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007-240-068
D�Lt Thurmanv Hicks Lane,app.600'N.of Eaton Rd�, ,trot 9 -,Chico mit #3714-77B,P,E;M(new single 007-240-068 PEM IT#94-3193 BURGOYNE , ROBERT `'P. 3530 HICKS LN., CHICO lie CONV GARAGE TO LIVING AREA/SF BURGOYNE, ESTHER 3530 HICKS LN, CHICO Cont: BAIRD ROOFING RE -ROOF uu /-z4u-UG8 0-0862 CRUZ, ROCKY _ 3530 HICKS LN, C \� n Cont: BLUE HAV NEW POOL MSTR_ 7- NOTES RESIDENTIAL ' 007-246-068 ' - � 05-0862 ` PERMIT NO. _ CRUZ, ROCKY 3530 HICKS LN, CHICO Cont: BLUE 1 ['AVEN POOLS NEW POOL MSTR517-01 SPECIAL CONDITIONS 'CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER _5/(Z-_�(Z -S 3/G_�Lj JOB FINALED (Date) Signatur 1 J=OK 0 = Not OK . = NotReadyable 1. MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 3. 1. Zoning Requirements -Setbacks -Easements Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 2. Soils; Special MH Support Sketch 6. 3. Sewer; Location -Test -Fall -C/O -Concrete Electric 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or / /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures- Panelboards-Ins. to Main Conduit 9. Health Department Approval Date 10. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Enclosure; Fending -Alarms 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Car -1 -Date Card 5-1 Date POO (Plans) OK except #'s etbac s=Easements Soi , Compaction -Structure Stability 3�.�ool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclos res; Conduit Entries -Terminals -Listed 7_1-6c.; Bon ng; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures- Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. % b.; Cir. Test -Water Supply Test Enclosure; Fending -Alarms .Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 1 V n P J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test 72. Elec. Outlets at Wood Panel, Int. & Ext. Date 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance Card B-1 Date Card B-1 Date Elec. Outlets & Receptacles at Kit. Counter Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al _ 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral ❑ Yes U No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector 87. Water Well, Disconnect, Electrical, Plumbing Date 88. Card B-1 Date Card B-1 Date 89. Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Glass Protection 36. A.C. Ducts Insulation & Support Corrections from Previous Inspections 37. Vent Fan, Exhaust above insulation Gas Test -Meters Tagged, Gas -Electric 38. Condensate Drain & Overflow, Size & Grade Water & Sewer Connected -C/O to Grade -HD Approval 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet Energy Compliance Certificate -Other Certificates 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth _ Clearance Looked under Floor ❑ Yes 83. Following Instld./Drive O Yes U No/Walks ❑ Yes O No/Planters ❑ Yes 0 No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: APN: 007-240-068-000 the Business and Professions Code, and my license is in full force and effect. /� ) O License Class: y' S3 License Number: �/ S �7 / Site Address: 3530 HICKS LN CHI Date: Z1 0.�Contractor. E1t.A._, R gip.-. Map Index: Description: NEW POOL MASTER4517-01 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: CRUZ, ROCKY ETAL to its issuance, also requires the applicant for such permit to file a AGUIRRE, HOPE signed statement that he or she is licensed pursuant to the provisions of HICKS LN the Contractor's State License Law (Chapter 9 commencing with Section 3530 7000) of Division 3 of the Business and Professions Code) or that he or CHICO, CA 95973-9701 she is exempt therefrom and the basis for the alleged exemption. Any 345-1537 (530)899-2789 (530)345-1537 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: BLUE HAVEN POOLS owner of property who builds or improves thereon, and who does DIVING LADY INC. such work himself or herself or through his or her own employees, 275 FAIRCHILD STREET provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one SUITE 100 A 95973 year of completion, the owner -builder will have the burden of 530-899-8445 proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: BLUE HAVEN POOLS and who contracts for such projects with a contractor(s) licensed DIVING LADY INC. pursuant to the Contractors' State License Law.). 275 FAIRCHILD STREET ❑ I am Exempt under Article 3 of the Business and Professions Code SUITE 100 A 95973 530-899-8445 (530)342-5724 Date: Owner: License #: 718849 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. Architect: I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: i.o-vv� Total Square Ft: 0 S. F. Policy #: 3 1 � � 2 y3 Valuation: $0.00 ❑ I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall / L `/t/ forthwith comply with those provisions. l G Date: Applicant:rj- WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost 'of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolu ' n , to do work indicated ov for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) B Date: Q� Name: PERMIT EXPIRES ON: O Address: ate ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. 1 hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized -a ent of the owner.7 I agree to comply with I it is to the of form or doc�ment of Butt County. I hereby all county and state laws relating to building construction. acknowledge unlawful alter substance any official authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. i Print Name: cs Signature Date: �` s--0 S— ❑ Owner ❑ Contractor ❑ Agent for Owner Agent for Contractor B. C. Building Permit 01-16-04 pq 1 t� 1 BUTTE COUNTY DEPARTMENT -OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** /LAPP, LICANT SIGNATURE X r/ t PUr-office use only: OWNER st ame C )first XO PV u,.1j t Name _ Addres -3 L City C�C�-� State State Zi p s Phone • S 9 State CA Fax E-mail clS- 1-5-37 g 9 ,� y /LAPP, LICANT SIGNATURE X r/ t PUr-office use only: ARCHITECT/ENGINEER CONTRACTOR Name -91164 o0 Address Yes No State City �I Su ivision Nam State CA Zip 9S- hone rE g 9 ,� y PI nner Fax 3 y _ S o? mail Lic. # G 37/88 Z/ Class /LAPP, LICANT SIGNATURE X r/ t PUr-office use only: ARCHITECT/ENGINEER Name Gl. tl.. ria.. b - _ ,d Address WORKER'S COMPENSATION City Yes No State Zip Phone Su ivision Nam Fax E-mail Page 63 State License Number /LAPP, LICANT SIGNATURE X r/ t PUr-office use only: APPLICANT NAME Name Gl. tl.. ria.. b - _ ,d Address WORKER'S COMPENSATION City Yes No State Zip Phone Su ivision Nam Fax E-mail Page 63 /LAPP, LICANT SIGNATURE X r/ t PUr-office use only: AP# 6U�- 2 L10 - ©�O Zoning _ ood Zone WORKER'S COMPENSATION SRA Yes No Occ. I Tye Const. Su ivision Nam Address Map Book Page 63 Lot # PI nner Date Approved: OVM FOR SUBMITTAL REQUIREMENTS PERMIT NO. BIN # LOCATION AP# 6U�- 2 L10 - ©�O Property Address 367-3 `c 7C,11 , Cross Street WORKER'S COMPENSATION Policy Number i ! 