HomeMy WebLinkAbout017-110-04511-30-45 647-90E
TVERSON, Scott
-120 ' 48 Merlin Lane, Chico a
Contr: Chico Electric
(ele'ctric'forl well)
11, -30-45
760'
.Permit*� P;
- 90B,,�
ew,single family)-'
'A' 1
Oil -300- O5
OI �-IID-fl`1 S
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OROVILLE, CALIFORNIA
GENERAL CLAIM
CLAIMANT: John Scotte Iversen
ADDRESS: P.O. Box 4653
CITY & STATE: Chico, CA 95927-4653 IMPORTANT:
November 5 1990 SEE INSTRUCTIONS
DATE OF CLAIM: ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
Owner has decided not to do work. Permit #760-90B,P,E,M,
AP#11-30-45, Receipt #58932, dated 3-20-90.
Total Permit Fees Paid ---------------------------------- $680.50
Retain Plan Checking Fees---------------------
Retain Building Permit Filing Fee------------- 10.00
Retain Electrical Permit Filing Fee----------- 10.00
Retain Plumbing Permit Filing Fee------------- 10.00
Retain Mechanical Permit Filing Fee----------- 10.00
Retain Energy Plan Checking Fee--------------- 15.00
Total Permit Fees Retained ------------------------------ 220.50
TOTAL REFUND DUE ----- -----------------------------------460.00
TOTAL
00
46_
1, the undersigned, declare under penalty of perjury that 'the services or articles claimed have been performed or delivered, and that this
claim is true and correct as stated.
Dated this day of ........................................O..v............... 19 .9V at....G ............ Calif. ...............G....J............�...........�.Cl
1.
Signature of Claimant
I,. the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de-
livered and that there is a Budget Appropriation ❑ or Specific Board ApprovalO (Check one) for same.
Dated this ............5,th............. .day or ,,,November 19 90 ' Oroville
et...............................Call t. ..... ......
.... P.... ....... ...... ...........
e artment Head or Authorized eputy
Dept. Exp. �1
Code .....�+4. f.-�10�.................. Code 4. 105.QO PAYABLE FROM i�Li P.L'ImLtS..............................
..... .......... FUND
DO NOT WRITE BELOW THIS LINE - AUDITORS USE ONLY
DEPT..& SUB. PROJ. SUB. OBJ.
CLAIM NO. INV. NO.
INV. DATE ENCUMB.
GROSS AMT.
' tIt ri I tfg i
i
OROVILLE, CALIFORNIA
GENERAL CLAIM
CLAIMANT: -nC)-A"J
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
J l 2 ' C/
ADDRESS: 1
0•
CITY & STATE:
C�h (_0
IMPORTANT:
DATE OF CLAIM:
�� Z �y
SEE INSTRUCTIONS
ON REVERSE SIDE
.✓30 04 A-A-� U1--OiI(o Pel-,,,
SUBMIT CLAIM
TO DEPARTMENT RECEIVING GOODS
OR SERVICES
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
J l 2 ' C/
L 44 ,q -v -z— 0 is rJ07- ?"O 63U 1 Ln A -T
5.�.t �NA J (cam nJu7- �� i3vt�p,n/�
UNT i (-- `✓ifs -z r� W 4� i i4
.✓30 04 A-A-� U1--OiI(o Pel-,,,
(j �J P�-r/1-w. t r �Pf� i� c.�r'nwJ �� •7 % O' -� ct b �U 2
N'2w SIe,1vLA, t (Zrz,5iOWC-
PC k
TOTAL
I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this
claim is true and correct as stated.
Datedthis .................................. day of ............................. 19....... at ................................. Calif.....................................................................................
Signature of Claimant
I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de.
livered and that there is a Budget Appropriation 0 or Specific Board Approval F--] (Check one) for the same.
Datedthis .................................... day of ............................. 19....... at .............................. . Callf.....................................................................................
Department Head or Authorized Deputy
Dept. Exp.
Code............................................ Code ................................................PAYABLE FROM............................................................................................ FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE
ENCUMB.
GROSS AMT.
0
INSTRUCTIONS to CLAIMANTS
All claims against the county must be itemized, giving dates and
character of service rendered or work performed, quantities, de-
scription and unit prices of articles furnished or delivered.
Claims must be certified by the claimant and submitted to the De-
partment head for approval. Upon approval the Department head
will forward claim to County Auditor for payment procedure.. Do
not file with the County Auditor first.
Claims should be presented to officials for approval immediately
upon completion of services requested or material ordered.
Claims are paid every Tuesday; however, same must be approved by
officials and in Auditor's office before preceeding Wednesday noon.
Compliance with above will expedite payment of claim, failure to do
so may delay payment considerably. _
COUNTY OF BUTTE 5 89 32
�..r��•- -_, 5 - OFFICIA RECEIPT
i OFFICE OR DEPARTMENT ISS/UING RECEIPT Z a 1950
`'. Received from Ou'J 's
-
The Sum of S U .JOn2 ✓
For NG��•�/ d `s . dG �r
Received:
/ Q �, i Received By
G
�COUNTY OF �BUTTE 60188
l�Cin. �CE�\�C/
OFFI ORD PAf�TMENT IS RECEIPT
Received from Com, C-R)
The Sum of L
For — U —
Received: C
Received By
CASH rX,
Title w _
CHECK
By
r'
�ic'.i �4C.'.Y, eF�.: �F+'.`. 4 !S.: -•-n -+.'hc•5tJ-a..;.-.�3%!��
_ .-.. -
CjDUNT`Y OF BUTTE - DEPARTMENT_ OF PUBLIC WORKS
7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
T�
0- 9
ASSESSOR PARCEL NUMBER
-30-45
ZONING
_
BUILDING PERMIT
OWNER TELEPHONE 1
SO. FT, OCC.1 BUILDING VALUATION
OWNER'S MAILING ADDRESS -
4653 CHicn q5997 I
1344P
976 8 n64 -no
CONTRACTOR'S NAME TELEPHONE
Rwli
VLH COn.Rtriictinn 891-9019
CONTRACTOR'S MAILING ADDRESS
0n 9592£
Fireplace
CONSTRUCTION LENDER UNKNOWN
Total Valuation $
Nf)nLENDER'S MAILING ADDRESS
Filing Fee
Permit Fee
$ 10.00
$ 331.00
ARCHITECT OR ENGINEER LICENSE NO.
Plan Checking Fee
165.50
ARCHITECT OR ENGINEER'S MAILING ADDRESS -
Energy Plan Checking Fee
Penalty
E$.
