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Cont: RIDGE ROOFING CO '
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-04-1609
DAUTERMAN, JOEL' '
;3060 VIENTO, CHICO, aiNALE
Cont: RIDGE ROOFINGGARAGE RE -ROOF 20.S
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796=90B,P,E,M t `'
_ . T)AV7RMAN j . Jool. & Lucinda. p _
3060 Viento Dr,, Chico
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�,. (new .single
Ry {93 4 2052 BPE
DAUTERMAN , JOEL sew
30609 `VIENT0, CHCIO
DETACHED GARAGE
0�- 04-1607
DAUTERMAN
3060 'IENTO_, CHIC_O'>
Cont: RIDGE ROOFING CO '
RE' ROOF X40
-04-1609
DAUTERMAN, JOEL' '
;3060 VIENTO, CHICO, aiNALE
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14
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.net\dds
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
the Business and Professions Code, and my license is in full force and
effect.
License Class: � 37 License Number: b
Date:6• if —O I'/ Contractor: _ �� e_ Roes x7 nsr
OWNER43UILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ 1 am Exempt under Article 3 of the Business and Professions Code
Date: Owner:
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
❑ 1 have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:
Policy #:
`icertify that in the performance of the work for which this permit is
issued. I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date: 6r /—
Applicant:_
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the
performAe%RvJ,2Le work for which this permit is issued (Sec 3097 Civ.)
Name:
Address:
PERMIT NO.
1609
-fD/d-2ZO-o36
Issued Date: 06/04/200.4 APN: 048-010-036-000
Site Address: 3060 VIENTO DR CHI
Map Index:
Description: TEAR OFF & REROOF/ COMP DET
SHOP(20Sgs)
Owner: DAUTERMAN JOEL J & LUCINDA A
P O BOX 3854
CHICO, CA
95927
Applicant: DAUTERMAN JOEL J & LUCINDA A
Contractor:
License #:
Architect:
Engineer:
Total Square Ft:
Valuation:
Census Code:
0 S. F. )V6)
$0.00
IreC'-=t
PERMIT EXPIRES ON:
under the applicable provisions of the Bufte County Coda anrUor
t ab��� ee for which fees have been paid. µ %
i / Date:
7
❑. 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 scheduledconstruction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of official form or document of Butte County. I hereby
authorize represent9tives of Butte�C/o/yntyto enter upon the above mentioned property for inspection purpo s.
Print Name: (fl� V %L �. Signature:
Date: !'l
❑ Owner UYContractor 0 Agent for Owner
❑ Agent for Contractor
X
x
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.netWds
PERMIT NO.
BP041609
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: 06/04/200.4 APN: 048-010-036-000
the Business and Professions Code, and my license is in full force and
effect./
/014
License Class: � — 3 License Number: 30n06
Site Address: 3060 VIENTO DR CHI
Date: 4 e/ Contractor. .14 e UO >
U Map Index:
OWNER43UILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Description: TEAR OFF & REROOF/ COMP DET
Contractors' State License Law for the following reason (Sec. 7031.5
SHOP(20Sgs)
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
Owner: DAUTERMAN JOEL J &LUCINDA A
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
P O BOX 3854
she is exempt therefrom and the basis for the alleged exemption. Any
CHICO, CA
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).):
95927
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
Applicant: DAUTERMAN JOEL J &LUCINDA A
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ I am Exempt under Article 3 of the Business and Professions Code
Contractor:
Date: Owner:
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
License #:
is issued.
❑ I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
Architect:
insurance carrier and policy number are:
Engineer:
Carrier:
Policy #:
I certify that in the performance of the work for which this permit is
Total Square Ft: 0 S. F.
issued, 1 shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
Valuation: $0.00
and agree that if I should become subject to the workers'
Census Code:
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant:_��j
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
I O ��
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.
4LS`��P� t
CONSTRUCTION LENDING AGENCY
This permit i5ARNeby issued under the applicable provisions of the Butte County Coda and/or
I hereby affirm that there is a construction lending agency for the
perform a work for which this permit is issued (Sec 3097 Civ.)
Resolution o do work indicaje ab a for which fees have been paid.
f —G q
Name:
BY: 2Date: " 1
Address:
PERMIT EXPIRES ON:
Date
Q. I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance ofofficial form or document of Butte County. 1 hereby
authorize representatives of Butte I to enter upon the above mentioned property for inspection pumo s.
�Coo
Print Name: �r�� V U (/ A' Signature:
Date:
❑ Owner ontractor ❑ Agent for Owner ❑ Agent for Contractor
j
A ,p
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
CONTRACTOR
OWNER
Name e l C�)e, utk f-rMl\--/,j
Address
State
City CV t i
Phone 2- -2,L'lq 0
State
Zip
Phone
ass)
Fax
E-mail
E-mail
CONTRACTOR
Name
axd ex
Address I d /2
City VGA
State
Zip
Phone 2- -2,L'lq 0
Fax
E-mail
Uc. #G/ 3 ' 3 Obi
ass)
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City � �
Address
Zip c1��
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name U��,V1S�Ll
Address
City � �
ate
Zip c1��
Phone Z —�-7
Fax
E-mail
APPLICANT SIGNATURE
X
For office use only:
Zoning
Flood Zone SRA I Yes
I No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
O-1-I�oT
BP
BIN #
LOCATION
AP# bLt —Of() 030
Property Address
300 Vt ert0 Gh �
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
Page 1 of 2
Description or cope of Work:
Sq. Footagere Losq'5
0 Structure Built without Permits
0 Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by: V ` �� Amount: V10-00 Bldg
SRA
Receipt* L-1 �% Sheriff
SMTP
Date: - U " D y Other
Total
REV 4-30-04
SUBMITTAL 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.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER!
❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed
calculations.
❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 5. Letter from Engineer or Architect for truss design review.
❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to
mobile or modular homes.)
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 8. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 9. Sanitation and site plan approval from the Environmental Health Department.
❑ 10. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
Mobile, Manufactured, or Modular Homes:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line information.
❑ 4. 2 Floor plans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.
❑ 6. Sanitation and site plan approval from the Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑ 1. 4 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 4. Letter from Engineer or Architect for truss design review.
❑ 5. 2 Energy compliance design and supporting documentation (if required).
❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 7. Statement of Intent for Non -heated and A/C (if required).
❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
❑ 9. Letter of intent.
❑ 10. Hazardous Material Form.
❑ 11. Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2
REV 4-30-04
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BPO41601D
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 ofIssu
��. �� APN'-01 i
the Business and Professions Code, and my license is in full force and
effect. p
�� 37 iii
License Class: Lic. use Number:
Site Address' MENTO DR CHI
r
Date: = t -C� Contractor: 1d �QNWP
We=
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
D tion.- TEAR OFF & REWOF/`M( MEIHINGLES
Contractors' State License Law for the following reason (Sec. 7031.5
0Q0SgS) "
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
i
to its issuance, also requires the applicant for such permit to file a
owp&' DAUTERNAN JOEL J & LUC0NDAA
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
P O WX MA
she is exempt therefrom and the basis for the alleged exemption. Any
CHICO
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
����®� ����� A
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ 1, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ 1 am Exempt under Article 3 of the Business and Professions Codepr;
Date: Owner:
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perl'ury one of the following declarations:
O 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
❑ 1 have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:
Policy #:
l7 I certify that in the of the work for which this isTotalc^i„��
performance permit
P ® &F
`
issued, 1 shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
%%tmfth•` (�
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
CmIlm Mode:
forthwith comply with those provisions.
Date: —Q Ll
Applicant: ze
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
/� �0 fes,
'� ll
compensation, damages as provided for in Section 3706 of the Labor
f /� ,
code, interest, and attorney's fees.
�” �f
re Ce 1 '}',� _ 1 0• S –7 (4 (moi
CONSTRUCTION LENDING AGENCY
This permit' reby issue der the applicable provisions of the Butte County Code 2nrllor
I hereby affirm that there is a construction lending agency for the
Resolutio s o work in ate d ab ve for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
L� iCi(a
Name:
BY Date:: JJ
PERMIT EXPIRES ON:
Address:
Date
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the o the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter e sance of a official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upontheabove mentioned property for inspecthub t,o purposes.
r
�j /,P–
Print Name: ns I\� Signatur
Date: d 1
11 Owner WContrctor ❑ Agent for Owner ❑ Agent for Contractor
Iq BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BP041607
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: 06/04/2004 APN: 048-010-036-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Site Address: 3060 VIENTO DR CHI
Date: Contractor:
Map Index:
Description: TEAR OFF & RE ROOF W/ COMP SHINGLES
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
(40Sg$)
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
Owner: DAUTERMAN JOEL J & LUCINDA A
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
P O BOX 3854
she is exempt therefrom and the basis for the alleged exemption. Any
CHICO, CA
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).):
95927
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
Applicant: DAUTERMAN JOEL J &LUCINDA A
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ 1, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
O 1 am Exempt under Article 3 of the Business and Professions Code
Contractor:
Date: Owner:
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
License #:
is issued.
❑ 1 have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
Architect''
insurance carrier and policy number are:
Engineer:
Carrier:
Policy #:
❑ I certify that in the performance of the work for which this permit is
Total Square Ft: 0 S. F.
issued. I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
Valuation: $0.00
and agree that if I should become subject to the workers'
Census Code:
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant:
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code anrVOr
I hereby affirm that there is a construction lending agency for the
Resolutions to do work indicated above for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
By: Date:
PERMIT EXPIRES ON:
Date
Address:
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
Print Name: Signature:
Date: 1
0 Owner ❑ Contractor 0 Agent for Owner 0 Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
APPLICANT NAME
OWNER
Name
"'
® ®< V Q,^yVla�
Address
-zO G O
City � I
Statec'L
Zip
Phone 3
$' 7
Fax
E-mail
s -•�
APPLICANT NAME
CONTRACTOR
Name
Name
k1
CO
City
g.^ Oa
State
Address
Phone
CityState
s -•�
C
State License Number
Zip
gs 9,69
Phone2
` 2 O
Fax
E-mail .
Lic. #L 3
z0 6
CI ss
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City �� 5
Address
Zip
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name
o rte. D i-v-)
Address Ll cis
City �� 5
State
Zip
Phone $,� - 77
Fax
E-mail
APPLI T SIGNATURE
t3•'ti
For office use only:
Zoning
Flood Zone
SRA
I Yes
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
eq -1(' (-5?
BP
BIN #
LOCATION
AP# O t l �7 _ I O, 0'1
Property Address :� 0 6 o �Q Gt•+ t
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 O"(► �'� m L
Description or Scope of Work:
Sq. Footage (� 0 S 0s
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received bOAP, Amount: ' Bldg
p ��7 SRA
Receipt #: `'( f Sheriff
MIP
Date: _ (��C� / Other
22i� O� Total
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 4-30-04
VON
SUBMITTAL 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.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER!
❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed
calculations.
❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 5. Letter from Engineer or Architect for truss design review.
❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to
mobile or modular homes.)
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 8. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 9. Sanitation and site plan approval from the Environmental Health Department.
❑ 10. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
Mobile, Manufactured, or Modular Homes:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line information.
❑ 4. 2 Floor plans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.
❑ 6. Sanitation and site plan approval from the Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑ 1. 4 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 4. Letter from Engineer or Architect for truss design review.
❑ 5. 2 Energy compliance design and supporting documentation (if required).
❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 7. Statement of Intent for Non -heated and A/C (if required).
❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
❑ 9. Letter of intent.
❑ 10. Hazardous Material Form.
❑ 11. Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2
REV 4-30-04
f
RESIDENTIAL
048-01-0-036 93-2052 BPE
DAUTERMAN, JOEL
30609 VIENTO, CHCIO
DETACHED GARAGE
V= OK
O = Not OK
Not
= Not Ready Applicable MOBILE HOMES
Date/Initials MOBILE HOME UTILITIES (Plans) OK except #'a
1. Zoning Requirements -Setbacks -Easements
-2. Soils; Special MH Support Sketch
3. Sewer; location -Test -Fell -C/O Concrete
.4. Water; Location -Teat -Easement Needed (Sketch)
- 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap: / /"L"ft.
/ /"Nat. or/ P'L"ft./ /"LPG
7. Well Clearance & Disconnect'
8. Utility Clearance
Date/Initials, MOBILE -HOME INSTALLATION (Plans) bK 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
f
_ f
4�� TtsT Co -476—c. -Ig
MISCELLANEOUS
ti/Loni ng2eq u irements-Setbac ks-Easements
tangs; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
jek�� a -
'��I-��11 Wig; Sils-Anchors-Studs-Rftrs-Trusses
ing; Nailing -Veneer -Stucco -Mesh
U&-Reof-Shthg-Roofing
L44-Evt- Steps-Doors-LreaAings
✓-/ti ti.
f.Z_f
Date/Initials POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
'4. Elec.; Receptacles and Lighting, 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
i
' t
s.
i
•
i
w
r
-
r
r
.E
V=OK
O t Not OK
- 3 Not Applicable
= Not Ready
RESIDENTIAL (Single & Duplex)
Date/Initials UNDERFLOOR (Plans) OK except #'a
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Grnd. / P' Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
S. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
6. Piers -Fireplace Ftg.-Steel
9. O.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. Plenums & Ducts; Clearance -Material -Support -Ina.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16. Insulation
Date/Initials PLUMBING (Permit) OK except #'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/Initials ELECTRICAL (Permit) OK except #'a
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/Meth. Fastners-Bond Gas & Water
27. 2 Appliance Circuta in Kitchen & Conductor Size/GFI
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga.
Cu or Al
29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral 0 Yes 0 No
30. Service -Riser Conductors & Ground -Mein Disconnect
31. Equip. Clearances Panels -Motors -Mach. Equip.
32. Clothes Closet Light -Shower Light -Spa Light
33. Smoke Detector
Date/Initials MECHANICAL (Permit) OK except #'s
34. A.C. Ducts Insulation & Support
35. Vent Fan; Exhaust above insulation
36. Condensate Drain & Overflow; Size & Grade
37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet
38. Attic Access & Platform if Furnance in Attic
Date/Initials FRAMING (Plans) OK except #'a
39. Sils, Proper Material & Anchors
40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
41. Bearing Walls over Girders & Floor Nailing
42. Draft Stop in Walls (rat proof)
43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearing
Date/Initials FRAMING (Continued)
45. Hangers -Post Caps -Anchors -Connectors
46. Cing. Joist-Rftr. ties- Puri In -roof Brac-Truss-Shthng.-Rfng.
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
50. Garage Fire Protection Framing
51. Property Line Firewall & Openings
52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
55. Siding -Nailing Veneer
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
57. Glazing Area -Glass Protection-Skyilghts-Plastic
58. Shear Walls; Nailing -Bolts
59. Insulation -Walls -Cel II ngs
60. Infiltration -Walls -Windows
Date/Initials FINAL (Plana) OK except #'a
61. Ext. Steps -Door & Sidelight Protection -Landings
62. Smoke Detector
63. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor -Ducts -Mach. Protection
64. Bedroom Exiting
65. G.F.I. & Bath Fixtures & Tub Access -Spa
66.. Elec. Trim & Subpanel; Breaker Sizes & Labels
67. Stairs & Rails
68. Fireplace or Stove; Clearances -Hearth
69. Elec. Outlets at Wood Panel; Int. & Ext.
70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
71. Elec. Outlets & Receptacles at Kit. Counter
72. Garage Fire Door; Swing -Landing -Closer
73. A.C. Duct in Garage -Damper
74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage; Above Floor -Mach. Protection
75. Plb., Elec. & Mach. Equip. Listed for Location
76. Elec. Receptacles In Garage; (G.F.I.)-Romex Protection
77. Insulation -Foam -Looked in Attic 0 Yea
78. Guard Rails & Deck Construction -Post Caps
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
80. Following instid.; Drive 0 Yes 0 No; Walks 0 Yes 0 No;
Planters 0 Yes 0 No
81. Stucco; Brown -Finish
82. A.C. Unit; Disconnect, Electrical, Plumbing
83. Vents Above Roof; Plbg: Appliance -Fireplace. -Clearance to
Openings
84. Water Well; Disconnect, Electrical, Plumbing
85. Exterior Elec. Trim; G.F.I. Receptacle -Underground
86. Ventilation Throughout House
87. Glass Protection
88. Corrections from Previous Inspections
89. Gas Test -Meters Tagged; Gas -Electric
90. Water & Sewer Connected -C/O to Grade -HD Approval
91. Energy Compliance Certificate -Other Certificates
Comments at Final:
COUNTY OF BUTTE Mig
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751�
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA (916) 872-6307
CORRECTION NOTICE
OWNER PERMIT NO.