3 Ll 3 Carrier 6 If hiring anyone other than license contracto's, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address De scriiption or Scope of Work: r - n 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. I I Received by:- Amount: Bldg I I KAFORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Receipt#: gp'516 Date: # r %1 S SMTP Other Total REV 2-24-05 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 fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). 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. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 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 www.buttecounty.net/dds OWNER: 4nLZ ASSESSOR PARCEL NUMBER W 1 v O R Proposed Building Use: �O®' Permit Technician. Date: W 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. 17 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings. ❑ 12. Hazardous Material Form. ❑ 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 16. Fire Sprinklers ❑ 17. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office ❑ 18. Soils Report and/or Engineered Foundation required. ❑ 19. Erosion Control Plan Required. ❑ 20. Fees as shown on the attached Schedule of Fees Due Sheet. ❑ 21. City of Chico Plumbing permit. ❑ 22. Site plan and business license approval from the City of Biggs. V023. California Department of Forestry plan approval ❑ paid. 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: 025. Contact Land Development about _ Improvements, _Drainage. ,$ 26. NPDES Form ❑ 27. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 28. Contractor's license information. (Number, Name Style, Classification). ❑ 29. Worker's Compensation Carrier and Policy Number. ❑ 30. Owner -Builder Verification ( _ Given to owner, _ Mailed to owner). ❑ 31. Letter of Signature authorization. ❑ 32. Recorded copy of Agricultural Acknowledgment Statement. ❑ 33. Existing violations and/or expired permits. ❑ 34. Deed Restriction. ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ❑ 36. Other: ❑ 37. Other: When issued Telephone � S?O ~�G I and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: ro Date: EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees, and other department costs are not refundable. Original -Applicant l �• v� UV(Y 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: ASSESSOR PARCEL NUMBER Proposed Building Use: Permit Technician: Date: Z?IL5 Lw' 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. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form ❑ 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable O16. Fire Sprinklers............................................................................................ - ❑ 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........................................................................ ❑ 20. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 21. City of Chico Plumbing permit........................................................................ ❑ 22. Site plan and business license approval from the City of Biggs .............................. ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: 4 Planning approval for (A) Use: (B)Parking: (C) Parcel Check:.0 ..... � � - ❑ . Contact Land Development about -Improvements, -Drainage ........................ 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ........................... ❑ 36. Other: ❑ 37. Other: G (� SCn When issued Telephone !Q � U I and hold for pickup. I have been informed of the above itG::�_ ms and requirements for obtaining a building permit. Applicant: 'D ro iy-' � Date: 1. Index permit application fol the above items numbered: Plan Check Letter 2. Additional items required Con@actor, desig'ner, owner, was advised-Qf the above data"by ❑ phone, ❑ mail, ❑ counter, by Date: Coptractor, designet, owner, was advised of the above data'6y ❑ phone, ❑ mail, ❑ counter, by Date: Contractor�esig er, owner, was advised of the above data by •O- phone, ❑ mail, ❑ coun er, b Date: Plans reviewed by: U t ` "` ' L'7 Date: e r ' �% Plans approved by: Date:hs Structural reviewed by: ' Date: Structural approved by: Date: Note transfer b� Date: Yellow: Building Division E.H. USE ONLY - 'Piot Ren Attachad ?` `w;riooa Ran Attachad Sant to B.D. TO: Building Departme.nt FROM: Environmental Health SUBJECT: Sanitation Clearance Druz j%yaere, 35-30 Z/7- 06?- Owner Location AP# Plan Approved for: Sewage Disposal X Water Supply: Public Private Well % Clearance for dwelling. Other 2i7,e ahno� ,c7oy% Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist Date 8/96 Department C o u n t Michael Crump, Director of Public o f B u t Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville. CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination Sys Lem (NPDES) Phase 11 Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement LLESS THAN 1 ACRE] Project Description: Project Location and/or Parcel Number: By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water 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. 11--) Signed: Title: Date: A/ J-�ULs — I.,ess than I Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Butte County Department of"Developnent Sei-vices ��T r� 7 County Center Drive 0 �° 0 Oroville, CA 95965 C b:;>'' G , C (530) 538-7601 Telephone o _ - _ - C (530) 538-7785 Facsimile BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit 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: o I need to submit applications for septic and/or well to Butte County Environmental Health immediately. • 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 s 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: Permit No.: 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: SIGNATURE OF APPLICANT DATE Copy to Applicant/EH/File K:Fonns/B1dgPermitwithoutClearances 020705 I - _ 11 1 007-240-068 03-0923 BURGOYNE', Ei_S'T'HEfR,, f 3530 HICKS LN, CHICO Cont: BAIRD ROOFING 1 RE -ROOF 41 COUNTY OF BUTTE = DEPARTMENT OF DEVELOPMENT SERVICES = B'UILDI G DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 8-75416) rmr�N (Rev. 12/96) APPLICATION AND PERMIT C, 3. 