$ 15.00
$
BUILDING ADDRESS
Permit fee
$ 521.50
PLUMBING PERMIT
Filing Fee 10.00
19048 MPY-lin Tani-, Phirr)
Each Trap
81 2.00 16.00
Solar or heat pump water heater
20.00
LOT NO. 4 SUBDIVISION NAME PARCEL MAP I Water piping
% �� 6 Each qas water heater or vent
1 5.00 5.00
1 5.00 5.00
USE OF STRUCTURE
Gas piping system 1 - 5 outlets
5.00 1 5.00
Building sewer
5.00 .00
SF ® Duplex❑ Mobilehome❑ Other
SPECIFY
Mobile Home Is G W
10.00 e
TYPE OF WORK
New® Addition❑ Remodel❑ Utilities❑ Installation❑ Other❑
Permit Fee
$ 46.00
Contractor
Describe work: 2 bedroom, 2 Story -(existing _
ELECTRICAL PERMIT
Filing Fee 10.00
200 AMP Service & Well)
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD -L 100 AMP
2.50
CONTRACTORS LICENSE LAW
1 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
❑ 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
OR ADDNSCONST. DACELING CLBLDGO P &\
/
2'/z¢sgft 48.00
NEW CONSTR.MULTI-OUTLET
NON.RESID BRANCH CIRC ITS
2.50 ea
(POWER APPARATUS e)
SINGLE OUTLET CIR.
Ex. Occup( OUTLETS OR FIXTURES
20Q80¢
SALO 30
FIXED
RESID IEA.)
Ex. Occup. OUTLETS PR
2.00
Temporary service.
10.00
Jwasale. (Sec. 7044)
Mobile Home Facilities
15.00
I, s the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
Misc. Wiring
15.00
❑ I am exempt under Sec. , Business and Professions Code
Permit Fee
$ 58.00
for this reason
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
MECHANICAL PERMIT
Filing Fee 10.00
Heating
❑ The permit is for $100.00 (valuation) or less.
LPG
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
9YConsent to Self -Insure.
Cooling 3 Ton
1 6.00 6.00
Hood
3.00 3.00
I shall not employ any person in any manner so as to become subject
Ventilation
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
Permit Fee
$
25.00
Contractor
provisions or this permit shall be deemed revoked.
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
tobuilding 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, judgments, costs, and expenses which may in any way accrue
Mobile Home Installation Fee
$
Energy Inspection Fee
$ 3-0-.-OD-
0. nnto
c
CONST PE
TOTAL F 'E
680.50
HAz
CUA
PARK
..-s
sc
L
PAR
PO
D
ISSUE
against said County in consequence of the granting of this permit.
-This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
X Com' L-� Date q0
Signatur� a of Applicant - OWner �antractor ❑ Agent ❑
An OSHA permit is required For excavations over 5'0" deep and demolition or construct-
structures over 3 stories in height.
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
WORKS
Date
ipt No. ✓%�
r
-D. P. W., •EL LO W -ASSESSOR• PINK -INSPECTOR. GOLDENROD -APPLICANT
......_ _�.._ �..� . _ �� . �...... rr r..n.. :9:0 - 10 8 16
FOR RESIDENTIAL DEVELOPMENT
Section 26-8. 1. of the Butte County Code
requires this acknowledgement be recorded
prior to issuance of a building permit.
I'he pr.opert.v described herein is adjacent
'
rol.l.ow5:
to -I.and or included within an area zoned
90-010816 1. Rec Fee
5.00
for a gr.i.cul.t.ur.al. purposes, and residents
l Cash
5.00
of th i.s pr(.)laer. ty may he subJecL to incon-
Recorded
ven.i.ences or discomfort arising from the
Official Records I
(Z(}nJ Lo rt-
use of agr:icult..uraa chemicals, including,
County of I
but, not l.imiLed to herbicides, pesticides,
Butte
and ferOl.izers; and from the pursuit
Candace J. Grubbs 1
of agri.cu.lt_ural operations including,
r Recorder 1
but not: limited to cultivation, plowing,
1:32pm 19 -Mar -90 I
VS 1
spraying, pruning, and harvesting which
`--- - - -- --------
- ---- -
occasionally generate dust, smoke, noise, and odor. Butte County has estrab.l.:i shcd
ag'r i cu.l -
Luralrones which have as a priority use for
productive agricultural purposes, and
r.esi.dent s
within said zones and on adjacent property
should be prepared to accept such inconven-i.ence
or diSCamfcirt from normal, necessary farm operations.
Burg )
All that
real. property situate in the CounLy of Butte, State of California, (Ic:,cri-bed as
rol.l.ow5:
PAa-�ziC. q 11-5
5NorAW v^J T91 -r r f4iLJ,9i,,r PiIIILCI n gp 67,-j(, 4. PcnrtO �✓
o + Tt4r
So %t+qAS-T- i
Qv An--TL.j'L- o q sqz_-C.gl 0 I q -To wN s i -),-t P .Z 3 /v o rc.-TEF�
(Z(}nJ Lo rt-
3 �'sq S�� l� 13•
'f (A. W t4 -i GN PAIL -G £C 9lilAi' WAS �t e OriOrP p 1 Z-
Cov 7.-1 orf r3 a7m t 6T411z- Qf 0^)
300k
71
Date:
:5ZG 51 0
PROPERTY OWNERS:
State of
On
this the 1 day of p C C h 1 D_9�0, be fo rc: me,
SS. the undersigned Notary Public, personally appeared
County of
Burg )
SO � � S • �rJPr S �•�
Personally known to me. [X Proved to me on the b�isis
of satisfactory evideiic.:c.
to be the person(s) whose name(s) V%r _ __
subscribed to the within instrument and acknowledged Lhat. h -�
executed the same for the purposes therein contained.'I'N W]"'MESS
WHEREQF_ I. hereunto set my hand,—nZl�o:f f ficial seal. .
1'resen.t A.P. No. 0-30- 4fS
f
NO OF DOCUMENT
�4,Gk O
O4J
O�
-
f'. 90-0..1,_0816- ;
;.,,_'90 01��16
. ;90-010816 �+•
90-010816 Rec Fee 5.00
Cash 5.00
-�
Recorded
Official Records
County of
'
Butte
Candace J. Grupbs f
Recorder 1.
1
()
1:32pm i9 -Mar -90 1 Vs
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,
OWNER 16e I-/ •SG PP/l_ / (/r/1Sq_/ A. P. No. .)/" 30 -4/E
Proposed Building Use BR �// Building Inspector Date 32'� J
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED APPROVED
2
3
4
5
6
7
8
9
17
18
19
20
21
22
23
24
25
26
27
All items have been submitted
Plot plans in duplicate/triplicate, signed by preparer of plans........
Complete plans in duplicate/triplicate, signed by preparer of plans . .
Complete engineered plans and calcs, with wet signature on plans ..
Hazardous Material Form ..........................................
Energy Design Compliance and supporting documentation .........
Statement of Intent for Non -Heated and AC Buildings ..............
