION AP# &6q_1 UU Property Addr s Ln. tty Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: a. '� O` Sq. Footage s ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must'be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. 40ye Received by Amount: Receipt #:.4.1 1-j 3SV7 C;g ill Date: V_ q_a5 '7// Bldg ` SRA Sheriff SMIP Other .it SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fid plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ . 2. Impact Fees. ❑ 3. `California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior, to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. 1% REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION 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: ( ` % t E�(( ASSESSOR PARCEL NUMBER 04�L_ / rV (V T< Proposed Building Use: Permit Technician: y Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. ( 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes) ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. O 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. O 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. Letter of intent for non-residential buildings 0 12. Hazardous Material Form 13. Acknowledgement of building permit application without required clearances. 4.0A PC) Q? O 14. Other Rejnainin items needed to issue the permit. (May require additional plan rEview upon receipt of the following items.) t_.OAV0074-- -I'Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 16. Fire Sprinklers............................................................................................ l7 17. - Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... - ❑ 19. Erosion Control Plan Required........................................................................ vo Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 21. City of Chico Plumbing permit........................................................................ 0 22. Site plan and business license approval from the City of Biggs .............................. L7� California Department of Forestry plan approval O'plid. Sent by: ............ 44.Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ............ ❑ 25. Contact Land Development about _ Improvements', _ Drainage ........................ 26. NPDES Form ............................................... :................................................ <T Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑/ 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... Letter of Signature authorization...r}.t..(�5:~A.. '..0 >�f �� n.. /r%4.$. t" (S)Recorded copy of Agricultural Acknowledgment Statement ................................. O . Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... O / 35. O Legal de cription, ❑ M.H. Title, title search, registration or MCO ........................ Gg' rMther: ❑ 37. Other: When issued Telephone ( // 17, 2" P/ and hold for pickup. I have been informed of the above items and requirements for obtaining a;building permit. Applicant. Date: y 6.:�- 1.Index permit applicati for a above itemsiiumbered: 0f Ian Check Letter 2. Additional items r uired� Contractor, desiip er, owner, was the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, o V ner was advised of the abov da a b ❑phone, ❑mail, ❑counter, by Date: Plans reviewed by: Date: Plans approved'by: Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division COUNTY OF BUTTE V �� DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE (530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER `�- A.P. # PROPROSED BUILDING USE l DATE _1zRECEIPT # DATE REC. � 1. BUILDING PERMIT FEES --- Balance Due ..................... $ v� --- FEMA Flood elevation review ... $ --- Additional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES �' �'1i'�`'� (paid at School District Office) (form available after Plan Chec 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. RECREATION DISTRICT FEES 4�, `Jie (paid at Recreation District Office) (form available after Plan C eck) I/ 5. RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $P CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per dwelling) Zoning $ P46. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 (paid at Building V & S M I P (- , ` 9. 10. OTHER 11. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT DATE Pursuant to Government Cp6e Section 66020, �re 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. 3/05) - %� r ;:c-^ta,. � Cil• y3l\3 T ;;:tt,` Ac0 GpUC �F� Department C c) u n t Michael Crump. Director of Public o f B U t \V*YVIorkS LAND DEVELOPMENT DIVISION Storm Water Management Pro;ram 7 County Center Drive Oroville. CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge 1=limination System. (�lPDES) Phase li Construction Storm Water Permit and Storm Water Pollution Prevention Pian (sWPPP) Acknowledgement BLESS THAN 9 ACRE) Project Description: NSF �� �� Project ect Location and/or Parcel Number: �� ��"�" 776 � n By signing below, L the project ownerlowner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that L therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project. that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. f Signed: Title:� Date: Butte County. Department o.f Developnent SerTrices 7 County Center Drive °,�''��r?F°° Oroville, CA 95965 ° "�_•�, �,a�. ° (530) 538-7601 Telephone (530) 538-7785 Facsimile �� RUILIDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES [ request and authorize the Building Division to process this building pen -nit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: I need to submit applications for septic and/or well to Butte County Environmental Health inhrnediately. ® I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained. a I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended .building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not limited to, verification the parcel was legally created, adherence to. all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: Applicant Name: Building site address: ' APN: (`tO61—Z �V -7'� 2 Permit No.: (is- 2 1//2i� I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: SIGNA F APP CANT DATE 2 0 2005 UTF� BUTTE COUNTY o � / o DEPARTMENT OF DEVELOPMENT SERVICES O .° BUILDING PERMIT APPLICATION o o AND SUBMITTAL REQUIREMENTS o 0 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 CHICO: (530) 891-2834 o OFFICE 9: (530) 538-7541 �► .