0 `.5 ASSESSOR PARCEL NUMBER `} t( f4 ZONING BUILDINGPERMIT OWNER / }1 / / -/ •)f TELEPHONE SO, FT, OCC. BUILDING VALUATION OWNERS MAIU G'ADDRESS } / / '1' o [' S - r �-�in�� "� �% ♦SO CONTRACTOR'S NAME-/ _ �/ j TELEPHONE � + vo CONTR/1C ORS MAULING ADDRESS/ /n CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ `� ARCHITECT OR ENGINEER LICENSE NO. • Filing Fee $ 20.00 Permit Fee $ q. vV ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ PERMIT FEE $ LOT NO. SUBDNISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF)f` Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 1 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ �� S �/�� �Pi,� e `�F��r�� Describe Work: �. �! Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20:00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 R LESS Main Service ..OR LESS 23.00 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 �M full force and effect. %% / License Class f-,. {j Lic. No. 1� / W/o OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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. ❑ I, 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 Main Service sow To +000A 46.00 NEw CONST. DIN . ING OCCUP. ( ADDNS.EW 3.5Q FTG. NOR CONST. MU Cp�Sr NoµgESID. @'%.50 FWWER APPARATUS 8 SINGLE OUTLET CIR. EX. Occup. OUTLET OR FIXTURES 20 .00 SAL @ +. 0 Ex. Occup. OFIXunFrs PESIp.OEq 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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. r1, I 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 S rA a, /__0 N/7 Policy Number --Re 1 f. `% (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 I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those. provisigns.A Id �/ X��� /} X - rL4:/? /lam yiX . OC Date .-3 Signature of'Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA'permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occCOs. n' •) TYPE 11.E TOTAL FEE $ —ij 4. V HAZ. D F IMP I FLOOD I CDF I PARCEL PD HD S This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicatedabove for which fees have been paid. Ate- - _ r _ /fnL-� �LIG[� 1Y- / _0 By f �fIxJCY Date u PERMIT EXPIRES ON ��- U 7 eta ReceiptNo. I5t)5 '� WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, CaUfornia-,95965 • Telephone (530) 538-7541 N (Rev. 12/96) APPLICATION AND P =RMIT (!-03-® All ASSESSOR PARCEL NUMBER(107 ZONING BUILDING PERMIT O OWNERTELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAIUNCatr S tl[�J e CONTRACTOR'S NA E HO E r OT � /✓ 111 CONTRAC. ORS ILl[9Si ADM/,) CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ (� ARCHITECT OR ENGINEER LICENSE NO. Filin Fee $ 20.00 Permit Fee s Od ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ SUILOING ADDRESS Energy Plan Checking Fee $ $ PERMIT FEE $ 1 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE Each Trap 7.00 - Solar or heat um water heater 23.00 SF X Duplex ❑ Mobilehome ❑ Other Water piping 15.00 SPECIFY Each as water heater or vent 15.00 TYPE OF WORK Gas piping system 1 - 5 outlets 15.00 New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation %❑n Other ❑ ` Describe Work:(/'•--�"o r/C /� i� ! t� ��J p t /tJ�7I Building sewer 15.00 Mobile Home I S I G I W @20.00 L3 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 800VR UE Main Service zoOA OR LESS 23.00 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 fUJ folce and effect./ (l� o !/ License Class Lic. NO. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUR SO OR ADDNS. ( &-A-CC. BUDS. 3.5¢FT; NEW CONST. MULTI.OUTLET NON•RES1D. 97.50 POWER APPARATUS 8 SINGLE OUTLET CSI R. 20 ® 1.00 Ex. Occup. OUTLET OR FIXTURES BAL @ .50 OWNER -BUILDER DECLARATION ouTEiErs RESID)EA 5.00 I hereby affirm under penalty of perjury that I am exempt from the Contractors LicenseFTemporary Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation,Facilities will do the work, and the structure is not intended or offered for sale.❑ ervice 23.00 20.00 23.00 I, 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 PERMIT FEE S MECHANICAL PERMIT Filing Fee 20.00 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: Heating ❑ 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 Cooling Hood 6.50 performance of the work for which this permit is issued. 1 have and will maintain workers' compensation insurance, as required by Section Ventilation 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 5 % PERMIT FEE $ Mobile Home Installation Fee $ Policy Number 3L E [o (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 Energy Inspection Fee $ �'Z o� L' b l TYPE TOTAL FEE $ TT, not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that f I should become subject to the HAZ. D F IMP FLOOD COF PARCEL PD HD S wo kers' compensation provisions of section 3700 of the Labor Code, I shall fo with comply with thos rovi 'ons. This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work XL _ Date indicate bove for which fees have been paid. Signature o Applicant - ❑ Owner ❑ Contractor ❑ Agen An OSHA rmit is required for excavations over 60" deep and demolition or construction structures over 3 stories in height. _ / ��of Al -1-03 By Date PERMIT EXPIRES ON )-/—/"Qy I Date Receipt No. Jr --- WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 1 „RESIDENTIAL 007-240-068 PERIIT#94-3193 BURGOYNE, ROBERT 3530 HICKS LN., CHICO CONV GARAGE TO LIVING AREA/SF -5 _ JOB FINALED (Date) Signature J=OK O = Not OK Not = Not Readyable MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except k's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /" L" ft. / /"Nat. or/ /"L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 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; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Bea ms- Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except q's 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.: Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. _ Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK O = Not OK -=Not Applicable = Not Ready RESIDENTIAL (; Date UV6ERFLOOR (Plans) OK except N's 1. 