Engineered truss details and layout in duplicate (required prior to plan check)
Mobilehome installation data including manufacturer's installation
instructions.......................................................
Fees of $ ........................
Chico Urban Area fees paid .......................................
Parkfees paid ....................................................
C d!/ I a School District fees paid .............. V _,2!
Sanitation approval from C: H�i%-/ Health Department
City of Chico plumbing permit .....................................
Plot plan and business license approval from City of
(see City for other requirements)
Planning approval for (A) Use: (B) Parking: ......
Improvements may be required. Contact Land Development Section DPW
Driveway permit (construction approval required prior to occupancy)
Pre -Inspection for required .. Pre-Inspec. request to
Building Inspector
Contractor's license information (No., Name Style, Classifications ...
Certificate of Workmans Compensation Insurance ..................
Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
Recorded copy of Agricultural Acknowledgment Statement .........
Letter of signature authorization ...................................
Date)
�Whe u issue the permit, process as follows: I Ma to owner Mail to contractor.
Teleph�Y�3� and hold for pickup a;,-_Nt!��ffice. Deliver w/inspector.
Other__ 3 y1 - !�jN/,L/
Applica
Date _ 3 - 2 0 -°lO
Copy of plans sent Health Dept., Fire Dept., Other Date
The following data must be submitted prior to permit issuapce: (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 —ma II—counter by date
Plans checked by Date Plans approved by O� Date
Sets of plans on hold in . File cabinet AP folder
Copy—DPW ,r
BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
(One Form per Building)
A.P. Number ' f 31- `i Building Department No.
School District (,H/ f :p City County Q Jurisdiction
Property Owner �j �o f �V;� /z.S� �✓
- 1
Project Location/Address /2o y (?, .04EXI,1-4/ L17.JE ezhtu
Subdivision Lot Number
Residential Development:
Sq. Footage
# of Living MHI Addition (Group R)
Units ,
Commercial/Industrial: a Sq. Footage
New Addition (Including Exterior
Roofed Areas)
,Building Department Representative Date
*******************************************************************
(Floor Plans reviewed by School District Personnel)
District Id No. 3W q (09
(J n A .IA 1 4 School District certifies that
n A++ f -1� I )p r -.C, rg:::, P) K �-� - //---3 V
(Applicant Name) (Phone Number)
P.O. ?d--� q (nom 3
(Street Address)
C h i n o 0 ri of -C� riA
(City) (State) (Zip Code)
has complied with the requirements of Resolution No. g9
by the payment of $ `� 011, 7 represent i'ng I 3q square feet.
School District Representative Date
PAID BY CHECK NO. I ��
BANK NO b- 74-7
PAID BY CASH
REMARKS:
white -applicant, yellow -building department, pink -school district
SCHOOL.FEE (8/88)
5/89
RESIDENTIAL PLAN CHECKING GUIDE
MISCELLANEOUS ITEMS TO LOOK OUT FOR (CONY D)
x rior plaster - weep screeds (Sec. 4706).
roper roof pitch for roof covering (Chapter 32).
of covering type - (fire hazard).
Rafter ties or bearing ridge beam.
&`S6�rage door or porch header sizes.
�. Adequate bracing.
1.16'Living area over garage - complete 1 -hour separation required on garage side
including supporting walls and posts, etc.
Y. Two exits on three-story dwellings (Sec. 3303 & see Mezannines - 1716).
Attic access and ventilation (Sec. 3205).
X1-3:' Underfloor access and ventilation (Sec. 25.16).
-1-4-7 Combustion air for fuel burning appliances.
-1-5-. Noise requirements on duplexes.
-1-6- Adobe soils - special foundation design.
Retaining walls requiring design.
Unusual shape, size, or split level house requiring lateral design.
41.9' Flashing at all exterior openings.
�_a&Ls't
iL
/�yu�edt �ut�n2Caur "
5/89
RESIDENTIAL PLAN CHECKING -GUIDE
(S.F., DUPLEX & MISC. ONLY)
Bldg. Permit #
OWNER A.P. # 19- 145
GENERAL
'i. Zoning requirements: (sideyards and number of permitted living units).
Valuation.
Plans signed by designer.
.",Energy Design and Compliance.
Existing violations on pr per•
-tl
6 J Items on data sheet . FG�/1
PLOT PLAN
a"' -Complete parcel size and dimensions.
L�etbacks, sideyards, easements, etc.
Le Other buildings or structures.
Grading, fills, drainage.
Flood hazard.
6Cl--�pecial conditions on creation map or compliance document.
AU & FAS road setback.
PT.nnp PLAN
Complete to scale plan with dimensions.
Required windows for light and ventilation (Sec. 1205).
Required windows for second exit (Sec. 1204).
Skylights (Chapter 34 & Sec. 5207).
Human impact glass (Sec. 5406).
L6 -""-Required room sizes, ceiling heights (Sec. 1207).
GFCIs in baths, garage, and exterior outlets (Article 210-8).
($Light fixtures, switches, receptacles, and exterior receptacles for maintenance
mechanical equipment.
Q! 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)).
]��-replace
3'0" exterior exit door (Sec. 3304(e)).
and wood stove location, alcoves, and clearance.
4-5�--Smoke detectors (Sec. 1210).
STRUCTURAL DETAILS
1 Foundation plan complete enough to construct building.
'-2. Floor construction details complete enough to construct building.
�3� Elevations and wall construction details complete enough to construct building.
l Roof construction details complete enough to construct building.
Fireplace construction details and talcs if necessary.
MISCELLANEOUS ITEMS TO LOOK OUT FOR
L4'."' -Stairway details: landings, rise and run, head clearance, handrails (Sec. 3306).
Guardrail details (Sec. 1711 & 3306(j)).
-3:'- Brick or stone. veneer (Chapter 30).
HOT WATER SYSTEMS 'rank Manufacturer/Model #
System'Type (storage b ) Capacity (or.apprgved equal) Special Feature(s)
s`%°di�6f' x.95 .� •�T�1�' X/D.t/� - . �
= SPECI•AL FEATURES/REMARKS (Add extra sheets if necessary)
COMPLIANCE STATEMENT
This certificate of compliance lists tile building features and performance specifications needed to comply with
'Title 24, Chapter 2-53 and Title 20, Chapter 2, Subchapter 4, Article 1 of the California Administrative code. -,This "
certificate has been signed by the individual with overall design responsibility and the building owner,'who shall1 ` .
retain a copy of it and transmit the certificate to any subsequent purchaser of the building. When this certificate, -of..,
compliance is submitted for a single building plan to be built in multiple orientations, all building conservation' •
features which vary are indicated in the Special Features/Remarks section:..
Designer Building Owner
Name: _ Name:, .. :...__ ....._._—.— ..�.._ ,
Title/Firm: J1'i!Ct1 o J. .% l7. Title/Fimi: Y- I -
2570 •oval Ci -cla Address:..