A "xrfiniebtspection indicates that the following violations of Butte County Ordinances exist at
the above addkew and should be corrected. Please notify this office when correction of work
is completed- ff you have any questions pertaining to this niatter, or need additional explanation,
please contact this office immediately.
ol� en, 0 - -
-S�� AJJyAJyy'A�
Date /07V Inspector z
REV 1QW
1
COUNTY OF BUTTE - DEPARTMENTOF PUB C 0RKS
7 County Center Drive - Oroville, California 95965 - Tele one: 916.`53 -7541
APPLICATION AND PERMIT
MIT
ASSESSOR PARCEL NUMBER
048-010=-036
ZONING
SR -3
BUILDING PERMIT IV
OWNERTELEPHONE
Joel Dauterman GS
345-2208
SO. FT. OCC. BUILDING VALUATION
1,440 M 25,920.00
OWNER'S MAILING ADDRESS
P.O. Box 3854, Chico 59927 Lo,5.- -7
48 C 624.00
CONTRACTOR'SNAME
Owner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace A 1,500.00
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $ 28,0
.00
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 236.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 118.00
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$369.00
PLUMBING PERMIT
FilingFee 15.00
3060 t0 Dr . Chico
Each Trap
1 5.00
Solar or heat pump water heater
1 20.00
LOT NO.
/I
SUBDIVISION NAME
PARCEL MAP
If E 6 �
Water piping
1 7.00 7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other Garage
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home I S I G JW I
@ 15.00
TYPE OF WORK
New LX Addition LJ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work:_ Detached_ Detached GArage
Permit Fee
$ 27.00
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 200A OR LESS
18.50
Main service 200A TO 1000AI
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
icense No. Classification
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for. -sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
DWELLING OCCUP'&)
NEW CONST.( ACC. BLDGS. I/
V 3.64sq.ft. 50.40
A
NEW CONSTR ULTI.OUTLET
NON.RESID BRANCH CIRC ITS
@ 5.00
POWER APPARATUS IN
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
20 764
FIXED APLNS
Ex. OCCup. OU LETS PIRESID IREA.)
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. byirin g
15.00
Permit Fee
$ 65,40
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
Consent to Self -Insure.
shall not employ any person in any manner so as to become subject
eti,
o the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Cooling
g
Hood
6.50
Ventilation
Permit Fee
$
LContractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgme ts, costs, and expenses which may in any way accrue
against s id Coun in ons equence of the granting of this permit.
Date
nature of A plicant – Owne Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.S
Receipt No. 143518
WNITE-D.P.W., TEL LOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
Mobile Home Installation Fee $
Energy Inspection Fee $
o'ccc�1 CONV TYP
ri/ ,A TOTAL FEE $ 461.40
HAZ 1) FEES I IMP FLOOD I CDF PARCELPD HD ss
This permit is hereby issued under the applicable provi-
Bions of the Butte County Code and/or resolutions to d0 I
work indicated above for which fees have been paid.
By ��DRE T ORKDae _
PERMIT EXPIRES Date
' r.. - , r r.- '. ^".• ` "!ti'^'r,^v.'r1� (j1'1-lELti.r-�ry(.7'y`Ly.0 .c...- >> .-.. .i iR. !L+ . ' i .. � , ..
COUNTYOF BUTTE - DEPARTMENTOF D�VELOPMENTSERVICES -,BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - K-E;� NE (916) 538-7541
OWNER , .,J
Proposed Building Use
PERMIT APPLICATION DATA SHEET
n/(/ P. No. `/11- 0 /U
Building Inspector Date .2
At time of permit application, I was advised the following data must be submitted 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. ............................. .
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) y California Engineer ................. r----�-,,�
14. Sanitation and plot plan approval �f` o 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). . .
20. Pre -inspection for required. .. oel ose4 -
40ata)
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 . ........................................
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.
Wheou
n - issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone t3gT- 7Zng- and hold for pickup at ��;� , � office. Deliver with inspector.
Other
Parcel
Acpp / � e
Acreage Applicant /,_2
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 Counter by _ Date
Contractor, designer,. owner, was advised of above required data by_ phone_ Counter by _ Date ---�
Plans checked by Date Plans approved by /, ��i� Date/
DVN Sets of plans-ems!Wd in <Deabim - A R Ick
Copy - bepartment of Public Works
F.1-1 US). OM y
I'llA PlUn Attached
1:1,,,,r Plan Au.clwd
S�nt to II.D.
TO: Iluddino Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location AP#
Plan Approved for: Sewage Disposal Water Supply: PLiblic Private Well
Clearance for bedroom mobile home. Other
J�, 41.�.
Hold final for:
Final clearance O.K. for:
NOTE:
Environmental Healt1P Specialist
8/92
7 tj -
Date
COUNTY OF BUTTE - Department of Public Works
7.County Center Drive, Oroville, CA 95965 Phone:
OWNER -BUILDER VERIFICATION
Attention Property Owner:
7
916-538-7541
i
3
i'
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 i
will be issued until this verification is received.
1. I personally plan to.provide the major labor and m erials for construction of
the proposed property im rovement (yes or no)
2. I (have/have not) /�'f� signed an application for a building permit
for the proposed wor .
3. I have contracted with the following person (firm) to provide the proposed
construction: .
Name
Address City
Phone 'Contractors 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 e
Address City
Phone Contractors'Lidense 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: ,
Property Owner u/!�
Social Security NuAer V
Date Z
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 per-
mitted to issue the permit.
OWNS S NAME:
ADDRES
BUILDING SI E/AREA:
CERTIFICATE OF ROOF -COVERING
A.P. #:
PERMIT #:
BUILDING USE:
FIRE
HAZAR\& ZONE
ALLOWED ROOFING FR6M LISTS BELOW
❑
VERY HIG
#1,
#2
❑
HIGH
#1,
#2, /#3MODERATE
#1,
#2,
LIST
#1
CLASS 'A' ASSEMBLY
VBUILT-UP
SS 'B' ASSEMBLY
CLASS 'A' PREPARED ROOF G
ROOF PER 3203(e)
❑
CLASS A OR B PREPARED ROOFING
LIST #2
❑
ASBESTOS CEMENT SHINGLES
❑
METAL ROOFING
[]
CONC. OR CLAY TILE
❑
(OTHER FIRE RETARDANT ROOFING)
[]
SLATE SHINGLES
LI
T #4
❑
(01'111?R NON-(,OMBl LIiL,I; ROOFING)
❑
C;L. S5 'C' 23511 AS111A1 l' SIII.NGLI;S
:I: HEREBY CERTIFY, I IYTALLED ROOF COVERING AS INDI(\kTED ON THE ABOVE
BIJILDING, IN CONFORM CE WITH STATE AND LOCAL REQUIR ENTS.
FIRM NAME/OWNER/(Please Print)
SIGNATURF,/OF GENERAL
OWNER
ATE
DATE
THIS C1RTTFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PR
.INSPECTION APPROVAL.
January 1988
[Kol
TO FINAL
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307 -
CORRECTION NOTICE
ODA Lrf-ft /Z -20 5 -2 -
OWNER PERMIT No.,
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction� of work
is completed. If you have any questions pertaining to this matter, or need additio.6al explanation,
please contact this office immediately.
'lops;
C-2 C6Zt,-U IC--'
Al
Date L) Inspector
RE\�10/92
I
ci z -30.2
' Lille -0 DI V
PACE 6 ARC WELDER QUALIFICATION TEST
FOR PIPING SYSTEMS OPERATING AT HOOP STRESSES OF
20X OR MORE OF SPECIFIED MINIMUM YIELD STRENGTH
XPASSED_ DATE LAST TESTED: Ic' /4 -9a --DATE: (o' ll'o - 93
Q FAILED. FURTHER TRAINING REQUIRED .
WELDER' SAF M A N, S. S. NO.: SS�,2 - io �- - IS -71
PIPE OIA. Io2 PIPE SPEC. SL CRACE WALL THICXNESS
EXX I 0 Q M I CRO WIRE BUTT TESTER:-
• cP.C.aE.t
Q EXXIa Q OTHER ❑ BRANCH WELO POSITION:-a21Z-DMT,AL. riX
ELECTRODE MATERIAL: f ELECTRICAL: WELDING:'
BEAD
MFC. L AWS CLASS
I DIA.
IST 8EAO
L N E - Of 0
40
I'
I,
�8
2NO BEAO
!
70
--
/LOCATION
oZ. oo
OTHER BEADS
Sot
TENS I LE.::TESTS:
A
POLARITY
AMPS
I VOLTS
I LOAO-LB.
lq
40
I'
I,
ISS
I
!
70
m
SPECIMENI WIDTH
THICKNESS
AREA -SO. IN.
I LOAO-LB.
I STRESS -PSI I RE.MARkS
I
I
I
I NO.
I
!
2 (
--
/LOCATION
oZ. oo
i
.3
I
I
I
I
I�3�."
$-
1�1L„
FACE BEND OR SIDE BEND:
SPECIMENLOCArION
I NO. CRACXS
MAX. DIMENSION I LOCATION
I QEIMARKS
I
I
17: oo
BETWEEN
I NO.
LENCTH
Z
FUSION REMARXS
--
/LOCATION
oZ. oo
ROOT BEN OR SIDE BEND:
I I q:oo
-�
SLAC INCLUSION
NO.
OK
2
17: oo
BETWEEN
I NO.
LENCTH
BETWEEN
NICK BREAK:
SPECIMEN
CAS POCXETS
SLAC INCLUSION
NO.
I NO.
MAX. SIZE
BETWEEN
I NO.
LENCTH
BETWEEN
FUSION REMARXS
I
/LOCATION
oZ. oo
3
'7:3o
I
I�3�."
$-
1�1L„
GooO ,�
Goa
•
10: 0
CONTRACTOR, PROJECT: eEC3vA Lt FtLATInr✓
QK
RESIDENTIAL,PLAN'CHECKING GUIDE
(S.F., DUPLEX & MISC. ONLY)
OWNER OC
GENER L
/oning requirements: (sideyards
7/ Valuation.
3' -R Mns signed by designer.
8/91
Bldg. Permit # 67 7- Z,4,5-2-
A.
DSZA. P.
Plan Checker
and number of permitted living units).
P ?per description of work on application.
Items on data sheet.. (W.C., fees, Health, Developer Fees, License law, etc).
�—R®Eor�pd e�-ree a€-��„a. •
PLOT PLAN
Y! mplete parcel size and dimensions.
'Setbacks, sideyards, easements, etc. ,
Other buildings or structures.
lily
a noise. CDF, firespraalc�ers,-case-c-amb_
c L UQV ItT
8. Building or at±±tttms across_kelt_����-
FLOOR PLAN
,---'-Complete to scale plan with dimensions.
• 205).
FZequirrad-ir}ndeta� €er 9cc61r�e'ir 04) .
. 5_2�) ,
i
7).
Is in •betrhs, g ge, k-i-t-ehen, and ex or outlets (Article 210-8).
Light fixtures, switches, receptacles, and exterior receptacles for main-
tenance of mechanical equipment. -
9. ions o wa e r 1
1 �Y- 3'0" exterior exit door (sec. 3304 (f).
1 Fireplace and wood stove location, alcoves, and clearance.
• ose
STRUCTURAL DETAILS
Standard bracing or engineered design (Table 25V)
Z ITn,�Sstnl�rarrjias__.� nr ap1;r lc. vuoc icyu• � + � ' lgn.
�---
�
Foundationplan complete enough to construct building.
�E ovations and wall construction details complete enough to construct building
8! Roof construction details complete enough to construct building. T/ Vx3fr
^ro trnrtinn dor •i i if r
y.
- Ti�k�ES
Garage door or porch header sizes.
k2�Eud heights.
1..4 nd-h'' c-- �p�Cal foundation riaci oo,
1
�a .
` 8/91
RESIDENTIAL PLAN CHECKING GUIDE
MISCELLANEOUS ITEMS TO LOOK OUT FOR
• ams
(Sec. 3306).
3. Bviele er-stee- 4eneaF (G'- 38). .
ermeeds (Sec. t7 ).
5��J=ope�rroo=nil*tt�ch for roof convering (Chapter 32).
Roof covering type
a �„„� _..__.._ _
--wccm--raao u t - 1 ,
II
C.
. Attic access and ventilation (Sec. 3205).
.62�s r access a cow 2�1.6�,
s.
'Y r- QariclCco.
1 . Flashing at all exterior openings.
1 n s.
-RE I 14TIAL
796-90B,P,E,M
py
Joel & -Lucinda Dauterman
3060 Viento Drive
Chico
(new single family)
Expires 4/18/91
Co/
bo Its aoUi&�
KO
-7
:`0 P-aSOF C
Address -&
GAS ll
Meter By Dat
ELECTRIC
Meter By
OFFICE COPY
Address
e
4i ELEC\ RIC e
Meter
JOB FINALED (Date)
Signature
J=OK
O = Not OK
Not
= Not Readyable MO BILE HOMES
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete - �}
4. Water; Location -Test -Easement Needed (Sketch).,
5. Electricity; Location-Clearences-Grnd-/ /Amp Concrete
6. Gas; Location -Test -Wrap: / /"L"ft.
/ /"Nat. or/ /"L"ft./ /"LPG
7. Utility Clearance `y
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 4 t
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-Beams-Rftrs: Coonectors
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. 1 Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, 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-PaneIboa rds-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
• Y�
,-1
r _ �J
;9'YOK
O=Not OK
- = Not Applicable
= Not Ready
Date UNDER OR Plans OK
oni>@-tetbacks-Ease r
g.,Vain; Soils-Elec. (
.M.
V
ESIDENTIAL (Single & Duplex)
Depth
0.-Ftg. ori Decks; S -Steel-#&Ftg. Depth`
malls, Main; St-f3lockouts-Wrapped
Stemwalls, Ga e; Steel-Blockouts-Wrapped
6a. Hold PoWns and Special Anchors
7. S - tee rapped ,
iers- ' .-Stee
9. D .; Fall -Fitting -T t-2 W C/O- er Tod -
10. G ipe; Size -An rs
1 ater Pi ; T -Anchor-Re tor -Service T46t
12. EI ric; Un r nd
13. Pienum Du ; Clearanc aterial-Support- .
44. Girufs-S
15. Insulation
Date Card B-1('�jr/LQa Date Card B-1
Date Card B-1 Date Card B-1
Date PLUM ING Permit OK exce t It's
16. ater Htr.; Vent-Acces Coition Air affle
Water Pipe; Test & Anchor -Nail Protection
18. D.W.V.; Test ittings Anchor -Nail Protection
wer Pan; Test, First Floor -Tub Access
20. est Tub & Shower,
Gas Pipe; Size � Anchors
DateCard B-1 Date Card B-1
Date Card 5-1 Date Card B-1
Date ELECTMALL(Permit) OK except ft's /
22,eFixuad'& Transformer Clea dwte-In;r Protection/
Doors
& No. of
mex Installed lose to EQ q _S(ydn C.J.
quip. round made up w/Mech. Fastner - and G &
7.pliance Circuts in Kitchen & Co r Size/GFI
28. Subfeed Wire Size)V/ ga. Cu oA A.C. Wire Size / / ga.
u r Al 171-1
ange Circ. / / ga. Cu or AI -O Circ. / / ga. Cu or Al.