2. Zoning -Setbacks -Easements -Flood -Slope Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /'• Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except u's 16. Water Htr.: Vent -Access -Combustion Air -Baffle -------------------- --------------------------------- 17. Water Pipe: Test & Anchor -Nail Protection - ------------ 18. D.W.V : Test -Fittings & Anchor -Nail Protection ---------------------- ------------------ 19. Shower Pan: Test. First Floor -Tub Access 20. Test Tub & Shower' -Second Floor -Tub Access 21. Gas Pipe: Size & Anchors ------ -------------------------- -------- ------------------------------- Date -------------------------------------- Date Card B_1 ---- Date -- Card B_1 ----------------------- - ------------ Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except h's _ _ 22. Fixture & Transformer_ Clearance -Ins. Protection -- ----- 23. Elec. Receptacles Spacing -Lights & Switches at -Doors ------------ 24 Size Boxes & No. of Conductors -Stapled --------------------------- 25. Romex Installed Close to Edge of Studs & C.J. --------------------------------- 26. Equip Ground made up w!Mech. Fastners-Bond Gas & Water -------------------------------------------------------- -- 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI ----------------------------------------------------- 28. Subfeed Wire Size r r ga. Cu or AI-A.C. Wire Size ! ! ga. Cu or Al 29. Range Circ ! I ga Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ -Yes - ❑ No 30 Service -Riser Conductors & Ground Mann Disconnect --------------------------------------------------- 31 Equip Clearances Panels Motors-Mech. Equip. --------- - ------ ---- ------------------------- ----------- 32. Clothes Closet Light -Shower Light -Spa Light ------------ ------------------------------------------- - --- ------------------- 33. Smoke Detector -------------------------------------------------------------------------------- Date Card B_1 Date Card B-1 ------------------ ----------------------------------- Date Card B-1 Date Card B -t Date MECHANICAL (Permit) OK except a's 34. -A. -C.- Ducts Insulation & Support -- - --------------- -------------- 35. Vent Fan: Exhaust above insulation -------------------------------------------------------------- 36. Condensate Drain & Overflow: Size & Grade --------------------------------------------------------------- -- -------- 37. ----- 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet --------------------------------------------------------------- 38. Attic -Access-&- Platform if Furnance in Attic ----------------------------------------- ------------------------------------ Date Card -B-1 Date --------------Card B-1 --------------------- Date Card -1 Date Card B-1 Date F IN Plans OK except 4's ----------- 40-- 41. 3. i -------------- foper Material & Anchors s Studs _Nailing_ Spacing-&-Bracing-Plates_Sound -------- .11 . Walls over Girders & Floor Nailing ---------------------- - --- - --- Stop in Walls (rat proof) --------------------------------------------------------- Stops: --------- ------------- ------ ----------- ---- Stops: Furred Ceilings -Stairs -Chases -Tub ------------ 44eaders & Beam -Size & Bearing 'Ingle & Duplex) Date RAMI G (Continued) _ 4157 Ha rs-Post Caps -Anchors -Connectors ----- 4 -Ing. Joist-Rftr_ties-Purlin-roof Brac-Truss-Shthng.-Rfng. _ ce Ties or Type A Flue -Fireplace Throat clearance ----iclAs; Size & Romex Protection -Draft Stop -Ins. Baffles 4 -B rm. Windows or Exiting Doors -Sill Hgt. & Dimensions -- \50.- ge Fire Protection Framing 51 er y Line Firewall & Openings _-_ . Doors -One 3' -Check Garage -3rd Story, 2 Exits -- __ airs; Width -Headroom -Rise -Run -Landing -Fire Protection plyw on Roof Overhang -Attic Vents -Rafter Outriggers Siding -Nailing Veneer co -Mesh -Drip Screed -Fd. Vents-Underflr. Access azing Area -Glass Protection -Skylights -Plastic - -ear Walls: Nailing -Bolts --------- 9. I talion -Walls -Ceilings 0. Infiltration -Walls -Windows Dat- and B-1-�- Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL Plans) OK except it's xt. Steps -Door & Sidelight Protection -Landings Smoke Detector Furnace: Vents -Clearance -Comb. Air -Connector - In Garage: Above Floor -Ducts -Meth. Protection ------------ ----------------------- --fi4 Bedroom Exiting - G F.I_& Bath Fixtures & Tub Access -Spa - --- ` ------------- - lec. Trim & Subpanel: Breaker Sizes &Labels ------------- airs & Rads tplace or Stove Clearances -Hearth /Stec. Outlets at Wood Panel: Int. & Ext. ------ ---. %0. it.Fixt & Appliance; Grnd.-Air Gap -Cooking Clearance > ec. Outlets & Receptacles at Kit. Counter - -- -- - 9 _------- ara a Fire Door: Swing -Landing -Closer ----- - A.C._Duct in Garage -Damper Wtr. Htr_Vents-Clearance-Comb Air-Connector-P.R.V. ------------ ri Garage: Above Floor-Mech. Protection ,L� - 741 Plb. Elec. & Mech. Equip. Listed for Location F11et. Receptacles in Garage: (G.F.I.)-Romex Protection Y,Jnsulation-Foam-Looked in Attic ❑ Yes - - 7--. and Rails & Deck Construction -Post Caps 7 Fdn Vents &Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes following instld. Drive ❑ Yes ❑ No: Walks ❑ Yes ❑ No; �n// Planters ❑ Yes ❑ No yl.mco Brown -Finish C. Unit: Disconnect. Electrical, Plumbing Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings -------------- - -- ---- - --- - - --- W r Well; --- Disconnect, Electrical, Plumbing -------------------------- ---- xterior Elec. Trim; G.F.I. Receptacle -Underground - - - -------------------- - --- V Platjon Throughout House ...... ....... - ------------------------- a Protection rre Mons from Previous Inspections ------ ------- - --- --------------------------------------- G T st-Meters Tagged; Gas -Electric__ 9 ter & Sewer Co nected-C/O to Grade -HD Approval -------------- ..