Address: -
Telephone: Telephone:
(signature) (date) (signature) __._ (date) ;
Documentation Author -- Enforcement Agency
Name: Name:
• Title/Firm: Agency:` -
Address: Telephone:-
Telephone:
elephone• -Telephone:
(signature)
Form Revised March 1988
(date)
(signature or stamp) (date) • `
p FEB 11990
Certificate of Compliance:
Residential
(Page 2 of 2) CF411 ..
s -• - frojectTitle ...-- — --
- _...
_ ..
;: Date _.
HVAC SYSTEMS
_
Minimum
Duct
I Type (furnace, air
Efficiency
Location
Duct Output
Manufacturer Model #
;. conditioner, heat um)
(SE, SEER,I4SPF)
(attic, ere.)
R -Value (Btuh)
(or approved equal)
&sr
_........
' Maximum Furnace Heating Output:
Btuh
HOT WATER SYSTEMS 'rank Manufacturer/Model #
System'Type (storage b ) Capacity (or.apprgved equal) Special Feature(s)
s`%°di�6f' x.95 .� •�T�1�' X/D.t/� - . �
= SPECI•AL FEATURES/REMARKS (Add extra sheets if necessary)
COMPLIANCE STATEMENT
This certificate of compliance lists tile building features and performance specifications needed to comply with
'Title 24, Chapter 2-53 and Title 20, Chapter 2, Subchapter 4, Article 1 of the California Administrative code. -,This "
certificate has been signed by the individual with overall design responsibility and the building owner,'who shall1 ` .
retain a copy of it and transmit the certificate to any subsequent purchaser of the building. When this certificate, -of..,
compliance is submitted for a single building plan to be built in multiple orientations, all building conservation' •
features which vary are indicated in the Special Features/Remarks section:..
Designer Building Owner
Name: _ Name:, .. :...__ ....._._—.— ..�.._ ,
Title/Firm: J1'i!Ct1 o J. .% l7. Title/Fimi: Y- I -
2570 •oval Ci -cla Address:..
Address: -
Telephone: Telephone:
(signature) (date) (signature) __._ (date) ;
Documentation Author -- Enforcement Agency
Name: Name:
• Title/Firm: Agency:` -
Address: Telephone:-
Telephone:
elephone• -Telephone:
(signature)
Form Revised March 1988
(date)
(signature or stamp) (date) • `
p FEB 11990
L
_ � ,,. � . � .• , a.. kms. r, ..
, COUNTY OF BUTTE -,DEPARTMENT OF PUBLIC WORKS
1 7 County Center Drive - Oroville. California 95965 -Telephone: 916/538-7541
APPLICAT11CIN-ARID PERMIT .
PERMIT NO.
PO—so
ASSESSOR PARCEL NUMBER
11-30-45
ZONING -
FR -5
BUILDING PERMIT
OWNER
Scott Iversen
TELEPHONE
93-1134
SO. FT. OCC. 'BUILDING VALUATJON
OWNER'S MAILING ADDRESS
P.O. Box 4653 Chico 95926
t
CONTRACTOR'S NAME
Chico Electric
TELEPHONE '
891-1933
CONTRACTOR'S MAILING ADDRESS
36 West Eaton Rd., Chico 95926
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Pian Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
-
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
12048 In Lane. Chico
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex,❑ Mobilehome❑ Other well .eipptric
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W 1 1
110-00@
TYPE OF WORK
New Addition ❑ Remodel❑ Utilities❑ Installation[] Other ®
Describe work: _
Well Electric — for Trees
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 6111 OR LESS
100 AMP OR LESS
10.00
Main Service EA, ADO'L 100 AMP
2.50 2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury
p y p I y (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Profession_ AACode,{and my license is in full force and effect.
License No.�T�49'Classification C_
❑ 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
NEW CONST. ( DWELLING OCCUP.&\
OR ACDNS. ACC. BLDGS.
/Z¢sgft
NEW RESIO. MULTI -OUTLET
NON-RESID BRANCH CIRC ITS
2,50 ea
(POWER APPARATUS e�
SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
20@50:
13AL@30
IXED
Ex. Occup. OUT ETS P(RESID.)REA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
X15.00 15.00
Pre -Inspection
X 15.0 15.00
Permit Fee
$ 52.50
Contractor
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.
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
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 toe ter upon the ove mentioned property for inspection purposes.
1 also agr a to save, in emnif and keep harmless the County of Butte against
all liabil les, judgmen s, co s, and expenses which may in any way accrue
again t 9si County honseluence of the granting of this perit.
X Date— 37
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 in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $ 52.50
HAz
cuA
PARK
SCHL
FLD
PAR
PD
HD
Issu
This permit is nereby issued under
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTORrOF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
D
�3`stories
Receipt No. J
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
\.J I.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville;=Califotnia 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
?9D j
ASSESSOR PARCEL NUMBER
11-30-45
ZONING
FR -5
BUILDING PERMIT
OWNER
Scott Iversen
TELEPHONE
893-1134
SQ. FT. OCC. BUILDING
VALUATION
OWNER'S MAILING ADDRESS
P.O. Box 4653 Chico 95926
"
CONTRACTOR'SNAME
C891-1933
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
36 West Eaton Rd., Chico 95926
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
Energy Plan Checking Fee
A$ $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other wPl l P1 Pr1-ri r
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
-
Mobile Home S G W
10.00e
TYPE OF WORK
New❑ Addition❑ Remodel[] Utilities❑ Installation❑ Other®
Describe work: _
WP11 Fl Prtri r - for TrPPs
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service jp0 AMP OR1 OR LESSv
10.00
Main service EA. ADD -L too AMP
2.50
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 effect.
and Prof essi ons ode and my license is in full force and
License No. Classification GI V
❑ 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
oR ADDNST ( DACELLLDGNG OCCUP.&)
21/2¢sgft
NEW CONSTRMULTI-OUTLET
NON-RESID BRANCH CIRC ITS
2,50 ea
(POWER APPARATUS 61
SINGLE OUTLET CIR. /
Ex. Occup(OUTLETS OR FIXTURES
20@g0¢
.20@50
EX. OCCUp- OUTLETS FIXED P(RESID.)REA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
X 15.00 15.00
Pre -Inspection
X 15.001 15.00
Permit Fee
$ 52.50
Contractor
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.
MECHANICAL PERMIT
FiIirig Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
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 Countyot
Butte to a ter upon the ove-mentioned property for inspection purposes.
1 also agr a to save, in emnif and keep harmless the County of Butte against
all liabil ies, judgmen s, co s, and expenses which may in any way accrue
again t s ' County n onse uence of the granting of this per it.
c
X DateA
Signature of Applicant - Owner
g pp 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.