Insulated Neutral es ❑ No
Conductors 8CGroUn_*Main Disconnect
3t.,K<uip. Clearances Panels-Motors-Mech. Equip.
2. Clothes Closet Light -Shower Light -Spa Light
oke Detector
Date L7-11,41) Card B-1 L) Date Card B-1
Date Car B-1 Date Card B-1
Date MEC NICAL Permit OK except tt's
Ducts Insulation & Support
V Fan; Exhaust above insulation
3646.oAdensate Drain & Overflow; Size & Grade
urnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet
• Attic Access & Platform if Furnance in Attic
cr
Date Card B-1 Date Card B-1
Date CcVd B-1 Date Card B-1
Date FRA (Plans) OK except #'s
3 . . s, Proper Material & Anchors
alls Studs -Nailing, Spacing & Bracing -Plates -Sound
41. Bearing Walls over Girders & Floor Nailing
Date
4F1.
46.
48.
Joist-Rftr. ties -Pu rlin -roof Brac-truss
ace ties or Tvpe A Flue -Fireplace Throat
ccess; Size
Windows or
Doors -Sill Hgt. & Dimensions
'W Garage Fire Protection Framing
erty Line Firewall & Openings
-Ext. Doors -One T -Check Garage -3rd Story, 2 Faits
3 St s; Width -Headroom -Rise -Run -Landing -Fire Protection
pl ood on Roof Overhang -Attic Vents -Rafter Outriggers
Siding -Nailing Veneer
co Mesh -Drip Screed -Fd. Vents-Underfir. Access
Glazing Area -Glass Protection -Skylights -Plastic
-96-ehelr Walls; Nailing -Bolts
59. Insulation -Walls -Ceilings
60. Infiltration -Walls -Windows
Date (: Card B-1 Date Card B-1
Dat Card 13-1 Date Card B-1
a
Date FINAL„( -Plans) OK except k's
64.�Ext. Steps -Door & Sidelight Protection-Langs
62. moke Detector
63. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor -Ducts -Meth. Protection
64,'*'6edroom Exitina
65.` .F.I. & Bath Fixtures & Tub AcE! a
Elec. Trim & Subpanel; Bre izes Label
Outlets at Wood Panef-frfr& Ext.
Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
L71,Alec. Outlets & Receptacles at Kit. Counter
7 rage Fire Door; Swing g -Closer
i
74.tr. Htr.; Vents -Clearance -Comb. Air-Connector-P-S.V.
In Garage; Above Floor-Mech. Protection
Plb. c. & Mech. Equi Listed for Locatio
7 lec. Receptacles in Gar4SpeJ6.LJ4t%romex Protection
(7-7 )nsqlotion-Foam-Looked in Attic 11 Yes
7 u Rails & onst ction-P s
7 . dn. Vents & Cr ole Door -Drainage & W d -Earth
Cle nce Looked under Floor
8 . ollowing instld.; Drive ❑ No; Walks El Yes o;
Plante Yes MNo
8 ucco; Brown -Finish
8 .C. Un(; Disconnec lectri a Plumbing
83. ents Abov oo ; Plbg.- pplianc-Fireplace. learance to
Op ' "gs
ate!ll; Disco nn lec ' Plumbing
8 xter�arr uec. Trim; .F. Receptacle -Underground
8 entil "on Throughout House
B ass Protection
88. orrections m Previous Inspections
g1f,ati qj) 89. Gas T41fmeters Tagged; Gas -Electric
90. Water & Sewer Conn ected-C O rade-HD Approval
1 Energy Compliance Certificate -Other Certificates
Date (>?, Card B-1 ' Date Card B/1
Dat Card B-1 4T2&J Date Card -1
Date Card B-1 Date Car B-1
Comments at Final:
42. Draft Stop in Walls (rat proof) I
® Fire Stops; Furred Ceilings -Stairs -Chase
44. Headers & Beam -Size & Bearing
(NOTE: An entry must be made each time you visit job site)
t } Y I ' 01! OF ilMgp�
t �I I.:r Il r: i -r.- 1 •.�. y.� r •;..,I �7' � -.a�. t ' �, irr`� s 3i„+µF i��iFi{'
t� i' r Z f,a ,;•
t{►. r"�I
li FI Ft. • CIT
E-4 FCaTE. 0 F H N FOR Mk'
��f
r: HE UNDERSIGNED MA NUFA C TUBER ' HEREB Y CER TIF/ES
�., ': that the products identified below and on attached sheets Nos. are marked''",'
with!the'Collective.Mark of the AMERICAN INSTITUTE CE TIMBER CONSTRUCTiON (AITC)
and were manufactured in conformance with applicable provisions of American National Standard
I ANSI/AITC 'A190.1-1983, Structural Glued Laminated Timber, and that such manufacture has
'�. been at our plant in SPRINGFIELD, OR _ which plant has a quality control system::
approved by'the Inspection Bureau of the AMERICAN INs*rITUTE OF TIMBER CONSTRUCTION
and inspected periodically by such Bureau.
The manufacture of these' members complies with the manufacturing and fabricating provisions'of
Chapter 25 of the Uniform Building Code.
JOB NAME( _ SEO(ln'(A SUPPL`f
i.
JOB LOCATION: FAIRFIELD -CA
CUSTOMEk'S ORDER NO. 90-39560
DATE ^: 14rOWS ORDER 1,10, 5502—C'
Joel DantPrm,n Intin
AITC HEREBY CERTIFIES that the said company at its said plant is licensed by the
AMERICAN INSTITUTE OF TIMBER CONSTR.UCTION to use the AITC Coflective'Ma.rk in respect
of products which comply with applicable provisions of said Standard, that the adequacy of .the quality
' control: system in effect at said plant is per iodically.inspected and verified by the Inspection Bureau of
I; `' . •
:the AMERICAN INSTITUTE'OF-TIMBER CONSTRUCTION, and that, in the judgment of AITC,
said company is capable of complying with 'applicable manufacturingand testing pt
g provisions of sai
Standard in respect of products manufactured at said plant. Con'd ->
formance with the Standard in respect
of any specific or particular product is the sole responsibility of the manufacturer; AITC's guarantee !',i:f!:
hereunder being that the said company is qualified to r'• ' I '
q produce a product meeting the said Standard ''J
and that its plant is periodically •inspected and verified by the AITC Inspection Bureau.
AITC Ceftif tate No..695-94 r A
AMERICAN INS'�ITUTE Or TIMBERCUNSTRUCTION'f�v�`
` . ;I I
}
rJ
I 1,s
U 19$3 AMERICAN tN5Trru7E OF TIMBER C
A!'rC FORM
�ti
i IIFj I ure of n� �t `
Y '
fIT-1
„ CER IFICATE 'OF COVORMAN U
t Cj
t {{ !,,- - -
]:j] (. f •:I �.
' (' �',►
kUNDERSIGNE- D MANUFACTURER HERE8 Y CERTIFIES y
That the products identified below and on attached -sheets Nos, �� are marked';
i
with lthe 'Collective;Mark of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION (AiTC)j
'and were manufactured' 'in
conformance with applicable p
rovisions 'of American National StandardANSi/AITC 'A190.1-19$3,
Structural Glued Laminated Timber, and that such manufacture has
'been at our plant in SPRINGFIELD,
_ , which plant has a quality control system
;'I I approved by the Inspection Bureau of the AMERICAN IN5"rITUTE OF TIMBER CONSTRUCTION
t
and, inspected periodically by such Bureau.
t
The, manufacture of these' mem
1i, . bens complies with the manufacturing and fabricating provisions of
;:lIM Chapter 25 of the Uniform Building Code,
P,T1r�
0 3983 AMERICAN tN$T;'rurE OF Tire.OER CONS-rRtjO•rtorq
41''
JoB NAME: SEi)UO [A SUPPLY ,� ',
I�`F�i�
JOS-LOCATION: FAIRFIELU •CA
q
CUSTOMER'S ORDER NO. 9Q— h —�'=9O
DATE— 7 IN+}ea'SORDE8NO. _ 5502—C'
Joel Dauterman 3060 viento Drive, Chico, CA 24F v-4
ROOF LQADEll END JOINTS
SIGMA ukE—COMPANY..._ ROSBQRQ LUMBER CO
�._
TITLE QUALITY CONTROL ADDRESS— J. _ND ST. _ DATE '�-1= 90
22
AITC .HEREBY CERTIFIES that the said company at its said plant is licensed by the
AMERICAN INSTITUTE OF TIMSER CONSTRUCTION to use the AITC Collective'Pfla.rk in respect
of products which comply with applicable provisions of said Standard, that the adequacy of the quality
f°
control( system in effect at said plant is periodically inspected and verified by the Inspection Bureau of
.tAe AMERICAN INSTITUTE OF TiMBER CONSTRUCTION, and that, in the judgment of AITC,
said company is capable of complying with -applicable manufacturing and testing provisions of said
1
!I
Standard in respect of products manufactured at said plant. Conformance with the Standard in respect
i
't i,
of any specific or particular product is the sole responsibility of the manufacturer; AITC's guarantee
hereunder being that the said company is qualified to produce a product meeting The said Standard
a
and that i&' last is periodically -inspected and verified by the AITC Inspection Bureau.
AITC Cerfibcate No.. 69594,..A
,
M
6 I _n
t, AMERICAN INSTITUTE OF TIMBER CONSTRUCTION
A�`r
•
; I .
0 3983 AMERICAN tN$T;'rurE OF Tire.OER CONS-rRtjO•rtorq
Owner:
C Y C E R T I F I C A T I
O N
3060 Viento D_riv_e-, C ::ic03 Ca. —_
LOCATION
A.P. No.
DEScIl I FI' 1.011 OF I NSIIIAT 1.011
ROOF
Materiel _
Tit icknesa0"else a) -
EXTERIOR WALL.
Natdrial_ Flberglass Dal_l5___ —
Thicknese(inchee)
Brand Name
Thermal Resistance (R Value)_
Brand Name OWenS-COrnlnO
Thermal Reeistaoce(R Valise) R19
CEILING
Batt or Blanket Type r1Oerg1asa Cults Brand NameQwenc-C-nrnin9
Thickness( inches)—__—_12'!_ 1-Ilennal Resletance(It Value) R38
_[l
Loose Fill Type l [I erulass.Bran) Neme _____ — ern l nn--v—
Mlnimum Thtcknee@(Incbes) 1 11 Number of Rage 29 Wt. per beg 35 lb.
Area covered(fi.ZZ)_ 145 "'lliennal Besletance(R Vsiue) R38
FLOOR, ELEVATED
Material. Flheralass 13a1_U —
Thickness(lnclies)_ 61"
FLOOR, SIAB
-
Tlllckness(Inches) _
wtviunATION WALL
Brand Name Owens-Corning
'Thermal Reslatance(R Value) R19
Brand Neme
Thermal Reelstance(R Value)
Miter!'a1 Brand Name
Thlcklteee(incllee) Thermal Reslstance(R Vslue
I hereby certify that the above insulation was installed in the 'above butldillj
JLo [orw'aoce witli the State of c:alifornle Energy Requirements.'
ncn
Loerke lnsulatlurl I:u,_- _ 444
FIRM NAME/0NNE11 STATE CONTRACTOR'S LICENSE 110.
—SIGNATURE OF INSTALLATION APPI.ICA'rOR
January 22, 1991
DATE
I hereby certify the above lne,llatlon and all cequlred items as ohown on the
Buiiding Department approved plane and attachinente have been installed wo
required by the State of California Energy Requirements.
All equipment, devices and materials are of the quality prescribed or are
specifically approved by the State of Callfornle.
FIIW NAME ONNER (Please print) STATE CONTRACTOR'S LICENSE NO.
SIATURE Of Qfi11FRAl. C0
GNr1'II
1A1'0R%UWNFR
DATE
THIS CERTIPICATE N119'r BE ON FILE WITH TILE BUILDING DEPARTHEN'r PRTOR TO FINAL.
INSPECTION APPROVAL. AND A COPY SIIAL.L. BE POSTED WITHIN THE B11I1.DI.NG .
lunuary 1984
M
I
0 Date—LI - V-7 Inspector
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
Center Drive, Orovi Ile — Phone: 538-7541
'A
7 Elliott Road, Paradise— Phone: 872-6307
OFCounty
C
CORRECTION NOTICE
a nil
j-k���
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of is completed. If you have any question pertaining to this
�1
m tt
atter, or additional explanation, please contact this office immediately.
LAJ
-42�
a/vi�
Cf*N W_:Uz� A
V---:) k
(A
co r—Cr
k�-A kf 4��
AA
U U- A.A-
0 Date—LI - V-7 Inspector
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
V 196 Memorial Way, Chico — Phone: 891-2751
7!cou n ty'Center Drive, Orovi Ile — Phone: 538-7541
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
A
T�
b(q C& -�x r
OWNER FLKmIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
completed. If you have any question pertaining to this
when co ction of work i
-ti'
op c
att;, or#need additio I , t* I a ta this office immediately
to yal exp ana
;7?lr d5 7r At R 6;' /V z�
< I '� ta
Bly P" 1�4 74
0/
AM 26<
D a t e A� — F16 I n s P e c t o rAv—l---
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
'196 Memorial Way, Chico — Phone: 891-2751 -
7 County Center Drive, Oroville — Phone: 536-7541'
747 E I I iott Road, Parad i se — Phorfe: 872-6307
41 CORRECTION NOTICE
- (7 0 .
'ERMIT NO.
A routine irispection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
ILI VV
Date Inspector
_J.
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS.
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phane: 538-7541*
747 Elliott Road, Paradise— Phone: 872-6307
CORWTIONAOTICE
_11U
PERMIT NO.
A routine inspection i d'icates that the following -violations of County Ordinance
n4
exist at the above address and should be corrected. Please notify this office
when c .' rrection of work is completed. If you have any question pertaining to this
m7ate'r.00r need additional explanation, please . contact this office immediately.
CD_ X k&V'k-_
Date Inspectoro
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, Califg7nia 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
ZONING
4
BUILDING PERMIT
ox
o E TELEPHONE
D S A R PAaterman-
Pin 'Rriv
SO. FT. OCC. BUILDING VALUATION
1760 R .70400
572 M 8008
CONT O N ME
c9WU�'
TELEPHONE
467. cov 4670
C C (LING ADDRESS
Fireplace 1 1000
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $ 84078
LENDER'S MAILING ADDRESS
Filing Fee
$
10.00
Permit Fee $ 388.00
ARCHITECT OR ENGINEER
LICENSE No.
Plan Checking Fee
$ 194.00
Energy Plan Checking Fee
$ 15.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
30 0 Viento Dr. Chico
Permit fee
$ 607.00
PLUMBING PERMIT
Filing Fee
10.00
Each Trap
3 1 2.00
24.0
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PA/RCiEL MAP
7
Water piping
5,00
5.0
Each qas water heater or vent 5.00
5.0
USE OF STRUCTURE
SF[X Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
5.0
Building sewer 5.00
5.0
Mobile Home I S I G JW O.00e
TYPE OF WORK
New l� Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: 3 8R _
Permit Fee $ 54.00
Contractor
ELECTRICAL PERMIT Filing Fee
10.00
V OR L
Main service 100 AMP ORSLESS
10.00
010.0
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Main service EA. ADD'L 100 AMP
2,50
L_
NEW CONST. DWELLING OCCUPM
OR ACDNS. ACC. BLDGS. h¢sgft
58.3
NEW CONSTR. U TI -OUTLET
NON•RESIO BRANCH CIRG ITS 2.50 ea
POWER APPARATUS &)
%SINGLE OUTLET CIR.