- ------------------------- Eneygy Compliant Certificate -Other Certificates - ------------- ------ Date r/ttj 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 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California' 95965 - Telephone (916) 538-7541 PERMIT Nq . APPLICATION AND PERMIT 9�' ��Z?:3 ASSESSOR PARCEL NUMBER 007-240-068 -ASR BUILDING PERMIT OWNER ROBERT BURGOYNE TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 3530 HICKS LN CHICO, 95926 — R 400 8,000,,00 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ 64.35 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 3530 HICKS LN PERMIT FEE $ 206.35 CHICO PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15,00 Each gas water heater or vent 15.00 USE OF STRUCTURE SF Duplex O Mobilehome El Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition ElRemodel O Utilities ❑ Installation O OLheXD5 Describework: CONY. GARAGE TO LIVING AREA PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Ef'RFATION�tQQL2i Main Service ( 211 00V OR LESS ) OA 23.00 Main Service ( 200A TO1000A) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. I S ACC. BLOS. ) so. 3.50 FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) O 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. (cense No. Classification 0 1, as the owner, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O lam exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. .50 Ex. Occup.FIXED APPWS. OR ( OUTLETS IRESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): O This permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Dept. of Development Services, wilding Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling . Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. 1 agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgmen s, costs, and expenses which may in any way accrue against said Count KconsP ence of the granting of this permit. X Date et natur nt - O Owner O Contractor ❑ Agent An O rmit is required for excavations over 5"0" deep nd demolition or con ruction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ LE6 0� OCC CONST. TrPE TOTAL FEE $ 2.35 HAZ. D. FEES IMP FLOOD X CD PARCF� PD H / 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. BY Date / 9 PERMIT EXPIRES ON/1'%/�s lDarel Receipt No. 170779 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTYOF BUTTE - DEPARTMENTOF DEVE6-GPMENTSERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 i PERMIT APP ICS r dfN DATA SHEET r OWNER O Y� r, A. P. No. Proposed Building Use G, BuildiN ly perctor Date At time of permit application, I was advised the following data must bcvsubmitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted......................................... 2. Plot plans, 3/4 sets, signed by preparer of plans. ......................... . 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ . ........... . 11. Impact fees as shown on attached schedule. .Or?1..N... 12. California Department of Forestry plan approval/fees. .......... ............ .......... 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval OK Health Department . ............ 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy)....Prear;gPert,o;request 20. Pre -inspection for required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner Mail to owner _). ........... 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ....................................... . 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ........................................ . 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ........................................ 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. - 34. Wh you issue the ermit, rRce as follows: Mail o owner. Mail to contractor. Telephone " B and hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Cofinter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail unter by _ Date Plans checked by Date Plans approved by Date 1 Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE Department of Development Services Building Division Oroville: 7 County Center Dr., Oroviile CA 95965 Ph: 916-538-7541 Chico: .1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: Name A /6 a -e Address City Phone Contractor's License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name 446 N e Address City Phone Contractor's License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed Propt Socia Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must . be completed and returned to our office before we are permitted to issue the permit. I� i`(p��+x�'�...✓t ��� 1•N���i�i._-RTS='i+r`:��.. i .. ��'�!�'t °.i��p{�r"�'-�, i:.0 � .'3� .':`'��t�3���. �r.�.t�t a.. �,... ``. .�. BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One Form Per Building) School District iUP7/ Building Department No. A.P. Number 7'" •/t/ �(l�O Ju,rIsdiction 0 City 1�0 County Property Owner_ I, Property Location/Address Subdivison Residential Development Commercial/Industrial Building Department Represe No. of Living MHI Units New Lot No. Sq. Footage D C/ Addition (Group R) 0 Sq. Footage Addition (Floor Plans reviewed by School District Personnel) (Including Exterior Roofed Areas) — Z /J�� Date District Identification, No. /✓//� School District certifies that (Ap ica ) 3S 3 o (Street Address) (C (State) .3 �/5--)9� (Phone Number) i (Zip Code) has complied with the requirements of Resolution No. .S%9 fZ by payment of $ �k� representing square feet. School District R Paid by Check Number Bank Number Paid by Cash 111-2 91- 19 Date If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeformmkl (4/92) jm COMPLAINANT: ADDRESS: PHONE NUMBER: OTHER COMMENTS• m v t Insulation Certificate ,Q [[ /n� , BUILDING OWNER h ,/fir, Li�/� j BUILDING PERMIT u/����� BUILDING LOCATION: Description of Installation ROOF Material Brand Name Thiclatess (inches) Thermal Resistance (R -Value) CEILING Batt or Blanket Type �Brand Namef L.'t. Thickness (inches) �o Thermal Resistance (R -Value) I C1 Loose Fill Type I v w -h lQeaLi . Brand Name N C -4-u. r -e C-�- uct,rr- Contractor's minimum installed weight/ft� Minimum thickness inches % Manufacturer's installed weight per square foot to acheive Thermal Resistance (R -Value) E_ RIOR WALL � Material -�.