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST TYPE
TOTAL FEE $ 52.50
HAz
CUA
PARK
SCHL
FLo
PAR
PD
HD
Issu
This permit is hereby issued under
sions or the Butte County Code and/or
work indicated above f r which fees
�DIR T R F PUBLIC
By
PERMIT E PIRES Date
the applicable provi-
resolutions to do
have been aid.
p
WORKS
Dice � he
Receipt No.
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville. Ca,lifQfnia 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
r- 3 0 �
ZONING
fl<- S~' I
BUILDING PERMIT
OWNER
JG d0'� I!J,�(�S/f'�/
TELEPHONE
Qc/3- 113v
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS ('1;9 C /
-o.4-V .$� / L (. %�
CONTgg��CTOR'S NAME
C�A/�L � 'crtz 1 --T;/
TELEPHONE
- i 3
CONT�ACTOR•S MAILING ADDRESS
Uo!O� 51`
Fireplace��/ii
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
�2o�/ g
/ L/�✓
Each Trap
2,00
C'/y/L O
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME PARCEL MAP
Water piping
5.00
Each qas water heater or vent
USE OF STRUCTURE r
L f�ZL IfL�crltl
SF ❑ Duplex❑ Mobilehome❑ theme SPECIFY
Gas piping system 1 - 5 outlets
Building sewer
Je
Mobile Home S G W
0
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ar
Describe work: �� I ctee a
Permit Fee
$
Contractor -
ELECTRICAL PERMIT
Filing Fee 10.00,
Main service 1011 OR LESS
100 AMP OR LESS
10.00 0, Ca
Main service EA. AOD'L 100 AMP
2.50 2,
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 Professionod and y license is in full force and effect.
License No. Classification �)�
❑ t, 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
OCCUP.ra`
NEW CONST. / DWELLING OR ADONS. ACC. BLDGS. 1
\
�Z
,dsq it
NEW CONSTR ULT' -OUTLET
Nr BRANCH CIRC ITS
2.50 ea
POWER APPARATUS tr\
SINGLE OUTLET CIR.
Ex. OCcup�OUTLETS OR FIXTURES
OAL9oc
20@93031
Ex. Occup. OUTLETS ED APPRESIO )REA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
9
15.00
ai✓
>-' %S– 1
Permit Fee
$ SZ —
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
FiIingFee 10.00
Heating
Cooling
g
Hood
3.00
Ventilation
Permit Fee
$
Contractor
I certify that I have readis application and state that the above information
y to all County Ordinances and State Laws relating
is correct. I agree to comtnid
to build' g construction, hereby authorize representatives of the Countyot
Butte to nter upon the above-mentioned property for inspection purposes.
I also ag ee to save, Inde ify and keep harmless the County of Butte against
all liabil ties, judgments, 1st and expenses which may in any way accrue
again t s i u y i co nce of the granting of this perm. t7 .
X Date
Signature of Applicant — Owner ❑ Contractor Agent ❑
An OSHA permit is required for excavations over 5' deep and demolition or construct•
ion of structures ovepr-3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE 5 S-
ALL
HA2
CUA
PARK
FLo
PAR
Pb
Ho ssuE
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 appiicable provi-
resolutions to do
have been paid.
WORKS
Date
Receipt No. U q ? 9t
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. 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. >�
OWNER S / �� /� _5�1/ A. P. No.
Proposed Building Use 1%C// P_Ae1_- t c, Building Inspector C-� Date c1�
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 .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions.......................................................
10. Fees of $ ........................
11. Chico Urban Area fees paid .......................................
12. Park fees paid ....................................................
13. School District fees paid ..............
14. Sanitation approval from Health Department
15. 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
(:)&/1 Driveway permit (construction approval required prior to occupancy)
20. Pre -inspection for fi /-,Cz % < <- required Pre-Inspec. request to -S
Building Inspector te)
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
23. wner-Builder Verification (Given to owner ❑, Mail to owner ❑) .....
2 . R corded copy of Agricultural Acknowledgment Statement .........
5. L ter of signature authorization ...................................
27.
When you issue the permit, process as follows: ail to owner -Mail to contractor.
Telephone
Other
Copy of plans sent
and hold for pickup ate off ice.
Applicant
Health Dept., Fire Dept., Other
The following data must be submitted prior
1. Index permit for above items No.
2. Additional items required:
Deliver w/inspector.
to
Date
it issuance: (Circle new item not 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 _maiI—counter by date
Plans checked by Date Plans approved by Date _
Sets of plans on hold in . File cabinet AP folder
Copy—DPW
PRE -INSPECTION
1 L
OWNER: DATE��
LOCATION:
tQ �, _ A.P.
Z n � � ��v � •
CONTRACTOR:
ZONING
PRE -INSPECTION FOR:
DATE TO INSPECTOR &//z
PERMIT HISTORY: NONE AS FOLLOWS:
TYPE OF OCCUPANCY
FIELD - INFORMATION
BUILDING USAGE: �V"""`'��"` "w V
TENNANT: -.
[� OCCUPIED HAS ELECTRIC HAS GAS E] HAS SANITATION FACILITIES
HEATED -COOLED PERSON CONTACTED
nTHFR rnmmFN'I: q : --
ACTION RECOMMENDED:
Mf ISSUE Q HOLD FOR
OTHER:
BY
DATE
1. Ceiling Insulation
2. Wall Insulation
1
4
Number
of stories
16
R -value
One
Two
Three
R-0
-103
-49
-32
R-19
-8
-4
-2
R-30
.2
-1
-1
R-38
0
0
0
U -value
R-19
8 6
4
0.50
-176
-84
-54
0.30
-102
-49
32
0.10
-26
-13
-8
0.08
-18
-9
-6.
0.06
-11
-5
-4
0.04
-4
-2
-1
0.02
4
2
1
0.00
11
5 -
3
S. Infiltration (Air Leakage)
Spacification Points
Standard 0
6. Glass Heat Loss
2. Wall Insulation
1
4
Total
Single- Single -
16
4
2
Family Family
Multi -
Percent
R -value
Detached Attached
Family
.41 to
R-0
-68 -51
-34
Double
R-11
0 0
0
less
R-13
2 2
1
-39
R-19
8 6
4
40
U -value
37
-26
-14
0.80
-153 -114
-76
-75
0.50
-91 -68
-46
1
0.30
-47 -36
-24
-21
0.10
0 0
0
12
0.08
4 3
2
-12
0.06
9 7
5
28
0.04
14 11
7
.2
0.02
19 14
10
-52
0.00
24 18
12
6
13
26
-49
-15
3. Raised Floor Insulation
-1
7
14
Insulation in Floor
-46
-14
-7
Number of stories
7
14
R -value
One Two
Three
-5
R-0
-17 -8
-5
23
R-11
-3 -2
.1
2
R-19
0 0
0
-37
R-30
3 1
1
9
U -value
21
-34
-7
0.60 .