Ex. OCCU OUTLETS OR FIXTURES 20a50C
p 9AL@3o
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EAJ 2.00
Temporary service 10.00
10.0
Mobile Home Facilities 15.00
Misc. �Virin 15.00
9
Permit Fee $
-
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT Filing Fee
10.00
Heating 100,000 1
7.
split System
Cooling 3T
6.00
Hood 3.00
Ventilation. 1 3.00
3.
permit Fee $ 29.50
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the 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, judgments, costs, and expenses which may in any way accrue
against s d:,/LC; t In co equen of the granting of this permit.
X Date ..e
Signature of Applicant - Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories '/ height.
Mobile Home Installation Fee $
Energy Inspection Fee $ 30,00
e C
coNST PE
TOTAL EE $ 811.30
1_�AZ
CUA
�-
PARK
�-
s, H
FLD
PAR
PD
Ho IssuE
This permit is hereby issued under
-ions or the Butte County. Code and/or
work indicated above for which fees
eIRE 11OR PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
Dat
��
Receipt No. IS,, /
WHITE-D.P.W.. TELLOW.ASSE R, PINK -INSPECTOR. LIE R-APPLICAN.T
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - OroviJle, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
42,-0)— 6
ZONING
S g:m
BUILDING PERMIT
OWNER
SCK �'Lfic✓ A U -r �•✓
TELEPHONE
$
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
3
5-? 2 AA
CON CT 'SN Me.
ELEPHONE
3 6
CONTRACTOR' MAILING (.4 DRESS
Fireplace
FireTota
CONSTRUCTION LENDER
UNKNOWN
Valuation
LENDER'S MAILING ADDRESS
Filing Fee
$ 10.00
Permit Fee
_r
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
FiIingFee 10.00
Each Trap
2,00 ✓
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
55,00 Ig—
Each qas water heater or vent
5,00 �r
USE OF STRUCTURE
SF Duplex[] Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00 –�
Mobile Home S I G I W
0.00e al
TYPE OF WORK
New gr Addition ❑ Remodel[] Utilities❑ Installation❑ Other ❑
Describe work: 3 &1Z)
Permit Fee
$ 5 I -U
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service ; 000V 01 0 AMP ORLESS10.00
CONTRACTORS LICENSE LAW
1 declare under penalty of perjury (check one):
❑I am licensed under p
provisions of Cha t. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
I. as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract -
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Main service EA. ADD'L 100 AMP
2.50 Z
NEW CONST. DWELLING OCCUPeI
.
OR ADONIS. ( ACC. BLOGS.
1/20sq ft 5
NEW CONSTR ULTI-OUTLET
NON-RESID BRANCH CIRC ITS
2.50 ea
(POWER APPARATUS R)
\SINGLE OUTLET CIR.
Ex. OCCUp(OUTLETS OR FIXTURES
200501
e ALO 30
FIXED
Ex. OCCup. OUTLETS PI RESID )REA.)
2.00 \
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for S100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
❑
to the W. C. laws of California.
to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating 160.1000.�
Cooling 73 1-
Hood
3.00 :7—
Ventilation
/ 3— _3__Notice
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the 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, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X Date
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ I
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 storiesinheight.
Mobile Home Installation Fee $
Energy Inspection Fee $3�j�
occ
CONST TYPE
/I O
TOTAL FEE $
HAz
I CUA I
PARK
I SCHL
FLD
I PAR
I PO
Ho
IssuE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
BY
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
Date
Receipt No. S�3 c3
WNITE-D.P.W.. YELLOW-A53E330R, PINx-1N3PCCTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT.OF PUBLIC WORKS - BUILDING DIVISION
' 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT APPLICATION DATA,SHEET
/ Permit No. 4
OWNER �E� �G.r, .tJ�4 I��:�rr�2MA/V A. P..No. 48-01•-16
Proposed Building Use ,Gi�r`�—�' Building Inspector int/ Date r
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED APPROVED
1. All items have been submitted . ....................................
2. Plot plans in duplicate/triplicate, signed by preparer of plans ........
3. Complete plans in duplicate/triplicate, signed by preparer of plans ..
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form ...........................................
6. Energy Design Compliance and supporting documentation ......... t
7. Statement of Intent for Non -Heated and AC Buildings .............. U_ ZZA
8. Engineered truss details and layout in duplicat e e r r to lan c ec Da 7o
9. Mobilehome installation data including manufacturer's installation
instructions.......................................................
10. Fees of $ ........................
_ 11. Chico Urban Area fees paid ....................................... -
Park fees paid ...............................................
4C .....
,L�T� el School District fees paid .........
1..... �'
Sanitation approval from - 6l!Z 'E, ' Health Department
a15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking:
18. Improvements may be required. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy) - %0-
20. Pre -Inspection for required Pre-Inspec. request to
Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
24. Recorded copy of Agricultural Acknowledgment Statement ..
25. Letter of signature authorization ............................... .. .
26.
27.
When you issue the permit, process as follows: Mail to owner.
X Telephone and hold for pickup at Opn office
Other — ! SCM , _
Copy of plans sent Health Dept.,
The following data must be submitted prior to
1. Index permit for above items No. a
2. Additional items required:
Fire Dept.,
s
Mail to contractor.
—Deliver w/inspector..
Other Date
checked above).
Contractor, designer, owner, was advised of above required data by_phone—nail counter by ..date
Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by dated
Plans checked by Date Plans_approved by Date J
2—Sets of plans on hold in
Copy—DPW
File cabinet AP folder
TO Buildina Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
owner Location A?#
Plan Approved for: Sewaqe Disposal. Water Supply
Hold final for: Water Supply
Final clearance O.K. for:.
clearance for 2 ' bedroom meb4&e home.
NOTE
Other
Water Supply
__V)_
d
Sa4ntarian Date
TO: Building DV artment
FROM: Encroac�ment Permit Section
RE: 'Driveway Clearance
a el
0
C- ,4alc,
bwner location AP #
.Driveway permit he-ne qee,! 'has been issued for the above property.
n b
e
sign.aAre date
RESIDENTIAL PLAN CHECKING GUIDE
(S.F., DUPLEX & MISC. ONLY)
Bldg. Permit # -79-G ''�
OWNER ��4UT(Z INlf�i A. P. # -- -O - 3Z
GENERAL
Zoning requirements: (sideyards
Valuation.
3.Plans signed by designer.
Energy Design and Compliance.
Existing violations on property.
6. Items on data sheet.
PLOT PLAN
and number.of permitted living units).
Complete parcel size and dimensions.
Setbacks,. sideyards, easements, etc.
Other buildings or structures.
Grading, fills, drainage..
Flood hazard.
Special conditions on creation map or compliance document.
FAU & FAS road setback.
FLOOR PLAN
Complete to scale plan with dimensions.
Required windows for light and ventilation (Sec.
Required windows for second exit (Sec. 1204).
Skylights (Chapter 34 & Sec. 5207).
Human impact glass (Sec. 5406).
1205).
Required room sizes, ceiling heights (Sec. 1207).
GFCIs in baths, garage, and exterior outlets (Article 210-8).
Light fixtures, switches, receptacles, and exterior receptacles
5/89
for maintenance
of mechanical equipment.
Locations of water heater, heating and cooling equipment, other electrical or
gas equipment, and plumbing fixtures.
Garage firewall, door size, and closer (Sec. 503(d)(3)).
1 - 3'0" exterior exit door (Sec. 3304(e)).
Fireplace and wood stove location, alcoves, and clearance.
Smoke detectors (Sec. 1210).
STRUCTURAL DETAILS
Foundation plan complete enough to construct building.
Floor construction details complete enough to construct building.
Elevations and wall construction -details complete enough to construct building.
Roof construction details complete enough to construct building.
Fireplace construction details and calcs if necessary.
MISCELLANEOUS ITEMS TO LOOK OUT FOR
Stairway details: landings, rise and run, head clearance, handrails (Sec. 3306).
Guardrail details (Sec. 1711 & 3306(j)).
Brick or stone veneer (Chapter 30).
5/89
RESIDENTIAL PLAN CHECKING GUIDE
MISCELLANEOUS ITEMS TO LOOK OUT FOR (CONY D)
Exterior plaster - weep screeds (Sec. 4706).
Proper roof pitch for roof covering (Chapter 32).
Roof covering type - (fire hazard).
Rafter ties or bearing ridge beam.
Garage door or porch header sizes.
Adequate bracing.
A—Living area over garage - complete 1 -hour separation required on garage side
•t.A
ncluding supporting walls and.posts, etc.
wo exits on three-story dwellings (Sec. 3303 & see Mezannines - 1716).
ttic access and ventilation (Sec. 3205).
nderfloor access and ventilation (Sec. 2516).
ombustion air for fuel burning appliances.
oise requirements on duplexes.
dobe soils - special foundation design.
etaining walls requiring design.
nusual shape, size, or split level house requiring lateral design.
lashing at all exterior openings.
j, R_�Ns vI"US-- � sP�y�Lf .
FE
REQUEST,,e'��= I BY: %—AIA
IZF;tt;�11"C.o DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT
�al -- A FOR RESIDENTIAL DEVELOPMENT
Sect.itin 26-8.1 of the Butte County Code
requires this acknowledgement be recorded
prior to issuance of a building permit.
90--1 1 181
All. that r.ea] property situate in the CounLy of Butte, State of California, as
follows:
Date: 1� I� Q PROPERTY OWNERS:
State of. C t l\A)
) SS
County of� _)
�...._....,.....
®irk'.' EFAL
Lip BETTY JANE FRY
WTARV GUBUC ,r,AL"WVA
BurrE cowm
My comm. Expires
On this the y day of �( ,\�% 19 qd , before me,
the undersigned Notary Public, personally appeared
Q) o 4 k A - a'a A -P �cm GM UU d
Personal]y known to me.Proved to me on the b�is.is
of sati,,factory ev:ideii(.:e.
to be the person(s) whose name(s)
subscribed to the within instrument and ac nowledge(]that �- —
executed the same for the purposes therein contained. TN WI-AINESS
WHEREOF, I hereunto set my hand and official seal.
Present A.P. No. (049-0-o-OB(D-o
Notary Puh].'ic
`L'he pr.opert:y described herein is adjacent
90-011181' � Rec Fee
9.00
to land or. included within an area zoned
Check
9.00
for agr.i.cu l.t..ur.a1 purposes, and residents
Recorded
of this pr(.)perLy may he sub.jecL to incon-
Official Records
,
ven:i.encrs or d i.scomfort arising :from the
County of
use of agr:i(AlIt.:ura1 chemicals, -including,
Butte
but not .1 imiLed to herbicides, pesticides,
'Candace J. Grubbs !
and fert.J Uzers; and from the pursuit
Recorder �
o af;r.i.cu.] t. ural operations including,.
! 1 .25pm 21 -Mar -90
BG 3
but not. 1 i.m:i i:ed to cultivation, plowing,
spraying, pruning, and harvesting which
occasionally generate dust, smoke, noise, and odor. Butte County has establ.islied
ugric.u]-
Lural zones which have as a priority use for
productive agricultural. purposes, aiid
residents
within said zones and on adjacent property
should be prepared to accept suclI inconvenience.
or discomforU from normal, necessary farm operations.
All. that r.ea] property situate in the CounLy of Butte, State of California, as
follows:
Date: 1� I� Q PROPERTY OWNERS:
State of. C t l\A)
) SS
County of� _)
�...._....,.....
®irk'.' EFAL
Lip BETTY JANE FRY
WTARV GUBUC ,r,AL"WVA
BurrE cowm
My comm. Expires
On this the y day of �( ,\�% 19 qd , before me,
the undersigned Notary Public, personally appeared
Q) o 4 k A - a'a A -P �cm GM UU d
Personal]y known to me.Proved to me on the b�is.is
of sati,,factory ev:ideii(.:e.
to be the person(s) whose name(s)
subscribed to the within instrument and ac nowledge(]that �- —
executed the same for the purposes therein contained. TN WI-AINESS
WHEREOF, I hereunto set my hand and official seal.
Present A.P. No. (049-0-o-OB(D-o
Notary Puh].'ic
c
89-50168
E
ORDER NO. BU -109800 BG
DESCRIPTION:
ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE STATE OF
CALIFORNIA, COUNTY OF BUTTE; DESCRIBED AS FOLLOWS: ,
PARCEL I:
PARCEL 1, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE
OFFICE OF THE RECORDER OF -THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, ON JANUARY 30, 1985, IN BOOK 98 OF MAPS, AT PAGE(S)
66.
PARCEL II:
A 60 FOOT NON—EXCLUSIVE EASEMENT FOR INGRESS AND EGRESS AND
PUBLIC UTILITIES, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED
IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, ON JANUARY 22, 1981, IN BOOK 81 OF MAPS, AT PAGE(S)
54. -,::
PARCEL III:
A NON—EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES
OVER THE EAST 30 FEET AND OVER THE SOUTH 60 FEET OF THE SOUTHWEST
QUARTER OF THE SOUTHWEST QUARTER OF SECTION 2, TOWNSHIP 22 NORTH,
RANGE 1 EAST, M.D.B. & M.
PARCEL IV:
AN EASEMENT FOR ROADWAY AND PUBLIC UTILITIES, DESCRIBED AS
FOLLOWS:
COMMENCING AT THE NORTHEAST CORNER OF PARCEL 1,,AS SHOWN ON THAT
CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE
COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JANUARY 22, 1981, IN
BOOK 81 OF MAPS, AT PAGE(S) 54; THENCE SOUTH 00 DEG. 52' 05"
EAST, 395.00 FEET; THENCE NORTH 88 DEG. 48' 14" EAST, 331.96 FEET
TO THE TRUE POINT OF BEGINNING FOR THE HEREIN DESCRIBED EASEMENT;
THENCE FROM SAID POINT OF BEGINNING NORTH 00 DEG. 52' 05" WEST,
30.00 FEET; THENCE NORTH 88 DEG. 48' 14" EAST, 243.84 FEET TO THE
BEGINNING OF A 20.00 FOOT RADIUS CURVE TO THE LEFT; THENCE ALONG
THE ARC OF SAID CURVE THROUGH A CENTRAL ANGLE OF 44 DEG. 24' 55"
AN ARC LENGTH OF 15.50 FEET TO THE BEGINNING OF A 50.00 FOOT
RADIUS CURVE TO THE RIGHT; THENCE ALONG THE ARC OF SAID CURVE
THROUGH "A CENTRAL ANGLE OF 268 DEG. 49' 50" AN ARC LENGTH OF
234.60 FEET TO THE BEGINNING OF A 20.00 FOOT RADIUS CURVE TO THE
LEFT; THENCE ALONG THE ARC OF SAID CURVE THROUGH A CENTRAL ANGLE
OF 44 DEG. 24' 55" AN ARC LENGTH OF 15.50 FEET; THENCE SOUTH 88
DEG. 48' 14" WEST, 244.19 FEET; THENCE NORTH 00 DEG. 52' 05"
WEST, 30 FEET TO THE POINT OF BEGINNING.
CONTINUED
m
..9fl-11161
ORDER NO. BU -109800 BG
PARCEL IV: - CONTINUED
EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF
PARCEL I, DESCRIBED HEREIN.
PARCEL V:
AN EASEMENT 60 FEET IN WIDTH FOR ROADWAY AND PUBLIC UTILITIES
LYING 30 FEET ON EITHER SIDE OF THE FOLLOWING DESCRIBED.LINE:
COMMENCING AT THE NORTHEAST CORNER OF PARCEL 1., AS SHOWN ON THAT
CERTAIN PARCEL MAP, RECORDED IN THE OFFICE.OF THE RECORDER OF THE
COUNTY OF BUTTE, STATE OF CALIFORNIA,. ON - JANUARY 22, 1981, IN
BOOK 81 OF MAPS, AT PAGE(S) 54; THENCE SOUTH 00 DEG. 52' 05"
EAST, 395.00 FEET TO THE TRUE POINT OF BEGINNING FOR THE HEREIN
DESCRIBED LINE; THENCE FROM SAID TRUE POINT OF BEGINNING ALONG
THE CENTERLINE OF SAID 60 FOOT EASEMENT, SOUTH 88 DEG. 48' 14"
WEST, 331.95 FEET TO THE WEST LINE OF SAID PARCEL 1, OF THE
ABOVE MENTIONED PARCEL MAP, AND THE END OF SAID EASEMENT.