*6A r4 Lot, ���`_G u�A Brand Name ' Thickness ( ches—) -J Ya lu The. mal Resistance (R-Vae) ` RAISED FLOOR . Material Brand Name Thickness (inches) Thermal Resistance (R -Value) e. } SLAB FLOOR Material Brand Name Thickness (inches) Thermal Resistance (R-Vaiue) Width (inches) 1. FOUNDATION WALL Material Thickness (inches) Deciaration Brand Name Thermal Resistance (R -Value) I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. General Contractor (Buiider� Lice e N ber �- tgnature ana itie � b-Cuntractor (Insulation installer) Licens Number � y� Signature and Title x Date TIIIS ERTIFICATE MUST BE PROVIDED TO THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN '171E BUILDING. JANUARY 1993 Certificate of Compliance: Residential (Page 1 of 2) CF -1 R B09:.to`i tJF_ r 112Z 9"c Project 714 — Date Project Address _ Building Permit # [VJc/SE_ LT/). Plan Check /Date Documentation Author - Telephone -311 N, 5-f S-TriN t ( Field Check / Date Compllance Method (Package, Point System or Computer) Cllrra:e Zone Enforcement Agency Use Only 4ENERAL INFORMATION Total Conditioned Floor Area: —14 CJ_-) ft2 Building Type: Single Family )4 Addition , (check one or more) Multi -Family Existing -Plus -Addition Front Orientation: North / East / South / West / All Orientations (Input orientation in degrees and circle one.) Number of Dwelling Units: Floor Construction Type: Slab Raised Floor (circle one or both) BUILDING SHELL INSULATION FENESTRATION ,,tisdina --#vices Fenestrai;on Area F enPclratior. Intaric. Exterior Overt+ap Orientation ;.f) U -Value irol.'ar bliru" eetc.) (shadescreen, etc.) (yes/no) (metai/wiod/vinyl) Front..... (11 �!�- .1i S STIO D14111� ijtn 5LaCJQN Y 9-5 M r TA L Front.... ( ) Left ....... ( ) Left....... ( ) Rear ..... ( ) Rear..... ( ) Right.... ( } RighL.... ( ) Wim. .01 " ' THERMAL MASS Type/Coverirtg Area Thickness !, Ls, ✓3 �1 f�Z. g t u C� A•/t�W rr_ GoN�I t -J Revised January 1M Construction Comment Insulation Assembly -oc:atiorUGommeMs Type R -Value U -Value (attic, to garage, typical, etc.) Wall .............. -13 l�✓�c.t.� Wall .............. Roof ............. 12-1 Pr77c �- Roof ............. Floor ............. S LA- GW C, /;- Floor ............. Slab Edge .... N �- FENESTRATION ,,tisdina --#vices Fenestrai;on Area F enPclratior. Intaric. Exterior Overt+ap Orientation ;.f) U -Value irol.'ar bliru" eetc.) (shadescreen, etc.) (yes/no) (metai/wiod/vinyl) Front..... (11 �!�- .1i S STIO D14111� ijtn 5LaCJQN Y 9-5 M r TA L Front.... ( ) Left ....... ( ) Left....... ( ) Rear ..... ( ) Rear..... ( ) Right.... ( } RighL.... ( ) Wim. .01 " ' THERMAL MASS Type/Coverirtg Area Thickness !, Ls, ✓3 �1 f�Z. g t u C� A•/t�W rr_ GoN�I t -J Revised January 1M Certificate of Compliance: Residential (Page 2 of 2) CF -1 R pi;imt ill's Tide/Firm: PLA+J ��UC-,C L.T/): HVAC SYSTEMS 57^-40AAO )0- L Note: Input hydronic or combined hydronic data under Water Heating Systems, except Design Heating Load. Distributi:jn Guicy, Heating Equipment Minimum Type and Durst or Telephone: Type (furnace, heat Efficiency Location Piping Thermostat pump, etc.) (AF%;Z1HSP'7' ducts/attic, etc.) R -Value _Type Cooling Equipment Minimum Duct Type (air conditioner, Efficiency Location Duct Thermostat Configuration heat pump, evap. cooling) (SEER) (attic, etc.) R -Value Type (split or package) At2 c,&_0 - Pi44 1 O o OL>TV_A1;1& WATER HEATING SYSTEMS 1J 1A Rated' Tank Energy' Extemal Factor or Tank Water Heater ^istribu for Number Input (kW Capacity Recovery St,*ndbyl Insulation Typeype A System or Btu/hr) (galions) Efficiency Loss (%) R Value 1. For small gas storage (rated inputs 75,000 Btu/hr), electric resistance and heat pump water heaters, list Energy Factor. For large gas storage water heaters (rated input 2 75,000 Btu/hr), list Rated Input, Recovery Efficiency Standby For instantaneous gas water heaters, list Rated Input and Recovery Efficiency. and Loss. SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) COMPLIANCE STATEMENT This certificate of compliance iis% ti's L4,",'. Pg features and performance; specifications needed to comply w., -t T,Le _4, Parts ; and S, of the Cafifomia Code of Regulatons, and tie a miriis alive reguiations to implement them. This certificate has been signed by the individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that is varied is indicated in the Special Features/Remarks section. Designer or Owner (per Business 6 Profession code) Name: i2d1Str/LT K V2a j o -i- rr- Tine/Frm: _ Address: J5630 141)c LA,.11L e- UK L,6, c.4. Telephone: 916- '34 5go 9 W. ar (signature) (date) Enforcement Agency Name: Tine: Agency: Telephone: (signature/stamp) (dale) Revised January 1992 Documentation Author Name: L.ARr2`/ WAaojr.../2 Tide/Firm: PLA+J ��UC-,C L.T/): Address: )0- L LJ ) L,U A.M S aya t� Guicy, 9s92-ic., Telephone: 9 L (o - n 9 Z- Boa r3 (Sipnatu (date) Point System Summary: Climate Zone 1,2 194f iE Tltla Date BUILDING DATA Conditioned Floor Area 4aD Number of Stories Slab/Raised Floor Check all applicable !!::it Type condition(s): [ j Single Farrily D,- at hod (3FD) b4 Addition Alone [ j Single Family .lMlacne' (SFA) [ j Existing Building [ j Mufti -Family (MF) [ j = :?si:r Plus-Addftion P -2R SCORECARD $ Measures Fenestration Area % North 8• East .�- 2. South -C�- West�L 12 SkylightE�- or Total ��� t 2 SCORECARD $ Measures Point Scores 1. Ceiling Insulation I `) mor _ 5 2. A=value U -value Wall Insulation 12=13 or _ R -value U -value 3. Raised Floor Insulation - _//N or _ `I- v a LI-value4. Slab Edge Insulation �� ��, or �- A-value F2 factor 5. Infiltration Any Ducts in Unconditioned Space? ( Y /©) _ 6. Fenestration Heat Loss 0(0-6 L_ 1 '2- �_ a _3 Type L -U -value Total % Fenestration Sum 1-6 7. Fenestration Heat Gain % Fenestration SCShade open Eff. % Fenes. Shade Eff. Ratio North _ -. x .60. 40- - East _ x West x Skylight Overhangs? Y N ) S. Interior Thermal Mass 10 0 or -C-S— .10 % Exposed Slab Int MasWCFA 9. Exterior Wall Mass -E3- _.._- _ __ _ _. _ -Q wan Ext Wall Mass Sum 7-9 10. Heating System ?8 x 6 *7,7 4- N/A �. 1 AFUE or HSPF Duct E3fiaenry Effecdw.AFUE Zonal control or.HSPF .. . 