� A FEE WILL BE REOUIRED AT TIME OFAPPLICATION U[� Website: www.buttecounty.neUdds J R (n <3 YPLEASE PRINT CLEARLY** APPLICANT NAME OWNER Last NameFirst 600 Name_ -err Address City city a111,0 V ' L Stat State Phone Phone 7 Z— �c y72 Fax E-mail Lic. # APPLICANT NAME CONTRACTOR Name � 600 Address State City Phone 5-32 -6 72_ Stat Zip Phone Map Book Fax E-mail Planner I Date Approved: Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name Flood Zone Address State City Phone 5-32 -6 72_ State Zp Phone Map Book Fax E-mail Planner I Date Approved: State License Number APPLICANT NAME Name-- -err Address'Zj =.5A Flood Zone City vY�.` � State Zp Phone 5-32 -6 72_ Fax S 3 Z — 72— E -mail Subdivision Name APPLICANT SIGNATURE For officp4se only. Zoning Property Addre� , Ln. Flood Zone Cross Street SRA Yes No Occ. ' ' Type Const xV � Subdivision Name Map Book Page Lot # Planner I Date Approved: PERMIT NO. 05-21-112-6, BIN # LOCATION Property Addre� , Ln. Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: r D v i. Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must'be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. _1U%D // Received by Amount: ( 2 JJ, % Bldg Cl� sRa, Receipt #: � ��`-� �D Sheriff tO i SMTP NnIm. 17 �'i z- _ _ _ Other Z CDF FIRE SAFE REQUIREMENTS ` AP# 069-170-008 PERMIT # 05-2426 NAME: Hirschy Under authority of Public Resources Code Sec. 4290, the following checked items are required by the Butte County Fire Department and made a part of this permit. These requirements are minimums and may be superseded by Butte County local regulations, which equal or exceed these standards. Butte County Building Inspectors will make compliance inspections. Driveway Standards [X] Surface. All driveway surfaces and structures (bridges, culverts and other appurtenant structures which supplement the roadway bed or shoulders) shall provided unobstructed access to conventional drive vehicles, including sedans and fire apparatus weighing up to 40,000 pounds. Pq Grade. Not to exceed 16 percent unless paved. Driveway Radius [X] No roadway shall have a horizontal inside radius of curvature of less than 50 feet and additional surface width of 4 feet shall be added to curves of 50-100 feet radius; 2 feet to those from 100-200 feet. pq 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 radius. C F [X] Turnarounds. If required, will have a minimum turning radius of. 40 feet from the center of the road. E [X] Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 -foot taper on each end. [X] Width. All driveways shall provide a minimum 10 -foot traffic lane and unobstructed vertical clearance of 15 feet along its entire length. Pq 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. Gates [X] 1. Gate entrances shall be at least two feet wider than the roadway they serve. 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 the roadway. 3. Where a one-way road with a single traffic lane provides entrance, a 50 -foot turning radius shall be used. . 11 M Setback for Structure Defensible Space [X] 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 provided for in these standards, annual maintenance must be provided for by the landowner. 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. pq 2. For parcels less than 1 acre, local jurisdiction shall provide for the same practical effect. See "Other Requirements below. [XI 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. Disposal shall be completed prior to completion of road construction or final building permit inspection. Other Requirements [ ] If Building Setback is 15 to 30 Feet: ✓ Class A roof ✓ Enclosed eaves [X] If Building Setback is Less Than 15 Feet= ✓ Class A roof with enclosed eaves and choose any 2 of the following: ❑ Metal or no doors on side toward property line with insufficient setback ❑ Interior automatic 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: o Stucco — 3 coat o Hardi-Board or Plank o Masonry o Masonry Veneer o Metal o Other Butte County Fire Department approved materials 9/20/2005 Darren Read Date Signature �A co 10 R E Q U I R E M E N T r ' CDF FIRE SAFE REQUIREMENTS AP# 069-170-008 PERMIT # 05-2426 NAME: Hirschy Under authority of Public Resources Code Sec. 4290, the following checked items are required by the Butte County Fire Department and made a part of this permit. These requirements are minimums and may be superseded by Butte County local regulations, which equal or exceed these standards. Butte County Building Inspectors will make compliance inspections. Driveway Standards [Xj Surface. All driveway surfaces and structures (bridges, culverts and other appurtenant structures which supplement the roadway bed or shoulders) shall provided unobstructed access to conventional drive vehicles, including sedans and fire apparatus weighing up to 40,000 pounds. [X] Grade. Not to exceed 16 percent unless paved. Driveway Radius [X] No roadway shall have a horizontal inside radius of curvature of less than 50 feet and additional surface width of 4 feet shall be added to curves of 50-100 feet radius; 2 feet to those from 100-200 feet. pq 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 radius. [Xj Turnarounds. If required, will have a minimum turning radius of 40 feet from the center of the road. [X] Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 -foot taper on each end. [X] Width. All driveways shall provide a minimum 10 -foot traffic lane and unobstructed vertical clearance of 15 feet along its entire length. [X] 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. Gates [X] 1. Gate entrances shall be at least two feet wider than the roadway they serve. 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 the roadway. 3. Where a one-way road with a single traffic lane provides entrance, a 50 -foot turning radius shall be used. c ED F IN E Q U Setback for Structure Defensible Space [X] 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 provided for in these standards, annual maintenance must be provided for by the landowner. [ ] 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. [Xj 2. For parcels less than 1 acre, local jurisdiction shall provide for the same practical effect. See "Other Requirements below. [X] 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. Disposal shall be completed prior to completion of road construction or final building permit inspection. 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