9
END OF DOCUMENT .
END OF DOCUMENT
3
COUNTY OF-BUTTg - Department of Public Works
7 County Center Drive, Orovil;le, CA 95965 Phone: 916-538-7541k'.
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) Gam/ J
2. I (have/have not) &ZLf signed an application for a building permit
for the proposed work.
3.
I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors 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
Address City
Phone Contractors 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: `
Property Owne x�/ �1
Social. Security Number _
Date -30 l~Z�
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 per-
mitted to issue the permit.
i
BUTTE COUNTY SCN(YOLS"DEVELOPMENT FEE CERTIFICATION FORM
(One Form per Building)
A..P..'Number. 40-0 1 `�6 Building .Department No.
School District a6fj City.= County Jurisdiction .
Property Owner Z-X_oGC— &UtK�/ AAA
Project Location /Addre.ss. 3drnQ
Subdivision Lot Number
Residentiai Development: a C� Sq.. Footage �?&5 ,/
of Living MHI Addition (Group R)
Units
Commercial/Industrial:
New
OSq. Footage
Addition (Including Exterior
Roofed Areas)
Date
(Floor•Plans reviewed by School District Personnel)
District .Id
-
No.
inn) _,g5`s5:E!>
n Lou
b 9-4i
School District certifies that
d
3/-fS— 38 i
.(Applicant Name
(Street -Address
r
(Phone Number
(City) (State) (Zip Code)
has complied with the requirements of Resolution No.
by the payment of $ %jj�� representing'7/ �D� square feet.
School District"Representative Date
�£ PAID BY CHECK NO.
BANK NO
PAID BY -CASH
REMARKS:
white -applicant, yellow -building department', pink -school district
SCHOOL.FEE (8/88)
i
JI
' l!�.i`srA# i'i:3iad f A `t 3.i,3 ti'
� f
y M�4J� =�If�� 40.*[r.H CF3 25-NG/LP
1R,•Ji;�•c�+i{.`1Yj� F'� /•MG -1,61
° ��`�K . '� ►'�"'ti # P f!s� "� a I � i 13 r y :. 7 ,
f' ?� pp��rry� r ryA�{rGM§ M -1,61 �;CF IiNG ( -61
:a� ��` '{C .Y feR 7; ! �S it 1 ,t ,
aAs M OF.L 0325 Lk-,
{.�j.�lfi]� `t*` �i���`* sr��,r�.��• G.iS�, ,. lsr..�i �..A t .R.ta� P.r ,..trr�Yi r.a..
t
J". � ,;'' :���� d;''�:� 4�"'t'��:«�3`=;ffd��tl1 3"#�i�►,1��=�1 � `S . , In ,
Ni'SAi/fNG"TANKLSS~WATER HEATER
�A INSTALLATIrON&MAINTENANCE
'� <�t ���� P�� ,`�'I"t::�Yl'�3�+ .� ��i 1`'1-�`�+Es�`i'� i�• �'�'t�� '� tq��-t . • r . ,. , c . .
r•�JF'INStC�C1'idN. ,
=t;10VA 004004 is i'��vTA JAtp,) ".»,14
€O�I:tIfR (Irl R5.:'
` 4. Immediately call your gas supplier
..� 3'14t���� i�,:�`3�t►f :fi �" ��`-����:�11�' -,. ';a,� . ...,., • „•' ,t -:�t F<,,
• A' WO:dMAOP31 t JASIA11 Q i00RtY0UR SAF"ON'td Of . t
# y��y#�A):f� y� ')'ff'0A' 'iis, 0_ .4 Mkt'0300 N0. x'09 ?'t Tl#t�?ifl-Q)' �. "I It
`• ,A. s:li�S*a 1�'"Y'r ,�r�f 'i +TT�•C w41r4:,,118
I yc!'. ' r t• rt�i; '9 !r•� r ♦^X �; ,71•x' ri`.j1
.: Do riot store 'or use gasolrid nor oth ti t j ,
flammable, combustible; or corrosive 1iapours t'
• lrl t';t LK3 M Yfi tand� ligiiidi 1 in�the vicinify)%i `thriV'dP1nji
_.. other appliance. t't 1y
' t+l-. 6W*Aj:. SRC 11A 01T,�,:) i 'AJA I t "10
m w FOROUR'Si4TISFAt11ON WINTER DRAIN DOWN
I. y�•9,MOW instal ing:-ths.•,appiance read these elf the appliance is'fto be left"in freezing
,4iF�sfructioti re.fulf conditions it 'MUit:' be drained' using the
t ` if�earsufet�tha-t the ater and gas pressures t drain off point fitted (see page B. Section
requir -d . sPt3 6tlailabf '(see pages 2 & 3), , f tdf tht'Dismahtling Procedure);+
t,
6e t�ure `h t'`they, Ovate flow through the t ! �t f? ft r i�!t 1 •ri
s , { , Oppl anc� orPecii)6ee OagO 6) s: „
�.
7 x
^' v
*� INSTALLER A"i hbse instr coons to or OWNER: Retain these insOuciion§ safely for
°adj Cetht-i ", kpp ante. fuiur4"r644nce. '
7
14 MY 0
BdX} 7789
FRF.bttCKS�BU)rtG►rrVlllt224U4 t .;; ate ,.•zE , , .
PHONEiJ703 ),37]4331�r'
FAX'(703)371=7455 27-16002-02
IMPORTANT THIS APPLIANCE MUST BE INSTALLED BY A PERSON SUITABLY QUALIFIED IN THE
INSTALLATION OF GAS APPLIANCES.
THIS APPLIANCE MUST BE INSTALLED IN ACCORDANCE WITH LOCAL CODES OR, IN THE
ABSENCE OF LOCAL CODES, THE -LATEST bItION OF THE NATIONAL FUEL GAS CODE ANSI
2223.1. COPIES OF ANSI 2223-1 ARE AVAILABLE,P 6M AMERICAN GAS ASSOCIATION, 8501 EAST
PLEASANT VALLEY ROAD, CLEVELAND (INDEPENDENCE), OHIO 44131.
THIS APPLIANCE SHALL NOT BE INSTALLED IN BATHROOMS, BEDROOMS, OR ANY OCCUPIED
ROOM NORMALLY KEPT CLOSED. ` I. � I f jj ;F. Eq ' - ` f "
OPERATION OF EXHAUST FANS, KITCHENI VENTILATION SYSTEMS, CLOTHES DRYERS, OR
FIREPLACES MAY CREATE CONDITIONS REQUIRING SPECIAL ATTENTION TO AVOID
UNSATISFACTORY OPERATION OF INSTALLED CTAS APPLIANCES.
THE APPLIANCE MUST BE LOCATED AS CLOSE AS PRACTICABLE TO A CHIMNEY OR GAS VENT.
FOR INSTALLATIONS AT ALTITUDES ABOVE 2,000 FT.,- PLEASE' CONTACT YOUR DISTRIBUTOR.
r. I .
r -
THE APPLIANCE SHOULD BE LOCATED IN AN AREA WHERE LEAKAGE OF THE WATER CIRCUIT
WILL NOT RESULT IN DAMAGE TO THE AREA ADJACENT TO THE WATER HEATER OR TO LOWER
FLOORS OF THE S`fRUCTURE.
WHEN SUCH LOCATIONS CANNOT BE AVOIDED, IT IS RECOMMENDED THAT A SUITABLE DRAIN
PAN, ADEQUATELY BRAINED, BE INSTALLED UNDER THE WATER HEATER. THE PAN MUST NOT
RESTRICT COMBUSTION AIR -SLOW.
THE APPLIANCE SHALL BE,ISOLATED FROM THE GAS SUPPLY PIPING SYSTEM DURING ANY
PRESSURE TESTING OF THAT SYSTEM.
t
THE APPLIANCE AND ITS GAS CONNECTION SHALL BE LEAK TESTED BEFORE PLACING THE
APPLIANCE IN OPERATION.
MINIMUM CLEARANCE FOR COMBUSTION
u„ salt) SIDESZ" ,f BACK U' a
-.11* 4(1 ITOP. 13'1 +h BOTTOM 6"
MINIMUMj`CLEARANCE FROM COMBUSTIBLE
E MATERIALS TO HEATER JACKET
SIDES 2", ,BACK 0"
_ _ _ .. _TOP_.13"_ _. BOTTOM 6"
MINIMUM CLEARANCE FOR INSTALLATION,
SERVICING AND PROPER OPERATION
,A v:s.:r.4 SIDES 4till BACK 9' .
TO i3" ,,.,,BOTTOM 911
.
^THE MINIMUM OPERATING HEAD THROUGH THE APPLIANCE IS 25ft. (11 Ib.f/in') AT A NOMINAL
WATER RATE OF 1.9 gal/min. AND ANY OTHER PRESSURE LOSSES INCURRED THROUGH THE
ADDITION OF EXTERNAL PIPES AND FITTINGS MUST BE TAKEN IN70 ACCOUNT ON INSTALLATION.
< p ,�.,. r fi 2
y,.^..yy .+'w''"�'.✓^f!l^i Y }- �,e�fyjj- 1'4 _
s�1 •' ' , A� �, �. ,"' ;€ `';,�y 4Y t 2 H7 i�'r�1, a iVT A. 1;.t%y i:;,$;
i
PLIANCE$ LO FATED IN _UNCONFINED SPACES
t "� t , `" i Fz • ' AP
' r�s�AN UNCONFINED SPACE IS ONE WHOSE VOLUME IS NOT LESS THAN 96 CUBIC FEET PER 1,600
"f 'k, Btu'PER HOUR'OF THE AGGR C�` E iN�'UT%�RAT(NG'OF�ALL�"APPL-IANCES INSTALLED IN THAT
SF;AC ROOMS COAIIMUNICATiNG-DIRE&LLY'WITH4THE SPACE' IN WHICKTHE APPLIANCES ARE
P k = INSTALLED, THROUGH OPENINGS NOT FURNISHED WITH DOORS; ARE CONSIDERED A PART
OF3,tHEYUNCONFINED SPACE"THIS,W.ILOALLC�NrrtN000H•�IN ILTRATION OF FRESH AIR FOR
THE PURPOSEOF _COMBUSTION OF THE GAS, VENTILATION AND DiLU,T10N O,Ft,THE. FLUE
wn1Y °'PROdUCTS?ANY AAv'l NOT` COMPLYING_ WITH THE ABOVE;SIZE REQUIREMENT IS CONSIDERED
A CONFINEb SPACE=iTFiEREFURE ACONFINED SPACE IS ArJY SPACE �IVHOSE VOLUME IS LESS
r THANlb CUP IC+FEET'PER 1,600 Btu.PER HOUR OF THE AGGREGATE INPUT-AATING OF'ALL
� Pf�L' "' 5 INS ALLED IN{THAT'SPACE s.� r1� 1.J A lztf std! !
r'Ifi faiiy#,+utte �
HOWEVER, IN SUILDI,NGS OF,TIGHT CONSTRUCTION (FOR;EXAMPLE WEATHERSTRIPPING
- ° HEAVY' INSULATED L�AULKED"VAPOUR EARR,IER ETC.); THERE IS A NEED TO TAKE AIR
FROM,OUTSIDE';THE BUILDING FOR EITHERtCONFINED OR UNCONFINED SPACES. (SEE
SECTION BELOW,ALL AIR FROM OUTSIDE;THE •BU.ILDING")..
Y, 4
.. t ,.
APPLIANCES LOCAT-EDWIN CONFINED SPACESI(AL� AIR FROM INSiDE;.THE BUILDING]
fPROVIDED WITH. TWO PERMANENT WENINGS ONE
THE GONINED1 SP, CE SHALL , BE , 3 t ,
i�,COMIVI N01t C3 WITH1 1 12 1OF THE,TOP A�1�7�64t C6h p C NG WITHIN1�2� OF THE BOTTOM
THE EI t✓LOSUBE_ EA&f dPENI[JG SF ALC N�i�/E A I�u�IN[MU[uI FREE AREA O.F 1 QUARE INCH
_ E r QEt 1•;(.. ,, bWi P&k.HOUR OF,THE TOTAL INPUT HATING OF ALL APPLIANCES IN,TI•IE ENCLOSURE.
CIHCUIIA MINCES ' I ULD' E` l IAL FI�EEbF�ENiNG BE LESS T HAN 100 SQUARE
,, :.(��+�GH'�X�rljil s�si'ds7t3?,� t%� itit'sf ir�iteY s i:ld,"& t�,e fs3i�iit3 M1@?33Y= iG3�Y t#r11 ft, ;s tt})"'tt ":`i'•3'v� ter tl'
r, 0011JErw r!Qhfv * *d) 'rkr�`a j��1�3•#F?iwo oro f ,+,)ht! trw non �+3 f!;3f;4�i4i�jt* Ezil•= if 'j Ivin r
,� ** i'i llip •''ffl 4w1,0 rt: . •r � rf:
V}'x3Y`it tx3 1t9tt: .
.,.;t"ri'APR(tiANCES�CeOCAtEOcINCONFINED.SPCEB,(ALL^tA1RaFROM OUTSIDE `THE BUILDING)
3 `+ WITH TWOIPERMANENT OPENINGS; ONE
THE*-CONFINED4SPACE.' SHALF4t BE'• P�,iOVIDED= ��
• `F1=GOMkiIENCING>E1MtT 'IN;12"� OFi!HE,TOP,,AND ONE!COMMENCING WITHIN 12" OF THE BOTTOM
','art�FTiIE,ENGLOS,Iv+EAEHjOPENING SNALL,HAVER.MINIMUMfFREEAREAOF„I;SOUAREINCH
s t, -ER,
4,60006s PER HOUR INPUT RATING OF ALL APPLIANCES IN THE ENCLOSURE IF THE
-` OPENING ISTHROUGH A DIRECT Oi'ENiiVi3'ORiHfiCSUGH`A`7VERTICAL`"DUCT.'
3
s 2,000 Bt'U9 Pi=R ISOUkil IPUf,!hAi'iNdt FOF#ALL'APPLIANCES` IN`THE' ENCLOSURE IF'THE
Y>� iii% i� k1r3,{
sT 1'°loci t.11 7oi�•+f r.,41 W 13 , ,•.s
- OPENING IS THROUGH HORIZONTAL (DUCTS'.
NOTE.'THAT,ANY,AIR bUCTS MUSt HAVi= 7f4E{SAME OR LARGER CROSS SECTION SIZE AS THE
OPENiNG�THEY F t6 AND 1AECTANGULARLOUCTS+MUST,,NOTAE;LESS +THAN 3” IN ANY
ECT[ON'iW&6sS SECTION.
! t�,. �: `1.,� k.,:s - y. 9SYr• 4.ry' ' • .rf^*�.' cSt+. :!# ... ! t? ,
r VEN.iNSTAL4AT[ON `
S�' A.IB (:b
.., , t N ,` t t... I. r'.A . y,
,yy,�r2Hj$rA LIANG FNECTDT f7 A .� 5 DIA VENT THE PITCH MUST BE UPWARDS
_.3,JrMj f h itt• ✓C 1 ' zt s t,•; ii +t; �s,
';t`i t�J�If E dbF LIANlrE ANb THE §LOPE MUSt GOruIPL'Yr W[tH ANS[ 2`22'
,. s ., i , • fi,. `. Q '� d t� r 't ALL
{ IAS ,, 1 P
tHE''ApPL[AN'IS1TO B� FI{.TIED ONTO'A,C�O BhUTIE�WALLatF�AF�PLIANCE SHALL BE
p O C E AS T .'IyNED11[V ANS Z 2 -EJ.qel� oo iT,l R � N „COMBUSTIBLE VNALL
Yt
" '1�i�F1 1rL iT�11 s. 1 S'fA LA'fION' U6AT'L'C 8i•i Ciii 1t r ; ' t
ate• ". - _.._ (
FOR INST LLATION "BETWEEN 2,000-4,500 k (610-1;370m) CONSULT, MYSON INC.
k.I0"•01 K'3 H Rii( ;)'t4�31°,•f',;.rt'} 1irQc,3d#t'? (.t !tra�I,t: ;`t .� .+?i1
• !, C yd rc,y �y . „
'��:,*b �T`r_1rr1f 't '}; 1> �}%# t t..p •tom +. r�, :r <3( , If 1' ,
1
s ,
..•ti•1 P , .