-144 -70
-46
15
20
31
-6
0
0.40
-95 -46
.-W
19
0.30
-69 -34
-22
6
0.20.
-43 -21
14
-26
0.10
-17 -8
-5
i
0.08
-11 -6
-4
-1
0.06
-6 -3.
-2
17
0.04
-i 0
0
4
0.02
4 2
1
15
0.00
10 5
3
10
Controlled
Ventilation Crawispace
14
-14
Number of stories
7
10
R -value
One Two
Three
-12
R-0
-11 4
-5
15
R-5
-4 -4
3
6
R-11 '
-2 -2
-2
19
R-19
-1 2
-2
10
4. Slab Edge Insulation
16
19
- - ' -
Number of Stories
9
11
R -value
One Two
Three
9
R-0
0 0
0
15
R-5
8 5
2
2
R-7
8 6
3
18
F2 factor
1
1
1
0.90
-4 -3
-1
2
0.80
-1 -1
0
0
0.70
2 2
1
-34 -30
0.60
6 4
2
-10 -9
0.50
9 6
3
0 0
0.40
12 8
4
S. Infiltration (Air Leakage)
Spacification Points
Standard 0
6. Glass Heat Loss
5
1
4
Total
na
16
4
2
U -value
1
Percent
14
4
.51 to
.41 to
.31 to 0.30 or
Glass
Single
Double
.60
.50
.40
less
50
-121
-53
-39
-24
-10
4
40
-90
37
-26
-14
3
8
35
-75
-29
-19
-9
1
10
30
-61
-21
-13
-4
4
12
29
-58
-20
-12
-3
5
12
28
-55
-18
-10
.2
5
13
27
-52
-17
-9
-2
6
13
26
-49
-15
-8
-1
7
14
25
-46
-14
-7
0
7
14
24
-43
-12
-5
1
8
14
23
-40
-11
-4
2
8
15
22
-37
-9
3
3
9
15
21
-34
-7
-2
4
10
15
20
31
-6
0
5
10
16
19
-29
-4
1
6
11
16
18
-26
-3
2
7
12
16
17
-23
-1
3
8
12
17
16
-20
0
4
9
13
17
15
-17
1
6
10
14
17
14
-14
3
7
10
14
18
13
-12
4
8
11
15
18
12
-9
6
9
12
15
19
11
-6
7
10
13
16
19
10
3
9
11
14
17
19
9
-1
10
13
15
17
20
8
2
12
14
16
18
20
7..Shading (Shade Open)
Efrective Percent Class
(percent glass x SC)
Effective
%Glass North East South West Skylight
18
5
1
4
1
na
16
4
2
5
1
na
14
4
2
5
1
na
12
3
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
11 13
14 14
8.5 7
10
a3. Shading (Shade Closed)
14 15
10. Exterior Wall Thermal Mass
EfEectlye Percent Class
Single- .
Single.
(percent glass x SC)
Wail
Effective
Family
Multi
Mass
Detached
Attached
%Glass
Norlt
Eat
Sotto
West
Skylight
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
na . not allowed
-24 .18
0.40 3.67
-34 -30
-26 -22
9. Interior Thermal Mass
Interior
Slab Floor
Raised Floor
Mass
Stories
Stories
/CFA One Two Three One
Two Three
0.0 -8
-5
-4 -2
.1 -1
0.1 -8
-5
3 -1
0 0
0.3 -7
-4
-2 0
1 1
0.5 -6
-3
-1 1
1 2
0.7 -5
-2
.1 1
2 2
0.9 -5
-1_
0 2
3 3
1.1 -4
-1
1 3
4 4
1.3 -3
0
2 3
4 5
1.5 -3
1
2 4
5 5
2.0 -1
2
4 5
6 7
2.5 0
3
5 7
7 8
3.0 1
4
6 8
8 9
3.5 2
5
7 9
9 10
4.0 3
6
8 9
10 10
4.5 3
7
8 10
11 11
5.0 4
7
9 11
12 12
5.5 5
8
9 11
12 12
6.0 5
8
10 12
13 13
6.5 6
9
10 12
13 13
7.0 6
9
11 13
13 14
7.5 6
10
11 13
14 14
8.0 7
10
11 13
14 14
8.5 7
10
12 13 •
14 15
10. Exterior Wall Thermal Mass
Exterior
Single- .
Single.
23 19 15
Wail
Family
Family
Multi
Mass
Detached
Attached
Fam4
0.00
0
0
0
0.20
3
2
1
0.40
5
4
3
0.60.
8
6
.4
0.80
10
8
5
1.00
13
10
7
1.20
13
12
8
1.40
12
13
9
1.60
10
13
11 ...
1.80
10
12
12
200
10
11 -_
.13
i
11. Heating System
or Solar
12 ° ` 8 6
5
SE or
HSPF
8. 5 4
(assumes ducts In attic)
3
WSB
Sum of 1.6
_
725
or -2 to
-14 to 4 to
_4
+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
2
Efrective SE or HSPF
(SE
or HSPF x duct eMciency)
Effective -25 or -24 to -14 to d to +6 to 16 or
SE HSPF less -15
.5 +5 +15 more
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
System Type
2
2
SE None
Resistance
10 9
7 6
4 3
Other
6 5
4 3
2 2
12. Cooling System
SEER
(assume: ducts In attic)
Stm of 7-10
-25 or -24 to 44 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
-4 -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'
120 15
13 11 9
7
5
13.0 20
17 14 12
9
_ 6
Effective SEER
(SEER xdud efficiency)
Stm of 7-10
Effective -25 or
-24 to -1410 .410
+610
' 16 or
SEER less
-15 -5 +5
+15
more
5.0 -30
-25 -21 -17
-13
-9 ,
6.0 -12
-11. 1-7
-6
4 1
6.6 -5
4 -4 3
-2
2
7.0 0
0 0 0
0
0
8.0 9
8 6 6
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
Zonal Control Adjustment
j 10
8 7 6
4
3
No
Cooling System Installed
Stories
One -5
-4 -4 -3
-2
-2
Two + 3
3 2 2
2
1
Single -Family Detached and
Attached
I Unit Size (sQ
Water
i199 1200 1700
2200
2700
Heater Credit
or 1 to to
to
or
Type. Type
less .1699 2199
2699
more
SG None
0 it 0 A.