11. Cooling System 10-0 x. SEER "" Duct Efficiency - Effeci SEER Zonal control Adjuatnwnt 12 Water Heating. System 1 Heater ype _5_3 Energy Factor -/2- Ext Ink. R on . -value Auxiliary Distritb System 2 Heater Type Energy Factor Ext Ins. R -value Auxiliary Input Distribution / Point Total: $ Fora, Revised January 1992 Point Goal: -$-' Mandatory Measures Checklist: Residential MF -1 R NOTE: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items msked with an nz�y to superseded by more .stringent complianes requirements listed an the Certificate ► am siianc . '+;'ten thiz chadchst is incorporated into the permit documents, ti* featureb noted shall be considered by all parties as .binding minimum component performance specifications for the mandatory measures whether they are shown slsewt`:arN in the documents or on this checklist only. DESCRIPTION Building Envelope Measures §I50(a): Minimum R-19 ceiling insulation. §150(b): Loose fill insulation manufacturer's labeled R -Valva. * §150(c;): Minimum R-13 wall insulation in framed walls (does not apply to exterior mass walls). * §150(d): Minimum R-13 raised floor insulation in framed floors; minimum R-8 in concrete razd floors. §150(1): Slab edge insulation - water absorption rate no greater than 0.30, water vapor transmission rate no greater than 2.0 punch. §118: Insulation specified or installed meets California Energy Commission quality standards. Indicate type and form. §116-17: Fenestration Products, Exterior Doors and Infiltration/Exfiltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Manufactured fenestration products have label with certified U -value, and infiltration certification. c. Exterior do6rs and windows weatherstripped; all joints and penetrations caulked and sealed. §150(g): Vapor barriers mandatory in crimate zones 14 and 16 only. §156(0: Special infiltration barrier installed to comply with §151 meets Commission quality standwds. §150(e): Ins,ta;lation of Fireplaces, Decorative Gas Appliances and Gas i cgs 1. Masonry and factory -built fireplaces have: a. Closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. Space Conditioning, Water Heating and Plumbing System Measures §110-13: HVAC equipment, water heaters, showerheads and faucets certified by the Commission. §150(i): Setback thermostat on all applicable heating systems. §150(@: Pipe and Tank Insulation 1. Indirect hot water tanks (e.g., unfired storage tanks or backup solar hot water tanks) have insulation blanket (R-12 or greater) or corribina t interior/ertsrior insulation IR -16 or greater). 2. First 5 feet of pipes tk:-est io water heater tank, non -recirculating systems. insulated (R-4 or greater). 3. All buried or exposedpiping insulated in recirculating sections of hat w system. 4. Cooling system piping below WF insulated. 5. Piping insulated between heating source and indirect hot water tank. * §150(m): Ducts and Fans 1. Ducts constructed. iristatfed and sealed to comply with UMC Sections 1002 and 1004; ducts insulated to a minimum installed value d R=4.2or ducts enclosed entirely within conditioned space. 2. Exhaust fan systems, have baddraftor automatic dampers 3. Gravity ventilating systems imving.conditioned space have either automatic or readily accessible, manually operated damper_ -- e ,��• - §114: Pool and Spa Heafg,S acid Equipment - 1. System is =OW w&78%111hennal offkw cy, on-off switch, weatherproof operating instructions, no e1ecftresWw46 hNifnopolight. 2. System is metaled witlh:- a At least 36' pipe h ihiisi6ter anid heater far future solar heating. b. Cover for outdoor Pab—cr amoorVa. - 3. Pool systern has crecdonatiii and a.dnxrtatim pump time switch. §115: Gas-fired central fhmaos; pod hater, spa heater or household cooWq appliance have no continuously burkhg pita tigtht- Wkspton: Non-eleftal coolding appliance with pilot < 150 Stwhr.) Lighting Measures §150(k): 40 hrmersAvatt or greater for general fighting in kitchens and rooms with water.dosets; and recessed catling IC NoLdadon paver) approved. -- _ Revised January 1992. DESIGNER I ENFORCEMENT I U 65 1 1 t,11A /-J14 1 1 rz� PERMIT NO. PERMIT EXPIRES. OWNER R. D. Thurmam. CONTR. owner LOCATION (A.P. 44-44-54 E/S Hicks Ln.,app.-600'N.of.Eaton Rd., .lot 9, .Chico - ell 3714-77B,P,E,M i Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED�\(,� (34? -2 19 (Date) 01 -0 (Signature) 2 1 �� �OFAVV =�k 'COUNTY OF BUTTE — DERARTKENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback -- Firewall Soil Pipin Forms Parapets 1st Floor v Main Bldg. Restroom Finish 2nd Floor Footings — Windows rd Floo Stemwall Siding 1.To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footin Garage Vents Water Htr. Stemwal —,f Insulation Heaters Slab Prov. for ph sically Appliances handica ed Carport Conformance of ex. Gas Piping & Test Footings structure Temp. Gas Siab Final Sanitation Patio FIREPLACE Final Z� % Footings Footina ELECTRICAL �1 Masonry Walls Throat — Rough Reinf. Steel Final �— " `1s Fixtures Bond Beam FIRE SPRINKLERS Motors Framing /— Test Water Htr. Stucco Final Subpanels Mesh MECtMICAL Grd. Fault Prot. Scratch Heating Service Brown Coo Ing Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Z, ` Final MOBILEHOME UTILITIES - - - - - - - - - - • - - - - - - - Elec- Service Elec. Pedestal Water Piping I Sewer Gas Piping MOBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping �} DATE REMARKS OR CORRECTIONS &7 l�-its-77 {-7VaA� -N, � A LO,� !�/ (NOTE: An mus A r =l this forV each time-777C. jrA you v'slt the job.� L�G� To, BUILDING DEPARTtiiENT =1 or,,. F zIIROV;��cri".L HEALTH R. Sewage -and/or. Water a:Id/or Addition Clearance(s) u F/ OWNER Plans are approved for: .3 -� J,�6-77 LOCATION AP# Sewage Disposal 4,aal Clearance ok forfor: .i-arasi: e is for a bedroom (home mobile home) . Other i'1 -ie addition(s) will be Sanitarian Water Supply Water Supply Water Supply A T^ Date mm ERSET• ;,• COMPANY %4' LICENSED CONTRACTOR ' Phone: 342-4764 P. O. Box 3506 — Chico, California 95926 INSULATION (Batted or Blown) THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE )6F CALIFORNIA, IN THE BUILDING LOCATED AT: v Street Lot Number EXTERIOR WALLS Manufacturer ® ` % Thickness/Type R Value Tract No. CEILINGS Batts: Manufacturer Thickness R Value S Blown: Manufacturer Thickness V� No. Ba s O Wt./Bag`s Sq. Ft. Covered 1 R Value FLOORS Manufacturer Thickness/Type R Value SLAB ON GRADE Manufacturer Thickness/Type R Value Width of Insulation Inches FOUNDATION WALLS Manufacturer Thickness/Type R Value GENE N R R /7/Y f�OLr LICENSE NUMBER BY TI LE DWA1� DATE 8'd� ii 1 UL 10 TRACTO LICENSE NUMBER B ITLE 4�L��`-'/ `-moi — DATE � d - ( DATE) ACCEPTED SAVE ENERGY - INSULATE! H SETH OMPANY (Authorized Representative) COUNTY OF BUTTE' — DEP(ARTMENT OF PUBLIC WORKS 7 County Center Drive .— � Uroville, California 95965 Tel ephorie: 534-4541 APPLICATION AND PERMIT authorize representatives of the county of Butte to enter upon the above-mentioned roperty for inspection purposes. X Date a 111,72 Sign ture of Permitee or Agent Receipt No.A Z7/5 , � White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRECTO F PUBLIC WORKS BY Date -zf�--77 ilding permit expires Date BUILDING Owner 42 SQ. FT. OCC. BUILDING VALUATION Mailing Address /- *a I phone o J^ Fireplace ✓ l Contractor Total Valuation -Cc Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 ZdU Each Trap 1.50 a8 / ARepair O drainage or vent piping 1.50 Water piping 1.50 Zoning Verification nl Each gas water heater or vent 1.50 A. P. No. y`- Gas piping system 1 - 5 outlets 1.50 a Each additional outlet .30 lipesT S ion FireDe--ptt.