3 t1
NAT. GAS
L.P. GMS
�ca's,�,,,ft,y:
INLET PRE$8ljRE
7' C.
1`�
14 W C.
�MAXOAS
:
Od
Rip 015% NTM BrFR,T`Me►uN
}udJ
ANOMIIU BURNER �IAANIf,OIO (ipE6SURE. Peipn . t*? !,.4.3:,W
C.,
10� W.C.
"INAL�HEAT INPUT ^ ' (
IN,=t�E
0.0.2.0
1
s ,
..•ti•1 P , .
3 t1
1 -
INSTALLATION INSTRUCTIONS
IXING
,Q8I!Oeiout the bottom cover., ;
1Aelnovcthe two screws,at the lower edge of the jacket and lift off.
ZSdcur6'the'9ppliance to the wall using No. 10 x 11/2" screws through the four holes in the rear of the
CllassiSzx*�t3fr''1t"'
PLooEun tQ ioui screws (with lock washers) in the chassis base and locate the deposit trays, secure
thrid rkbhteh :the 666, screws. "
t,Cortnacttithe,draft+ hood,toaa 5" dia. vent pipe.
WATER LINES-, r{&41 . s. • . • . r
IF THE HEATER IS INSTALLED IN 'A CLOSED WATER SYSTEM CONTACT THE WATER
SUPPLIER OR THE LOCAL PLUMBING INSPECTOR ON HOW TO CONTROL THIS SITUATION
ICorsnect th�,water�'lin6 to.the fittings provided (9/a'.N.fS.T. Male Pipe Threads).
-InThe cold twatertconnection is on the right hand side.
The hot water connection is on the left hand side:' 0
The minimum recommended .pipe size is 1/2" I/D unless low pressure supply.
WFor static supply line,orlow pressure it is recommended that 3Y," I/D be used.
p�,Riis appliance is egUippdd with an automatic gas shuto"/energy cutoff system actuated by high water
,temperature. A listed tbmperature and pressur6ioliet"Valve shall be installed at the time of installation
t:",othe'appliance`.=�
gl,Localcodeslshall govern the, installation of apressure and temperature relief device. We recommend
that this device be installed in the hot water ouilet'of this heater and it must be upstream or ahead
of any water shutoff "valve. For safe operation of the appliance the outlet discharge of the relief device
$musts notbeplugged,ytestricted or reduced in any way to restrict the relieving capacity of the valve
1168H 6ischar'6e..Th6 ei16f device dutlet should be conrlected td suitable size tubing or piping and run
auto a idItatile"placd'for,disposal of hot water if'discharge should occur.
M�NOC%" _' %E tHACL•BEIPLACED BETWEEN THE'PRESSURE RELIEF VALVE AND THE HEATER.
I'%;,'r.r� -ick j er► ! !•:+ '•.
The Imesl It
shduld-not restrict the flow of water and should be so run to allow complete drainage of the
valve and.line upon discharge.
a .a : a -ire I -it -
turn on thetwater;supplyaand open all hot water outlet faucets.
it jurn the,water throttle (see diagram page 6) three full turns counterclockwise
to allow the water to pass through the appliance.
?liWait Uhtll thaiwater flows through all the hot water outlet faucets:
yLiProgreSsively'turn'off all the hot water outlet faucets starting with the lowest outlet.
Check for water leaks. ,
GAS LINES
;r3 SOME UTILITIES NOW`USE HIGH PRESSURE.GAS DISTRIBUTION LINES INSIDE THE BUILDING.
IN tHESE•INStANCES AN INDEPENDANT GAS REGULATOR MUST BE FITTED IN ADDITION TO
THE �REGULATOR4SUPPLIED WITHIHE�HEATER.
t jATHE,,INL�ETtGAS PRESSURE MUST NOT EXCEEDrTHE VALUE SPECIFIED ON PAGE 3.
NATURAL GAS: — CONNECT 3/i" I/D GAS SUPPLY LINE TO THE MANUAL GAS VALVE (V4" N.P.T.
FEMALE PIPE THREAD).
L.P. GAS: — CONNECT 1/2" I/D OR sire" I/D GAS SUPPLY LINE TO THE MANUAL GAS VALVE (3/."
N.P.T. FEMALE PIPE THREAD).
TO REDUCE THE RISK OF DAMAGE TO THE GAS UNION CONNECTION WE RECOMMEND THAT
THE PRESSURE REGULATOR/MANUAL GAS VALVE IS FITTED TO THE GAS SUPPLY LINE BEFORE
CONNECTION TO tHE HEATER. - i
DO NOT OVERTIGHTEN THE GAS INLET CONNECTION ON THE HEATER.
TO ASSIST IN THE DISMANTLING OF THE HEATER THE GAS SUPPLY LINE SHOULD BE FITTED
IN SUCH A WAY TO ALLOW -THE PIPEWORK TO DROP APPROXIMATELY'/h" TO ALLOW THE
CONTROLS TRAY TO BE REMOVED. .
TURN ON THE GAS SUPPLY AND BE SURE THAT THERE ARE NO LEAKS USING SOAP AND WATER
SOLUTION. f
NEVER USE AN OPEN FLAME TO CHECK FOR GAS LEAKS.
Re -fit the outer jacket.
The appliance and its individual shut-off valve must be disconnected from the gas supply piping system
during any pressure testing of that system at test pressures in excess of 1/2 psig (3.50a).
The appliance must be isolated from the gas supply piping system by closing its individual manual
shut-off valve during any pressure testing of the gas supply piping system at test pressures equal to
or less than 1/2 psig (3.5kPa).
4
COMMISSIONING .7HE APPLIANCE
iu.,4 SRi tid f f +:. • `"»r v t:. S
`1:IGHTING INSTRUCTIONS
*
71
s
r. ti'• * +• �' bar l ? .r'
�`, 'ra f.� • .T. '
Pilot Viewing
Wihdo*
�Y
�: Ewa �...1..•
7
jr
t;
' �'' •' 8tartir � Pilot
`
on
Full Got
.. t,�'as c'3 Firs
t Ef f cu #r+l1 ry � nw •iDH , ►. r
c�P11.'x X�? it136t i R Iii} bf 'v i,�! ? ;ar r' :,) ., t 1 " t }t r +}." t ;! t r .r,.,.,
1ify'�}]Chock that.the•Mahual fit+. Oa_s,Control-Valve,is;inithe,Open position.*
r.. � • N it S
+e1 n•, r' *:!• ,•' !* tte is r'! vd,
2� , urn � � all hot�water outlet faucets..7;; .4 �c ::sj rfai{$ r;l�, rY + ; ; b'" ri `
3.':- Turn OFF the Gas Control by pressing and releasing the left hand button 'O' WAIT 5 MINUTES.
� E f ,_T
P r"1t f •€=1x,Rtti !•-. PA(� : " t t ti . � �•.rr, , p` 4..ully depress the Starter/Pilot button ' (Dl *and hold until the air is purged from the system. All the `a
r airtmust be purged fr-oni the system before the Pilot will ignite, this may take 2.3 minutes.
N - 4
T. 4�i` 9`r '�'n ,-�+•, .•,r. ..
t5 ;.Repeatedly'pr'eS tend Fel�se-'the Spark Ignfition button S` until the Pilot is Iii.
Y , . gNQbserva=through the apertureAn!the, jacket.:toj 60srif+ra tP ►!, v,lhl, _ -ti vo�dlr, '
F;ICeep'jfie=Stiher/Piloi button depressed for 10 seconds iafter:the ,Pilot is -lit then release.
1_ The appliance lfi now Ih .the Pilot only position. g
lbthe'py_Ioperation'hornii,Nil
6Press'dawn.the,full gas lever to release Starter/Pilot button.
the kpolianco is,how.in the working position and will supply hot water when a hot water outlet faucet 2
y`
1s opened,. ♦��' - ,, �" • , •.-
q, 1)iAA0-44A ;Wil' Tv i.sr 1; ; I.44 i'-U'r E r 1` w a} }, }.�
771 the apphance,can be returned to the Pilot only position at any time by depressing the Starter/Pilot
`button.. "
8:..' Ta §h t"d6vH"the'appliance press the Olt button 'p`
ti.1'i`A.f41116`'1 "4 +PiA tIt, V rjl
9.,'Shr6uld overheating occur or the gas supply fall b. shut off, turn off the manual gas control valve
to the appliance `
f
r
5 •,
WATER TEMPERATURE ADJUSTMENT
THROTTLE
r.
Sr h
Remo-ve bottom cover. � �
Remoi►e�ttAr�jacket �;' ``
Press the 'OW'buhon 'O' to turn off the heater. Fully open the furthest HOT water outlet faucet and
adjust the water throttle (fig. 2) to give at least 2.4 gpm (which takes 6.2 secs to fill a quart measure).
Turn OFF the hot water outlet faucet.
Check that the burner manifold pressure is correct (a pressure test point is provided on the left hand
side of the controls tray) by lighting the appliance and opening fully the hot water outlet faucet. Then
readjust the water throttle to give 1.9 gpm (which fakes 7.5 secs to fill a quart measure). Replace sealing
screw after use.
IF THE BURNER MANIFOLD PRESSURE IS LOW THE OUTLET WATER TEMPERATURE WILL BE
REDUCED<,i�•,fi �lif rv9'e.', .-;1 ..� ' _ . i' •
Check outlet Water temperature. The temperature should be 140°F. approximately.
off (±i f }I'.`• •tjl'
IMPORTANT If installing the appliance at altitudes between 2,000 and 4,500ft (610-1,370m) there will
be a reduction in outlet I Water- temperature. '''i I—
IN HARD WATER AREAS -OUTLET WATER TEMPERATURES IN EXCESS OF 140°F MAY RESULT
IN SCALE FORMATION.
Replace bottom. covers! v
BE SURE THAT THE CUSTOMER HAS A FULL EXPLANATION OF THE APPLIANCE.
r4r;�i,•'�fl{��.,i�i�..,..ta.r�t,y�. , r.i ,,,,;r,a,,,f,.. , • . ..
s
THIS THERMOSTAT IS NON-ADJUSTABLE AND IS CALIBRATED AT 140°F.
CAUTION
WATER TEMPERATURES ABOVE 130°F INCREASE THE RISK OF SCALD INJURY.
6
yj } d
rr =' 'fINit.Nl1NCE
;`�'' tti�x •� r :'
({
S•'1 No loon,
.,��`�`�.��.r: , fEt 0411:01iVIN�i�P�IN1`.`S�fMUSTuBErIIbHERED,rTO.r�:'t�+�'I tt�+� •t.ti,�r.,- � •rt ,,;,;.• t�.�, .., ,
f`hfi 1 bi)htjFsrt4e71ahs,jlleflb"fMiti oil�'b� flammable vapors'and liquids in the vicinity
i`�' r, vy "# E109� �• ii37tr" 1 '+ itx�?t�' ii i itik tt ;f 9 ti noii !Yf^�fj n!..t
f � : •S ^! t% .Cafe ,. rlrn , ... r}
TW
W N�Otsotistruct the_fioW ofi combustion and ventilating air.
`J s ~ ti Tr r annubti bxiMihsiloh of the venting systeM, dean and repalr4as, necessary.•i I , ?
IbOI IYe UI exftirr�inallan of the bUr er and pilot Name and check that they burn with a blue flame.
.t, �!f'� t r 71
fool ,•, f,r :, r h s
III,nubafbf tie tnibin valve push rod,LUbriCate the push rod and push rod seals with
n�i�i�gfb •ei3O, E0N1i�i �otning1 I.
1_ _ ... t.
i1b a,fe�tiiat;lsiast bnc���yAar)?f►tanual operatioftofathe,ptessure and temperature relief valve.
•: .
„; • iMpOp`tA�If SAitiP i lllfatih the pfbssura and telnpdtaiure felief valve shut dowh the appliance by
" pf ilih h3 '� O06h a`hot water fai►cet and iilbw water to pass throygh the appliance,
►v�`i Citi fhe�e hC t ii&,bbfb►e`closing.the faucet: Opetate the pressure, and temperature relief
?�Ti t d
�� ,v b f ;tl b r r ft`bfi1`ifa rflage by water t?vith a suitbbfe,cohtainet,
�YA1f1F1'•1i.±ii _ r p'twr:sryr� t
` 6, f�tK�`f1i�otomPERAtk� g ANb"PRESSURE. RELIEF VALVEON"THE APPLIANCE DISCHARGES
s ERi�DiCiAt LaY,, •.THi MAYrBE DUE TO!THERMAL"
EXPANSION "IN A CLOSED WATER
. si I
�tct��5YSTtEMhtsONTACTt�TWEkINATER, SUPPLIER tOR. LOCAL+PLUMSiNGj,I SPECTOR ON HOW
A -& dorT( COKFIECT ;7�IIS :tSITItiIAT�I;ON: DO NOT PLUG TH� EIVIPERATUI� E AND PRESSURE
R iliEF _VALV tr;n� iw
Y'r xt�ri �W,!� til biut[t Y +ti,�,OW �nae�e.r+r��>�� �*`�rsi>� •T r *,y r -� i - ; i
061L77 tJ"ont jinn Unt��TC.sl..0fi l? 'll •� 4'�'�t� •,N:e .tn n.^
RETENTION FLAME
TY►'L. ALL FORTS
r t?rbveAl 3. biuq I)&lotJ vlis its -BLUE FLAME
adf. ttbtrt#�ts►t tit y I€►�rfe�ti a Ing ^y "fN ; t
FIG. 4. r) VELLONV TIP
' n' "O; SLIGHT YELLOW TIP BLUE FLAME
i+k .}up fleaw .;4tf+,qu�ololl r• ��r_ G PERMISSABLE ON
.y SLIGHT YELLOW TIF
1;i1$1 rllt�il^ IERMISSABIE ON
L.P. GASL.F GAS
BURNER FLAME I
FIG. 5.
�s2h:l �w t'�'r't'- �f µ;*. `' i ��# J,:'i: rt, .a :•Yw. '? •, 1:7...3 :la t•.
iM�vOivtra_ jig. _ 'Y VIA i�� N' ` r'.i': t :►tj rtitl,j'i) Lir' . Fii 1
g ! PILOT FLAME !A'.ti-:1 a'rA d f..r•, • I 1A 0% ; •, . , 7•
'r IT • IS RECOMMEN Et7 tTHAT THE�APPLIAI�CE WEki414I) ANNUALLY FOR CORRECT
OPERATION AS L&EeSELOW." • `.`.': ;
i�S✓ �.elR7s1V:^i i.i{ � ji V � LJ,".'�'' t r 7 sGt �• if i� l 1 }�'.•� 7 �' ih.? i. ' ^ ?..i ..
NECK ACTION IF, NOr
:tfti�Tpi�oipnition system operate I Remove all the deposit from the electrode and check
,,. 4 h >rcorrectty?fOdf
1atr7? pll;ij for electrical shorting. The spark gap between the
sg odi Ftr• nit, 1 electrode tip and the. pilot hood should be W'
x �,.. electrode .