0
0
or Solar
12 ° ` 8 6
5
4
HP -HWR
8. 5 4
3
3
WSB
5 3 3
2'
2
POU
8_ 5 4
3
3
SE None
37 -24 -18
-15
-12
Solar
-1 -1 .1
0
0
HWR
-18 -12 -9
-7
-6
WSB
-25 -16 -12
-10
.8
POU
-18 _-12 -9
-7
-6
IG None
-5 -3 -2
-2
-2
Solar
7 5 -4
3
2
POU
3 2 1
1
1
IE None
-28 -19 -14
-11
-9
Solar
8 5 4
3
3
POU
-10 -6 -5
4
-3
Multi -Family, (Individual units)
n size (sp
Water
699 700 1200
i700
2200
Heater Cred-d
TypeType
or 10 to
less 1199 1 699
m
3199
-or
SG None
0 0 0
0
more .
0,
or Solar
14 7 5
4'
3
HP HWR
9 5 3
2
2
WSB
9 4 3
2
2
POU
9 5 3
2
2
SE None
-45 -23 -15
.11
-9
Solar
2 1 1
0
0
HWR
--23 -12 -8
-6
5�
WSB
-25 -13 -8
1 -6
.5
_R U.
_23 -12 -8
-6
.5'r. ,
IG None
-8 -4 -3
-2
-2
Solar
6 3 2
1
1
_ POU
1_0 - 0_
0
0
IE - None
30 -15 -10
• -8
-6
Solar
18 9 6
4
4
POU
-8 -4 .3
-2
-2
Interior Mass/CFA
\ TTPE 2 PASS
11.7.ur"c\.21
le•�ve \.d .1_bl .t TYPE 1 MASS (UIMC & 4.2, ie: exposed slab)
0% 5% 1OY. 15% 20% 25% 30% 35% 40% 45% 50% 55% 60% 69t 70% 75% 80% , 857'. 90% 95% 100% 105% 110y. 115% 120% 125'
V. 0 0.2 0.4 0.6 0.8 1.1 1.3 1.5 1.7 1.9 2.1 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 5.3
10y. -0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.9 2.1 2.3 2.5 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 2.2,24'21 29 3.1 3.3 3.5'3.1 3.9 4.1 4.3 4.5 4.8 5 5.2 5.4 56
30% 0.5 0.7 0.9 1.1 1.4 1.6 1.8 2 2.2 24 ' 2.6 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
40% 0.7 0.9 1.1 1.3 1.5 1.7 1.9 22 24 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
5095 0.9 1.1 1.3 13 1.7 1.9 21 23 2.5 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 5.8 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 55 5.7 5.9 6.1 6.4
70% 1.2 1.4 1.6 1.8 2 2.2 2.5 27.2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3.•4.6°4.8 5 5.2 5.4 5.6 58 6 6.2 64
75% ; 1.3 1.5 1.7 1.9 21 2.3 25 27 13 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 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 56 5.8 6 6.2, 64 66
85% 1.4 1.7 1.9 2.1 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 52 54 5.6 59 6.1 63 65 67
90% 1.5 1.7 2 2.2 2.4 Z6 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 4.8 5 5.2 5.4 5.6 5.8 '6 6.2 6.4 6.7 6.9
100Y. � 1.7 1.9 2.1 2.3 2.5 Z8 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 53 5.7 5.9 6.1 6.3 6.5 6.7 7
105% 1.8 2 2.2 2.4 2.6 2.8 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
Itoy. 1.9 2.1 2.3 2.5 2.7 2.9 9.1 3.3 3.8 3.8 4 4.2 4.4 4.6 4.8 5 5.2 5.4 5.7 5.9 6.1 6.3 6.5 6.7 69 7.1
115% 2 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 5.1 5.3 S.5 5.7 5.9 6.2 6.4 6.6 6.8 7 . 7.2
120% 2 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.4 4.6 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 3.6 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
Measures
1. Ceiling Insulation P, !0 or
R -value [38] U -value [0.030]
2. Wall Insulation YlZ 19 or
R -value [11] U -value [0.098]
3. Raised Floor Insulation
4. Slab Edge Insulation
5. Infiltration
6. Glass Heat Loss
7. Shading (Shade Open)
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
. r '
11. Heating System
• " �,tZonal�Coitrol? (Y / N )
r 12 iCooling System ,
t' Zonal Control? ( Y / N )
13. Water Hing
eat
r
or
R -value 1191 U -value [0.037]
or
R -value [0] F2 factor [0.77]
Standard
1I'
Type [double] U -value [0.65] % Total Glass [ 16]
% GlassO�. Y SC Eff.71
? Gla
X =ks i 1E
X = 3. 73
�. X =IJ
X =
%GlassSSC Eff.%
X _
X
X Gly _ Aj,
----J'7-
TYPE 1 MASS AREA %
Interior Mass/CFA COND. FLOOR AREA
TYPE 2 MASS AREA $
Exter%orWall Mass
ND. FLOOR AREA
6 X 93
SE or HSPF Duct Efficiency [0.78] Effective SE or
[0.7y¢.61 HSPF 10.5 151
(� X Y =7 3b
SEER [9.5] Duct Efficiency [0.74] Effective SEER [7.03]
�G
Type [SG] Credit [none]
Point Scores
Sum 1.6
4-1
0
Sum 7-10
a
D.. S... T...../.
Certificate of Compliance: Residential Climate Zone 11
Project Title
BUILDING DATA
Cnnditioned Floor Area
sed Floor
Single Family Detached (SFD)
[ ] Single Family Attached (SFA)
(] Multi -Family (MF)
Noo -QO
Building Permit #
ks -/-3
Checked By / Date
Fnforon. ent ARencv Use only
GWLArea %
North
Number of Stories 4—East
Number of .Units South _
[ ] Addition Alone West —
[ ] Existing Building Skylight —
(] Existing -Plus -Addition Total -0
BUILDING SHELL INSULATION.
Component Insulation Locafion/Commenits
TvDe R -Value (attic, to garage, typical,
Wall...... ...
Wall ..............
Roof ............
Roof ..t ..........
Floor... .........
Floor.. ...
Slab Edge.....
GLAZING
Glazing
Shading Devices
Area Glass Type Interior Exterior Overhang Framing Type
North ( )Jf�,.
� /)4
North ( )
East ( )
:.�. t�14
EastSouLh ( )
(
Sou til
Duct
West ( )
N A
West
Location Duct '
Skylight. ...
THERMAL MASS << -
Type/Covering
L ' Area Thickness
(slab/ex22 ecltile. etc.) (SO (inches) Locadon/DCseription (kitchen. bath, etc.)
Maximum Fumace Heating Output: Btuh
HOT WATER SYSTEMS
f Tank Manufacturer/Model #
Svstem Type (storage gas, etc.) Capacity (or approved equal) Spe�a�lfi'.e
rte► 07
SPECIAL-FEATURESIREMARKS (Add extra sheets if necessary)
1
l
l
I
I
Mandatory Measures Checklist: Residential - MF -1R
NOTE. Lowrise residential buildings subject to the Standards must contain these measures regardless of the comPliance
approach used. Items marked with an asterisk (•) may be superseded by more stringent compliance: requucn=u listed
on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall
be considered by all parties as binding minimum component performance specifications for the mandatory measures
whether they are shown elsewhere in the documents or on this checklist only.