�. Fire Zone Use Permit Building sewer 5.00 EQA Parking Parcel Plans Declaration PSrcel Ma p 60' R/W Im rovements p Lawn sprinkler system 2.00 ti6ldg. Plans Recd Z6 arce Approval PIa pproval Permit Fee $ $ NEW ❑ ADDITION F1UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 p� Main service BooV OR LESS 5.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 Single Family Q Duplex ❑ Mobil Home ❑ Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 ONEW R ADDNST ( DDWEACCLLIN GOCCUP. &\ r20Sq ft NEW CONSTR. (MULTI -OUTLET \/ NON RES,D. BRANCH CIRCUITS/ 2.50ea NEW CONSTPOWER APPARATUS & NON- R. RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLE7S OR FIXTURES) BAL 109 FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 VQI am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ 0a WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. EJ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 3,06 Heating ,� Cooling Ventilation Hood 2.00 p� Permit Fee$ T/ $ a 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby O<� TOTAL PERMIT FEE $ authorize representatives of the county of Butte to enter upon the above-mentioned roperty for inspection purposes. X Date a 111,72 Sign ture of Permitee or Agent Receipt No.A Z7/5 , � White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRECTO F PUBLIC WORKS BY Date -zf�--77 ilding permit expires Date RESIDENTIAL PLAN CACKING GUIDE (S.F., DUPLFIX., & MISC. ONLY) Bldg. L, A.P. A. ENERAL zoning requirements (sideyards and parking). 9:-�aluation. 3. Signature by R.C.E. or Architect (if required). B. PLOT PLAN If --Complete parcel size and dimensions. f__ Setbackq, sideyards, easements, etc. 3. Other buildings or structures. 4. Grading, fills, drainage. Permit # �3 7l # C. FLOOR PLAN Complete to scale plan with dimensions. 2�_ Required windows for light and ventilation (Sec. 1405). 3:—Required windows for second exit (Sec. 1404). .Allowable glazing for energy requirements (20% max. per State law). �_ Human impact glass (Sec. 5406). _&._ Required room sizes, ceiling heights (Sec. 1407). Ir— G.F.C.I.'s in baths and exterior outlets (Sec. 210-8). 8--- Light fixtures, switches, receptacles, and exterior receptacles for maintenance of mechanical equipment. �- Locations of water heater, heating & cooling equipment, other electrical or gas equipment, and plumbing fixtures. 9-- Garage firewall, door size, and closer (Sec. 503(d)(4)). L'4— 1 - 3'0" exterior exit -door (Sec. 3303d). Fireplace location. Smoke -detectors (Sec. 1413). D. STRUCTURAL DETAILS ,!Foundation plan complete enough to construct building. &,-F1ooT construction details complete enough to construct building. t,,. 4—.Elevations and wall construction details complete enough to construct 4—. Roof construction details complete enough to construct building. ,6 -'.—Fireplace construction details and calcs if over one-story in height. -Sufficient data and details to satisfy energy insulation requirements E. MISCELLANEOUS ITEMS TO LOOK OUT FOR d.:,-CCX plywood on exposed locations and overhangs. 2. Stairway details (Sec. 3305). 3. Guardrail details (Sec. 1716). 4. Brick or stone veneer (Chapter 30). 6,--ftterior plaster --weep screeds (Sec. 4706 & 4708) . 46:�—Proper roof pitch for roof covering (Chapter 32). Rafter ties or bearing ridge beam. C --Garage door or porch header sizes. 46,---kdequate bracing. building. (State law). 10. Living area over garage - complete 1 -hour separation required including supporting walls and posts, etc. ... 11. Two (2) exits on three-story dwellings (Sec. 3302). + •� 1 ! � AWEN PGDLS),, P_ol bBU "H pate sSince 15 - , Wet°'_�3UN fAdoRE Te:elyGaya. } j} j E I i i} 1} j 1 1 1 i 1 i i 1 i j i �::� I-777 -� ;tip � _ •a9;. .:...: ;;f_ ::i1;;i r -i i tt t � ,t }}i1 �j� jI•���� � '• I ' i �I i i t � IT ti f ii �fE1,�11 .�I i A c ¢I, L I' N E �-� IW •int I i I i «,r�;,c: Yii y ✓l 514 i UI ^` qOV _ � �. _ .- ; ' S E P T t •G . t I I t , I ` � +;_.._... i-rA,ivjPDrlsingding:' ' I I- 1I i1 r. oil, i• - - - - + -- - - - - _LDLEACH LIN_E dol ` 1 S T l N Cr _ E" 5. D t N1 E.T4 . R IJ_ f - i I i��m, 1 i i i ' I t 1 I i i I 4rVL; RE?th iFATIo t4 -rep10 �!8 ID C j ,liy t A RE -A II pI� oN j r ., - — -- •--- ;—-,— i i - - - ±. _ =7 'Al i ! 1 ; .fla{1etic.� Yo�J _, ESD . ! � • ' - i i i 1 � .i 2' r t e o. S w.2 Tu K N. i ; i 15 . ,� i R :Ii 110. �- r2y NAND Environmeni a Health Z. V ' i - - � - - - - --.._:. _ _ `� - - - - - • - - - - - LSCrTIc..- `.j ; ' , : ; . ti;G!R .A ,9 MAR 2 005 !rc/aCH FiELD ' P00f_ `I I �8 1 0, PLA/JT£R 3Chlco, CA 32HosE dim It EL��' BUTTE C®UNiy BUILDN G lDlVIS-f �8 e�_i SPP GENERAL POOL SPECIFICATIONS: (Temp.# SUR. sAM EXCAVATION Access Fron Rear Bob Cat Shuttle Dig Remove Dirt YE--5- Remove ESRemove Stump(s) Remove Fence Replace Fence C4, Remove Concrete ® S. F. Sawcut Concrete_ �� Ft. STEEL Expansive Soil Steel Pattern BH PLUMBING Filter Run Fig: a 0 Return Lines 3 P -Trap B/Wash Line �6 Gas Line Fig Drill Drive A u-ro F-1 L L ELECTRICAL Run By Ftg 9 0 r GUNITE Love Seat S Swim Out 0 Ext. 2nd Step Pc r P l a m R.B.B.in. X C Ft. R.B.B. T in. X Ft. .COPING 7Type CA IJ T I L Ever, TILE Type CHG10E Spa Dam G/ Accent Tyle • Approve above specification • Approve equi�. a location • UnderstandRhatdeckinashown Prepairbd Especially Street DECKING Type K o o L Color rlDoV F Cr R F -Y Risers 0 Footings G% Mastic r' Drains a (00" S/S NAtiJ0 RAIL W rrH ANCNO9 EQUIPMENT No Smart Vac 11 Ph n r,q.&0s)c' Heater BTU ( Nat Pro Div. Board Slide Water Feature rg'-SH re—A? ASC r NST WiTN Flee-popTIC PLASTER Color SMA 9 _7 R R LII" '9LU! GREEN SPA Size (25 In 12 Out Plumbing Run G% Dam Wall Length Number of Jets Blower Hp ;Yes ii No Remote Model #' < Spa Side Switch Yes Smart Light Yes LNo 100 Watt Light Yes (fJ ) BUYER Initials for i stration purposes only and' O d -square feet of deck. c Date City C H/ C o Zip 95-973 Home Phone P, 9`91 - P 7 P 9 Work Phone i8 9/— 13 3-L zuC- / <-2 " Lot Block Tract Mapsco No. T- e_ AW- AW.Aw 1111 IC