• } a " #n, ttx'E4��t'iy ori1 +r•, r;{., ; r e
r; 4.'1s, tf .pilot flame stable, Does the pilot Harte Replace the pilot filter. Check the pilot flame
,g? tu�a+otc�tittikp}lith't tioupls Alignment with the thermocouple. Change the pilot
t>s ?#rFa'tff tits .19XIti., lFrttci �,tti !it r t#? Injector: Clear aeration holes at the base of the pilot
rift9; `acs 'Rl;o;r} rtrkv�^ rtr'p�t; ,.t jj fes�,tUbe: l
< Saf
r.�oes.tft Mane ety,Devtce hold open -tet ^� _
afteii0"eeconrfa ofi the pilot flame Clean or..r�piace the thermocouple. Replace.the
,.`6ei�bnylyl! t`i E.C.O. device.'Replace the Flame Safety Device.
• - `� { ` fl�fil�f�c�p��3iiF �1Wft'` tEirlr �...... . ..1�-.,.., ..,,,,..�•,.•�{ ""..,.
r . i€�vt��.tt#nif►�E t1JJ!.lk7r• nt•;1 77 F.
....ae•w' "— �•r ; .
r 4. �IsYthe�watet sm rature correct? :dam ;� Adjust the watef, throttle It necessary.
t1tLltiif �jjtttr�l. .er- �t y<• r
Shoblif iipprdtj 140°F. " r'Adjusf the,gae reQulator:if necsi3sary.-
'�'iu0Tltiil[Y,fife4F iEv1Ci },'it ti. W.�E+.yw.at.+ Wp.
Win
S. Are there any Water" leaks? Repla&e waterjeals If necessary if leaks are found.
r'fItIM30 ..,'P.w,tCi �'#�tCf �t 0 r`° f ¢ E t.
7f i. 1 j 6� k�a
there any gas" baks?,�rf�:,Replace sealingrwashdrd,.. gaskets or joints as
necessary if leaks are found.
i s
01,W J03.4ts rt4tct:Yi tl tt:jgs Vrir r:i• . sr ( +
T. Afelftlairtlbiirrtei Narhba stable? Clean the flue ways burner ports and vent pipe as
1;};Acfui gr~li#fta,Vf.A'riitttbe'ri2ttit,•�t :t necessaryt.�. et I?
i -d1'il�t1to t,"2 3rII)? Tom.•}{th;A,".'tj sloe v i
S. Is the water heater noisy when In operation? ; Descale the heat exchanger with a descaling agent
y 1':} #ffiit�[rTnt� 4�5'+rt'?►t0 e. tsar. as necessary.
C•tc3 r �F.ato f irr i'g+ �Do"tfie riiaiti burRero appear"clean with the Follow the cleaning instructions, section 6 of the
top port at" Gt"itructed? dismantling procedure.
�ftrri'?^8rr tkli}�itt�t'�;ibtit':kt� !;!t"r1t.,"�Iti�`} 4�'+ , .'' •
F+„ 7
oLdling probleM3 WCessive mineral build-up) usually occur in tank -type heaters. Because MYSON
heaters do not lktore hot water, and becaullib cdhbtaht- flow through the unit tends to flush the beat '
exchartgir, Scaling should not be a serious problem, Since MYSON heaters are designed for man
yearn of use, however, provision has been made for sim
ever becomes necessary. Pie descaling in the unlikely event that this
TO DESCALE HEAT EXCHANGER
ACID RlspITING
iLlD TANK � I f PINCH COCR
FIG. 6.
11.091111111 Tull
ING BODY
Remove the heating unit and invert on a
suitable bench or table.
Using rubber tube and acid resisting tanks
assemble as shown.
Fill the upper container with a proprietary brand
of descalant or a solution of 10 parts water to
1 part Hydrochloric Acid. The water should
preferably be hot then add ACID TO WATER
not water to acid.
Muriatic Acid, which is a pre -diluted solution of
Hydrochloric Acid, may be used for this
Procedure if it is further diluted to yield the same
ten to one proportion of water to Hydrochloric
Acid.
Adjust pinch cock and allow the fluid to slowly
Pass through the heating unit into the collecting
tank.
Continue the process until the fluid ceases to
bubble. It may be necessary to replenish the
solution.
Disconnect and thoroughly wash out the
heating
WARNING unit with clean water.
ACID/WATER SOLUTION MUST BE USED WITH EXTREME CAUTION. TAKE CARE NOT TO SPLASH
ONTO THE SKIN OR INTO THE EYES. WASH ANY AFFECTED AREAS WITH LARGE AMOUNTS
OF COLD WATER AND SEEK MEDICAL ADVICE.
DISMANTLING PROCEDURE
REPLACEMENT PARTS MUST BE FITTED BY A PERSON SUITABLY QUALIFIED IN THE
MAINTENANCE OF GAS APPLIANCES.
ff
Fig. 1.
8
I. TO DRAIN THE APPLIANCE
Slide out the bottom cover.
Turn off the gas supply.
Turn off the water supply.
Opeh a hot water faucet to reduce the
pressure and drain the appliance using the
drain offpoint fitted on the underside of
the diaphram housing (No.16 on the
replacement parts page).
2. TO REMOVE OUTER CASE
Shut down the appliance.
Slide out the bottom cover.
Remove the two screws securing the outer case
at the lower edge. Swing out the lower edge
and lift off the outer case.
3, JO REMOVE CONTROLS ASSEMBLY
Complete section 1 and 2.
Release the Gas ihlet Connection at 2 Fig. 1.
Drop the Gas Supply Pipe approx. '/z ^ to clear
the Gas Inlet Connection.
Release screw securing A/V sensing tubes at
3 Fig. 1 and disconnect tubes, do not lose 'O'
Flings.
Release electrical connections 6 Fig. 1.
Holding the controls tray securely release two
screws 4 Fig. 1.
Remove complete controls/burner assembly
tray by pulling carefully forwards and slightly
downwards.
VCA ta,u,;4&C u; %_umpnance: xesidential r Climate Zone TI
1> ATE R M.t4N 4
ProjectTlde a
Eay e B ding Peanit N
Project Address X x d
C IM4 Checked By / Date
DocuryentaUon Author Telephone Fnfomernent Agency Use Oniv
BUILDING DATA �j
"
North ( )
Condition Floor Area I%�
Number of Stories
Slab s oor
Number of -Units
to a Family Detached (SFD)
[ ] Addition -Alone
[ ] Single Family Attached (SFA)
[ ] Existing Building
[ ] Multi -Family (MF)
[ ] Existing -Plus -Addition
BUILDING SHELL INSULATION.'
Component Insulation LocatiloniComments
Type R -Value (attic, to garages, tlmiael, etc.)
Wall..............IL-��-
1 � Ext waI.Is
Wall ..............
Roof .............
Roof .............
Floor .............
Floor .............
Slab Edge.....
GLAZING
Glazing
•3 oO TT'i c�
Area Glass Type
Shading Devices
Interior Exterior
Glass Area % Glass
North 9 - _-S_
East 190 ,
South —/to aq
West_ g
Skylight O
Total • -7150
I
Mandatory Measures Checklist: Residential MF -1R
NOTE: Lowrise residential buildings subject to the Standards must contain these measures: regardless of the compl
tm iance
approach used Items marked with an asterisk (•) maY be superseded by mare stringent compliance requirements listed
the Certificate of Compliance. When this checklist is incorporatedinto the permit documents. the features noted shall
be considered by all parties as binding minimum k component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only.
DESCRIPnON DESIGNER ENFORCEMENT
Building Envelope Measures _ 1. ._.
Overhang Framing Type
NJ
North ( �_ L•
North ( )
/4'Afo /tilt
EastEast
South (�
SOU th ( )
West (Ig
West ( )
Skylight.......
THERMAL MASS
__ Type/Covering Area
Thickness
(slab/exposed, tile. etc. _ Of)
ILAOM e
(inches) Location/Description (kitchen, bath etc.)
HVAC SYSTEMS Minimum
Duct
.Type (furnace, air Efficiency
Location • Duct Output Manufacturer/ Model #
conditioner, heat pump) (SE, SEER,HSPF)
(attic, etc.) R -Value (Btuh) (or approved equal)
FUR��4t .71
S•7 SVCS _.
1442'
Maximum Furnace Heating Output:
Btuh
HOT WATER SYSTEMS
Tank Manufacturer/Model# '
system type (storage gas, etc.) Capacity (or approved equal) Special Feature(s
SPECIAL FEATURES/REMARKS--(Add extra sheets if necessary)
I
!l.'
§2.5352(a): Minimum ceiling insulation R-19 we average.
62.5352(br Loose fill insulation manufacturer's labeled R -value.
' §2.5352(c): Minimum wall insulation in flamed walls R-11 weighted average (does not apply to
exterior mass walls). '
§2.5352(k): Slab edge insulation. water absorption rate no greater than ea03%, water vapor
transmission rate no greater than 2.0 pear rmh.
§2.5311: Insulation specified or installed mats Cal ifomia Energy Commission (CEG) quality
standards. Indicate type and form.
§2.5352(f). Vapor barriers mandatory in Climate Zones 14 and 16 only.
§2.5317: Infiltration/Exfdtration Controls
a. Doors and windows between conditioned and unconditioned spaces designed to limit air
leakage.
b. Doors and windows certified.
c. Doors and windows weatherstripped; all joints and penetrations caulked and sealed
12.5352(e): Special infiltration barrier installed to comply with §2-5351 .neetsCEC quality
standards.
§2.5352(d): Installation of Fireplaces
1. Masonry and factory -built fireplaces have
a Tight fitting, closeable metal or glass door
b. Outside air intake with damper" control
c. Flue damper and control
2. No continuous burning gas pilots allowed..
HVAC and Plumbing System Measures
62-5352(8) and 2-5303: Space conditioning equipment sizing: attach calculations.
§2-5352(h) and 2-5315: Setback thermostat on all applicable heating systems.
• §2-5316(a): Ducts constructed• installed and insulated per Chapter 10, 1976 UMC.
§2-5316(bj: Exhaust systems have damper controls. -
§2-5314(c): Gas-fuetl span heating equipment has intermittent ignition devices.
§2-5314: HVAC equipment, water heaters. showerheads and faucets certified by the CEC.
§2-5352(1): Water heater insulation blanket (R-12 or greater) or combined interior/exterior
insulation (R-16 or greater); fust 5 feu of pipes closest to tank insulated (R-3 or greater).
§2-5312(Excep6on 1): Pipe insulation on steam and steam condensate return & recirculating
piping.
§2-5318(d): Swimming Pool Heating
1. System has:
a On/off switch on heater.
b. Weatherproof instruction plate on heater:
e. Plumbed to allow for solar.
2. 75 percent thermal efficiency.
3. Pool cover.
4. Time clock.
5. Directional water inlet.
Lighting and Appliance Measures
62-5352(j): Lighting - 25 lumens/watt or greater for general lighting in kitchens and bathrooms.
12-5314(c): Gas ford appliances equipped with intermittent ignition devices.
§2-5314(a): Refrigerators, refrigerator -Geezers, freezes and nuorescent lamp ballasts certified
by the CEC. Indicate make and model number.
r
COMPLIANCE STATEMENT
This Certificate of compliance lists ttr building features and performance specifications needed to comply with
Title 24. Chapter 2-53 and Title 20. ClaptcA2. Subchapter 4. Article 1 ofthe California Administrative code. This
certificate has been signed by the individual with overall design responsibility and the building owner. who shall
retain a copy of it and transmit the certificate to any subsequent purdtaser of the building.
Designer
Name.
TitkJFrrm: .
Addmss:
Tekpht nc
Building Owner
Nam
Titk/Fimt:
Address:
Telephone:
(date) )
.. (date)
Documentation Author Enforcement Agency
- Nerne:
Address:
Atatcy-
.3.; Tekphonc
1. Ceiling Insulation
R -value
R-0
R-19
R-30
R-38
U -value
0.501
0.30
0.10
0.08
0.06
0.04
0.02
0.00
Number of stories
One Two
-103 -49
-8 -4
-2 -1
0 0
-176 -84
-102 -49
-26 -13
-18 -9
-11 -5
-4 -2
4 2
11 5
Three
32
-2
-1
0
1
-54
32
-8
-6.
-4
-1
1
3
2. Wall Insulation
- - -•-0.60 .
-144
-70
Single-
Single -
-120
-58
Family
Family
Multi -
R -value
Detached
Attached
Family
R-0
-68
-51
-34
R-11
0
0
0
R-13
2
2
1
R-19
8
6
4
U -value
-2
0.04
-1
0.80
-153
-114
-76
0.50
-91
-68
-46
0.30
-47
-36
-24
0.10
0
0
0
0.08
4
3
2
0.06
9
7
5
0.04
14
11
7
0.02
19
14
10
0.00
24
18
12
3. Raised Floor Insulation
-5
1
Insulation In Floor
23
R -value
Number of stories
Two
R -value
One
Two
Three
R-0
-17
-8
-5
R-11
-3
-2
-1
R-19
0
0
0
R-30
3
1
1
U -value
-14
-48
-69
- - -•-0.60 .
-144
-70
-46
0.50
-120
-58
38
0.40
-95
-46
30
0.30
-69
-34
-22
0.20
-43
-21
-14
' 0.10
-17
-8
-5
0.08
-11
3
-4
0.06
-6
-3
-2
0.04
-1
0
0
0.02
4
2
1
0.00
10
5
3
Controlled Ventilation Crawlspace
-55
-18
Number of stories
-2
R -value
One
Two
Three
R-0
-11
-7
-5
R-5
-4
-4
3
R-11
-2
-2
-2
1 R-19
-1
, -2
-2.
4. Slab Edge Insulation
-12
-5
1
Number of Stories
23
R -value
One
Two
Three
S R-0
0
0
0
R-5
8
5
2
R-7
8
6
3
F2 factor
20
31
3
0.90
-1
3
-1
0.80
-1
-1
0
0.70
2
2
1
0.60
6
4
2
0.50
9
6
3
0.40
12
8
4
5. Infiltration (Air Leakage)
Specification . Points
Stsberd 0
6. Glass Heat Loss
Total
-14
-48
-69
_-Efrectlre
U -value
Percent
-12
-42
.51 to
.41 to
.31 to 0.3
Glass
Single
Double
.60
.50
.40 le
50
-121
-53
-39
-24
-10
40
-90
-37
-26
-14
3 1
35
-75
-29
-19
-9
1 1
30
-61
-21
-13
-4
4 1
29
-58
-20
-12
-3
5 1
28
-55
-18
-10
-2
5 1
27
-52
-17
-9
-2
6 1
26
-49
-15
-8
-1
7 1
25
-46
-14
-7
0
7 1
24
-43
-12
-5
1
8 1
23
-40
-11
-4
2
8 1
22
-37
-9
-3
3
9 1
21
-34
-7
-2
4
10 1
20
31
3
0
5
10 1
19
-29
-4
1
6
11 1
18
-26
-3
2
7
12 1
17
-23
-1
3
8
12 1
16
-20
0
4
9
13 1
15
-17
1
6
10
14 1
14
-14
3
7
10
14 1
13
-12
4
8
11
15 1
12
-9
6
9
12
15 1
11
-6
7
10
13
16 1
10
-3
• 9
11
14
17 1
9
-1
10
13
15
17 2
8
2
12
14
16
18 2
or
>s
l
t
0
2
2
3
3
4
4
4
5
5
5
5
i
5
7
7
7
B
B
3
)
7..Shading (Shade Open)
-14
-48
-69
_-Efrectlre
Percent Glass
16
-12
-42
-59
(percent gtasa x SC)
na
Effective
-10
-35
-50
-46
%Glass
North
East South ' West
Skylight
18
5
1 4
1
na
16
4
2 5
1
na
14
4
2 5
1
na
123
-5
3 5
2
na -
11
3
3 5
2
na
10
2
3 5
2
1
9
2
3 5
2
2
8
2
3 5
2
2
7
1
3 4
2
2
6
1
3 4
2
3
5
1
2 4
2
3
4
0
2 3
1
3
3
0
1 2
1
3
2
0
0 1
0
3
1
-1
-1 -1
-1
2
0
-1
-2 -4
-2
0
na = not allowed
12
Effective SE or HSPF
6 1
IB. Shading (Shade Closed)
Effective Percent Glass
(percent glass x SC)
Effective
%Gleet Nath Etat South West Sky%hi
18
-14
-48
-69
-64
na
16
-12
-42
-59
-55
na
14
-10
-35
-50
-46
na
12
-8
-29
-40
37
na
11.