DESCRIPTION DESIGNER ENFORCEMENT
Building Envelope Measures
• §2.5352(a): Minimum ceiling insulation R-19 weighted average.
§2.5352(b): Loose fill insulation manufacturer's labeled R -Value.
• §2.5352(c): Minimum wall insulation in framed walls R -I 1 weightedaverage (does not apply to
exterior mass walls).
§2.5352(k): Slab edge insulation - water absorption rate no greater than 03%. water vapor
transmission rate no greater than 2.0 permlumch.
§2-5311: Insulation specified or installed meets California Energy Commission (CEC) quality
standards. Indicate type and form.
§2.5352((): Vapor barriers mandatory in Climate Zonas 14 and 16 only.
§2.5317: Infiltration/ExfiltrationControls
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 staled
§2.5352(e): Special infdcration barrier installed to comply with 12.5351 meets CEC 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 and control
c. Flue damper and control
2. No continuous burning gas pilots allowed.
HVAC and Plumbing System Measures
12-5352(8) and 2-5303: Space conditioning equipment siring: attach calculations.
§2-5352(h) and 2-5315: Setback thermostat on 311 applicable heating systems.
• §2-5316(a): Ducts constructed, installed and insulated per Chapter 10, 1976 UMC.
§2-5316(b): Exhaust systems have damper controls.
§2-5314(c): Gas -rued space 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 interiorkxterior
insulation (R-16 or greater); fust 5 feet 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
I. System has:
a. On/off switch on heater.
b. Weatherproof instruction plate on heater:
c. Plumbed to allow for solar.
2. 75 percent thermal efficiency.
3. Pool cover.
4. Time clock.
5. Directional water inlet.
Lighting and Appliance Measures
§2.53520): Lighting - 25 lumens/wart or greater for general lighting in kitchens and bathrooms.
12-5314(c): Gas fired appliances equipped with intermittent ignition devices.
§2.5314(a): Refrigerators• refrigerator -freezers. freezers and fluorescent lamp ballasts certified
by the CEC. Indicate make and model number.
COMPLIANCE STATEMENT
This certificate of compliance lists the building features and performance specifications needed to comply with
Title 24, Chapter 2-53 and Title 20, Chapter 2. Subchapter 4. Article 1 of the California Administrative code. This
certificate has been signori by the individual with overall design responsibility and the building owner. who shall
retain a copy of it and transmit the certificate to my subsequent purdtaser of the building.
Designer
Name:`
TttwFum
Address:
Tckphonec
tic. 8:
(signature) (date)
Documentation Author
Name:
TitkJFirm:
Address:
Building Owner
Name: SGS' ZyiEX5C/d
Titk/Frm-
Address: o 6 -ax Yb s 3
C�th.c.o 69c- qrc z
Telephone f7�r �tf ` 3(o2Y
(kg n) ) (date)
Enforcement Agency
Name:
Agency:
Tekphotte
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)
V- N.
Maximum Fumace Heating Output: Btuh
HOT WATER SYSTEMS
f Tank Manufacturer/Model #
Svstem Type (storage gas, etc.) Capacity (or approved equal) Spe�a�lfi'.e
rte► 07
SPECIAL-FEATURESIREMARKS (Add extra sheets if necessary)
1
l
l
I
I
Mandatory Measures Checklist: Residential - MF -1R
NOTE. Lowrise residential buildings subject to the Standards must contain these measures regardless of the comPliance
approach used. Items marked with an asterisk (•) may be superseded by more stringent compliance: requucn=u listed
on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall
be considered by all parties as binding minimum component performance specifications for the mandatory measures
whether they are shown elsewhere in the documents or on this checklist only.
DESCRIPTION DESIGNER ENFORCEMENT
Building Envelope Measures
• §2.5352(a): Minimum ceiling insulation R-19 weighted average.
§2.5352(b): Loose fill insulation manufacturer's labeled R -Value.
• §2.5352(c): Minimum wall insulation in framed walls R -I 1 weightedaverage (does not apply to
exterior mass walls).
§2.5352(k): Slab edge insulation - water absorption rate no greater than 03%. water vapor
transmission rate no greater than 2.0 permlumch.
§2-5311: Insulation specified or installed meets California Energy Commission (CEC) quality
standards. Indicate type and form.
§2.5352((): Vapor barriers mandatory in Climate Zonas 14 and 16 only.
§2.5317: Infiltration/ExfiltrationControls
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 staled
§2.5352(e): Special infdcration barrier installed to comply with 12.5351 meets CEC 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 and control
c. Flue damper and control
2. No continuous burning gas pilots allowed.
HVAC and Plumbing System Measures
12-5352(8) and 2-5303: Space conditioning equipment siring: attach calculations.
§2-5352(h) and 2-5315: Setback thermostat on 311 applicable heating systems.
• §2-5316(a): Ducts constructed, installed and insulated per Chapter 10, 1976 UMC.
§2-5316(b): Exhaust systems have damper controls.
§2-5314(c): Gas -rued space 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 interiorkxterior
insulation (R-16 or greater); fust 5 feet 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
I. System has:
a. On/off switch on heater.
b. Weatherproof instruction plate on heater:
c. Plumbed to allow for solar.
2. 75 percent thermal efficiency.
3. Pool cover.
4. Time clock.
5. Directional water inlet.
Lighting and Appliance Measures
§2.53520): Lighting - 25 lumens/wart or greater for general lighting in kitchens and bathrooms.
12-5314(c): Gas fired appliances equipped with intermittent ignition devices.
§2.5314(a): Refrigerators• refrigerator -freezers. freezers and fluorescent lamp ballasts certified
by the CEC. Indicate make and model number.
COMPLIANCE STATEMENT
This certificate of compliance lists the building features and performance specifications needed to comply with
Title 24, Chapter 2-53 and Title 20, Chapter 2. Subchapter 4. Article 1 of the California Administrative code. This
certificate has been signori by the individual with overall design responsibility and the building owner. who shall
retain a copy of it and transmit the certificate to my subsequent purdtaser of the building.
Designer
Name:`
TttwFum
Address:
Tckphonec
tic. 8:
(signature) (date)
Documentation Author
Name:
TitkJFirm:
Address:
Building Owner
Name: SGS' ZyiEX5C/d
Titk/Frm-
Address: o 6 -ax Yb s 3
C�th.c.o 69c- qrc z
Telephone f7�r �tf ` 3(o2Y
(kg n) ) (date)
Enforcement Agency
Name:
Agency:
Tekphotte