-7
-26
-36
33
na -
10
-6
-23
-31
-29
-74
9
-5
-20
-27
-25
-65.
8
-5
-17
-23
-21•.
-56
7
-4
-14
-19
-18
-47
6
3
-11
-15
-14
38
5
-2
-9
-11
-10
-30
4
-1
-6
-8
-7
-23
3
0
-4
-5
-4
-16
2
1
1
-2
-1
-9
1
1
1
1 ..'
1
-4
0-
_2
3
4'
3
0
9. Interior Thermal Mass
Interior
Mass
ICFA• One
0.0 -8
0.1 -8
0.3 -7
0.5 -6
0.7 -5
0.9 -5
1.1 -4
1.3 -3
1.5 -3
2.0 -1
2.5 0
3.0 1
3.5 2
4.0 3
4.5 3
5.0 4
5.5 5
6.0 5
6.5 6
7.0 6
7.5 6
8.0 7
8.5 7
Stab Floor Raised Floor
SID60S Stories
Two Three One Two Three
-5 -4 -2 -1 -1
-5 3 -1 0 0
-4 -2 0 1 1
-3 -1 1 1 2
-2 -1 1 2 2
-1 0 2 3 3
-1 1 3 4 4
0 2 3 4 5
1 2 4 5 5
2 4 5 6 7
3 5 7 7 8
4 6 8 8 9
5 7 9 9 10
6 8 9 10 10
7 8 10 11 11
7 9 11 12 12
8 9 11 12 12
8 10 12 13 13
9 10 12 13 13
9 11 13 13 14
10 11 13 14 14
10 11 13 14 14
10 12 13 • 14 15
10. Exterior Wall Thermal Mass
Eff. % Glass
Exterior
Single- Single -
Measures
SEER
Wall
Family Family
Multi
Mass
Detached Attached
Family
0.00
0 0
0
Wall Insulation
0.20
3 2
1
X
0.40
5 4
3
4 to
0.60
8 6
4
less
0.80
10 8
5
+15
1.00
13 10
7
-12
1.20
13 12
8
-4
1.40
12 13
9
-6
1.60
10 13
11
.
1.80
10 12
12
-3
2.00
10 11
_ 13
-4
11. Heating System
-3
-2
-2
SE or HSPF
9.5
0
(assumes ducts In attic)
0
0
Sum of 1-6
0
10.0
4
-25 or -24 to -14 to -4 to +6 to
16 or '
SE HSPF
less -15, -5 +5
+15
more
0.72 6.60
0 0 0 0
0
0
0.75 6.88
3 3 3 2
2
1
0.80 7.33
8 7 6 5
4
3
0.85 7.79
13 11 10 8
7
5
0.90 8.25
17 15 13 11
9
7
0.95 8.71
20 18' 15 13
11
8
12
Effective SE or HSPF
6 1
21
(SE or HSPF x duct efficiency)
Effective SEER
Effective -25 or -24 to -14 to -4 to
+6 to 16 or
SE HSPF less -15 -5 +5
+15 more
3.6
0.30 2.75
-73 -64 -56 -47
-38
-30
na 3.41
-45 -39 -34. -29
-24
-18
0.40 3.67
-34 -30 -26 -22
-18
-14
0.50 4.58
-10 -9 -8 -7
-5
-4
0.56 5.13
0 0 0 0
0
0
0.60 5.50
5 5 4 3
3
2
0.70 6.42
17 15 13 11
9
7
0.80 7.33
25 22 19 16
13
10
0.90 8.25
32 28 24 20
17
13
1-00 9.17
37 32 28 24
19
15
Zonal Control Adjustment
0
0
System Type
0
0
8.0
Resistance
10 9. 7 6
4
3
Other
6 5 4 3
2
2
12. Cooling System
SCORE CARD
SC
Eff. % Glass
.15
X
Measures
SEER
1.
Ceiling Insulation
or
(assume:
ducts
In aide)
U -value [0.030]
2.
Wall Insulation
Sim of 7-10
Z
0_
X
-25 or
-24 to
-t4 to
4 to
+6 to
16 or
SEER
less
-15
-6
+5
+15
more
8.0
-14
-12
-10
-8
-6
-4
8.5
-9
-7
-6
-5
-4
-3
8.9
-5
d
-4
-3
-2
-2
9.0
-4
-3
-3
-2
-2
-1
9.5
0
0
0
0
0
0
10.0
4
3
3
2
2
1
10.5
7
6
5
4
3
2
11.0
10
9
7
6
4
3
= 12.0
15
13
11
9
7
5
13.0
20
17
14
12
9
6 1
21
23
Effective SEER
2.7
2.9
3.2
(SEER xduct efficiency)
3.6
3.8
4
Sian of 7-10
4.4
4.6
Effective -25 or
-24 to
-1410
-410
+6 to
16 of
SEER
less
-15
-5
+5
+15
more
5.0
-30
-25
-21
-17
-13
-9 '
6.0
-12
-11•
-9
-7
-6
4 ,
6.6
-5
4
-4
-3
-2
-2
7.0
0
0
0
0
0
0
8.0
9
8
6
5
4
3!
9.0
16
14
12
9
7
5
10.0
22
19
16
13
10
7
11.0
26
23
19
15
12
8
12.0
30
26
22
18
14
9
13.0
33
29
24
20
15
10
58
Zonal Control Adjustment
0.7
0.9
1.1
1.3
10
8
7
6
4
3
2.8
No
Cooling System Installed
I
-Stories
3.8
4
4.3
4.5
4.7
4.9
One
-5
-4
-4
-3
-2
-2
Two +
3
3
2
2
2
1
25
27
3
3.2
3.4
3.6
3.8
Single -Family
Detached and Attached
4.4
4.6
4.8
Unit Size (sf)
5.3
Water
5.7
i 199
1200
1700
2200
2700
Heater
Credit
or .I
to
to
to
or
Type.
Type
less
1699
2199
2699
more
SG
None
0 • i. 0
0.
0
0
or
Solar
12
` ` 8
6
5
4
- HP
HWR
8
5
4
3
3
2.9
WSB
5
3
3
2
2
4.4
POU
8_._
5
_4 .
3
3
SE
None
-37
-24
-18
-15
-12
"
Solar
-1
-1
-1
0
0
3.2
HWR
-18
-12
-9
-7
-6
4.7
WSB .
-25
-16
-12
-10'
-8
6.1
POU
-18
_-12
-9
-7
-6
IG
None
-5
-3
-2
-2
-2
3.5
Solar
7
5
4
3
2
5
POU
r3_
2
1
1
1
IE
None
-28
-19
-14
-11
-9
2.3
Solar
8
5
4
3
3
3.8
POU
-10
-6
-5
-4
-3
5.3
Multi -Family (individual units)
5.7
5.9
6.1
6.3
Unite Size (s
80%.
1.4
Water
1.8
699
700
1200
1700
2200
Heater
Credit
Or
to
to
to
or
Type
TYPO
less
_1199
1699
2199
more
SG
None
0
0
0
0
0 i
or
Solar
14
7
5
4
3
HP
HWR
9
5
3
2
2
4.8
WSB
9
4
3
2*
2
63
POU
9
5
3
2
2
SE
None
-45
-23
-15
-11
-9
3.6
Solar
2
1
1
0
0
5.1
HWR
-23
-12
-8
-6
"-5,
66
WSB
-25
-13
-8
-6
-5
_000__23
27
-12
8
-6
-5
G
None
-8
-4
-3
-2
S
-
Solar
� 6 .
i 3
2
1.
:1 1 .
6.7
POU
1
0 .:„0
1.9
0
0
E
None
..30
-15
-10 -
-8
.6-
-
Solar 18
:< 9.
6
4
4
`
POU
-88
--4-
-3
-2
-2
Point System Summary: Climate Zone 11
SCORE CARD
SC
Eff. % Glass
.15
X
Measures
1.
Ceiling Insulation
or
_
Interior Mass/CFA
R -value 1381
U -value [0.030]
2.
Wall Insulation
Ie"'II or
Z
0_
X
t TYPZ I MSS
U -value [0.098]
3.
Raised Floor Insulation
A' � � or
SC
Eff. % Glass
.5
R -value 119]
U -value (0.037]
4.
Slab Edge Insulation
11000" or
R -value [0]
F2 facuw 1037]
5.
Infiltration
Standard
6.
Glass Heat Loss
X
Ic.rpet.d �l bl
[double]
U -value [0.65] % Total Glass (16]
7.
Shading (Shade Open)
COND. FLOOR
AREA
4 TYPE
1
MASS(UIMC
.
• 4.2
t .
, : 0
leexposed
slab)
.72,
x
3
.
SE or HSPF
Duct Efficiency [0.78]
0%
5%
10Y.
15%
20%
2S%
30%
35%
40%
45%
50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100% 105% 1101/. 115% 1201/ 115`
OY.
0
0.2
0.4
0.6
0.8
1.1
1.3
1.5
1.7
1.9
21
23
2.5
2.7
2.9
3.2
3.4
3.6
3.8
4
4.2
4.4
4.6
4.8
5
53
101/.
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.9
2.1
2.3
25
2.7
2.9
3.1
3.3
3.5
3.7
4
4.2
4.4
4.6
4.8
5
5.2
5.4
20%
0.3
0.6
0.8
1
1.2
1.4
1.6
1.8
2
2.2
24
27
29
3.1
3.3
3.5
3.7
3.9
4.1
4.3
4.5
4.8
5
52
5.4
56
30%
O.S
0.7
0.9
1.1
1.4
1.6
1.8
2
2.2
2.4
26
2.8
3
3.2
3.5
3.7
3.9
4.1
4.3
4.5
4.7
4.9
5.1
5.3
5.6
58
40Y.
0.7
0.9
1.1
1.3
1.5
1.7
1.9
2.2
24
26
2.8
3
3.2
3.4
3.6
3.8
4
4.3
4.5
4.7
4.9
5.1
5.3
5.5
5.7
5.9
501/.
0.9
1.1
1.3
1.5
1.7
1.9
21
23
25
27
3
3.2
3.4
3.6
3.8
4
42
4.4
4.6
4.8
5.1
5.3
5.5
5.7
5.9
6.1
55%
0.9
1.1
1.4
1.6
1.8
2
2.2
24
2.6
28
3
3.2
3.5
3.7
3.9
4.1
4.3
4.5
4.7
4.9
5.1
5.3
5.6
5.9
6
6.2
60%
1
1.2
1.4
1.7
1.9
21
2.3
2.5
2.7
2.9
3.1
3.3
3.5
3.8
4
4.2
4.4
4.6
4.8 '
5
5.2
5.4
5.6
5.9
6.1
63
65%
1.1
1.3
1.5
1.7
1.9
2.2
2.4
2.6
2.8
3
3.2
3.4
3.6
3.8
4
4.3
4.5
4.7
4.9
5.1
5.3
5.5
5.7
5.9
6.1
6.4
70%
1.2
1.4
1.6
1.8
2
2.2
2.5
21
2.9
3.1
3.3
3.5
3.7
3.9
4.1
4.3
4.6
4.8
5
52
5.4
5.6
58
6
6.2
64
75%
1.3
1.5
1.7
1.9
21
2.3
25
2.7
3
3.2
3.4
3.6
3.8
4
4.2
4.4
4.6
4.8
5.1
5.3
5.5
5.7
5.9
6.1
6.3
6.5
80%.
1.4
1.6
1.8
2
2.2
2.4
26
2.8
3
3.3
3.5
3.1
3.9
4.1
4.3
4.S
4.7
4.0
5.1
5.4
56
5.8
6
6,2
64
66
65%
1.4
1.7
1.9
2.1
2.3
25
2.7
2.9
3.1
3.3
3.5
3.8
4
4.2
4.4
4.6
4.8
5
52
54
5.6
59
6.1
63
6S
67
90%'
1.5
1.1
2
2.2
2.4
26
2.8
3
3.2
3.4
3.6
3.8
4.1
4.3
4.5
4.7
4.9
5.1
53
5.5
5.7
5.9
6.2
6.4
66
68
95%
1.6
1.8
2
2.2
2.5
27
2.9
3.1
33
3.5
3.7
3.9
4.1
4.3
4.6
4.6
S
5.2
5.4
5.6
5.8
6
6.2
6.4
6.7
6.9
100%
1.7
1.9
21
2.3
25
28
3
3.2
3.4
3.6
3.8
4
4.2
4.4
4.6
4.9
S.1
5.3
5.5
5.7
5.9
6.1
6.3
6.5
6.7
7
105%
1.8
2
2.2
2.4
2.6
28,
3
3.3
3.5
3.7
3.9
4.1
4.3
4.5
4.7
4.9
5.1
5.4
5.6
5.8
6
6.2
6.4
6.6
68
7
110*/.
1.9
2.1
2.3
2.5
2.7
29
3.1
3.3
3.6
3.8
4
4.2
4.4
4.6
4.8
S
5.2
5.4
5.7
5.9
6.1
6.3
6.5
6.7
6.9
7.1
115%
2
2.2
2.4
2.62.8
3
3.2
3.4
3.6
3.8
4.1
4.3
4.5
4.7
4.9
5.1
5.3
5.5
5.7
5.9
6.2
6.4
6.6
6.8
7
7.2
120%
2
2.3
2.5
2.7
29
3.1
3.3
3.S
3.7
3.9
4.1
4.4
4.8
4.8
5
5.2
5.4
5.6
58
6
6.2
6.5
6.7
6.9
7.1
7.3
125%
21
2.3
25
2.8
3
3.2
3.4
3.8
3.8
4
4.2
4.4
4.6
4.9
5.1
5.3
5.5
5.7
5.9
6.1
6.3
6.5
6.7
7
7.2
7.4
Point System Summary: Climate Zone 11
SCORE CARD
SC
Eff. % Glass
.15
X
Measures
1.
Ceiling Insulation
or
,1
x
R -value 1381
U -value [0.030]
2.
Wall Insulation
Ie"'II or
Z
0_
X
R -value[ 11
U -value [0.098]
3.
Raised Floor Insulation
A' � � or
SC
Eff. % Glass
.5
R -value 119]
U -value (0.037]
4.
Slab Edge Insulation
11000" or
R -value [0]
F2 facuw 1037]
5.
Infiltration
Standard
6.
Glass Heat Loss
X
[double]
U -value [0.65] % Total Glass (16]
7.
Shading (Shade Open)
COND. FLOOR
AREA
a. North
b. East
c. South
d. West
e. Skylight
8. Shading (Shade Closed)
a. North
b. East
c. South
d. West
e. Skylight
9. Interior Thermal Mass
10. Exterior.Wall Mass
11. Heating System
Zonal Control? ( Y / N )
12. Cooling System
Zonal Control? ( Y / N )
13. Water Heating
% Glass
SC
Eff. % Glass
.15
X
1 72
.�
X
,1
x
=
,6
3.7
x
=
Z
0_
X
% Glass
SC
Eff. % Glass
.5
X
(Oro5.1
X
X
=
r
x
X
TYPE 1 MASS AREA $
Interior �ss/CFA
COND. FLOOR
AREA
TYPE ''22AREA $
ND. L OR AREA �=0
EzuriorWall Mass40
.72,
x
3
= •
SE or HSPF
Duct Efficiency [0.78]
Effective SE or
[�
HSPF [029 S]
76]
x
6Z
_
SEER (9.5]
Duct Efficiency [0.74)
Effective SEFUR [7.03]
,..
_
Type [SG]
Credit [none]
Point Scores .
0
0
f-9 f''7
Sum Ib
+Z
f 07
d
Pninf rntny
11
Sum 7-10
+05
f2