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HomeMy WebLinkAbout024-080-115/ ' | | | ' ------� ---------------� ---------� - " ,ROBERTS, Brad419 O'Brien Ave., Gridley024-08-0-115 92-3686B.ROBERTS, Brad4i9 O'Brien Ave, Gridley `-__ - r__�_� _ - _ -.-. -._ c-..- _ v V I � �7 �-�•� J 1i1 i` 0 Cie COUNTY OFo BUTTE DEPARTMENT OF PUBLIC WOF PERMIT N 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 024-080-115 ZONING A 5 BUILDING PERMIT OWNER BRAD ROBERn TELEPHONE 81 V ��716 SQ.FT. OCC. BUILDING VALUATION OWNER*S MAILING ADDRESS 419 01BRIAN AVE GRIDLff 95948 CONTRACTOR'S NAME owm TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ 15.W ARCHITECT OR ENGINEER E NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 419 O'BRIAN AVE GRIDIM 9,5948 Permit fee $ 30.00 PLUMBING PERMIT FilingFee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME 1 PARCE MAP Water piping 7.00 Each qas water heater or vent 7.00, — USE OF STRUCTURE SF DuplexF� Mobilehome[] Other SPECIFY Gas piping system 1 - 5 outlets 5.001 Building sewer _T_F_ 15.00 Mobile Home S FG W @ 15.00 TYPE OF WORK r Ne%0 Additiol Remodel [I Uti I i ties [J Instal I ation E� 6ther Describe work: FOR LANDING5:5��RS� RF Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS CONTRACTORS LkE�NNSE LAW I declare under penalty of perjury (check one . EJ I am licensed under provisions of Chapt. 9, Div. 3 of the Busines S 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 I., for sale. (Sec. 7044) El 1, as the owner, aim exclusively contracting with licensed Ontract- ors. (Sec. 7044) ic 0 1 am exempt under Sec.—, Business and Professions Code for this reason Main service 200A TO 1 OOOA) 37.501 NEW CONST DWELLING OCCUP. 3.64 sq.ft.1 OR ADDNS. ACC.BLDGS. NE CON I"ULT'fiTLET NOWN-RESIS-T."' BRANCH CIRCUITS) @ 5.00 POWER APPARATU &) SINGLE OUTLET CIR. Ex. OCCLIP( OUTLETS OR FIXTURES 20 @ 7 97c 5AL_ 50) 46 FIXED APPLNS. OR — Ex. Occup. OUTLETS (RESID.) EA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): [_ I The permit is for $100.00 (valuation) or less. Ej 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 15.00 Heating Cooling LHood 6.50 I 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 ot 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 aga.Lrist said County in cons guence of he granting 0 f th* Aerrq,,- X Date'sUa 15. 199a J Signature yApplicant Owner El ControctorE] Agent F-1 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 Jf0TAL FEE 30.00 E AAZ I D FEES I IMP I FLOOD CDF PARCEL This permit is hereby issued under the applicable provi- sions of the Butte unty Code and/or resolutions to do 591, / work indicat�d above for which fees have been paid. ;�, 4� �611R&TOR OF PUBLIC WORK� By D i a 1621Z 46 PERMIT EXPIRES Date & J y 7 1 Receipt No. WHITE-D.P.W.. YELLOW-ASSE3SOR, PINK -INSPECTOR. GOLDENROD-APPL I CANT .1 COUNTY OF B�UTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATIO-WiND PERMIT PERMIT NO. qj ��(O: _1 1 .00, ASSESSOR PARCEL NUMBER 024-080-115 ZONING A 5 BUILDING PERMIT OWNER BRAD ROBERTS TELEPHONE 846-0716 SQ.FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 419 O'BRIAN AVE GRIDLEY 95948 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN al Valuation $ 4q S. oo LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ 15.00 ARCHITECT OR ENGINEER E NO. Plan Checking Fee $ ARCHITECT OR ENGINEER's MAILING ADDRESS Energy Plan Checking Fee $ Penalty BUILDING ADDRESS 4 19 O'BRIAN AVE GRIDLEY 95948 Permit fee $ 30.00 PLUMBING PERMIT __FilingFee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME 1 L MAP Water piping — 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF[J Duplex0 Mobiiehome[I Other SPECIFY Gas piping system 1 - 5 outlets 5.00, Building sewer 15.001 Mobile Home is @ 15.001 TYPE OF WORK _90012 NeVRSW-.. Addition R emode I El Utilities E] InstallationEl Other E] Describe work:. P xl?MTT PnR LANDINGS AND STATRS 44- I I Permit Fee $ Contractor ELECTRICAL PERMIT Fi I i ng Fee 15.00 Main service 600V OR LESS - .200A OR LESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El 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) 0 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) r_1 I am exempt under Sec.—, Business and Professions Code for this reason Main service 200A TO 1 OOOA) NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. 1 _37.501 3.6* q.ft.1 N E WCO NSTFL MULTI -OUTLET ,.'0 r N -RE BRANCH CIRCLJI S) @ 5.00 PO ER APPARATUS &I SINWGLE OUTLET CIR. I Ex. Occup(OUTLETS OR FIXTURES 20 754 AL 6 AF;A FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 1 3.001 Temporary service 15.001 Mobile Home Facilities 15.00 Misc. Wiring 5� I— Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): F-] The permit is for $100.00 (valuation) or less. Ej 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 w,ith such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Fi I ing Fee 15.00 Heating Cooling Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. 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, judgments, costs, and expenses which may in an, way accrue n OnU ag st said" ,f he granting of this er i u ce 0 X d24 0 tya Date. 16. Si gn. 'ur. . Applicant O.n.r 0 Contractor 0 Agent El J An OSHA permit is re for excavations over 5'0" deep and demolition or construct- 3quttred ion of structures over s ories in height. Mobile Home Installation Fee 4; Energy Inspection Fee $ OCC CONST TYPE qn TOTAL FEE $ 30.00 AZ I D FEES -IMP I FLOOD I CDF ISSUE This permit is hereby iss under the sions of the B tte C q y ode and/or work indic a e f which fees OF PUBLIC By PEflMIT EXPIAES _76ate <-O applicable provi- resolutions to do have been paid. WORKS Da Receipt No. Igb J WHITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD-APPL I CANT COUNTY OF BUTT .."PARTMENT OF PUBLIC WO BUILDING DIVISION N -7541 7 COUNTY CENT D I OROVILLE, CAtIFORNIA 95965 TELEPHONE (916) 538 PERMIT APPLICATION DATA SHEET OWNER J::�UJXV Proposed Building Use A. P. No. Bu ild-ing Inspector o Date /0-/(0-91;L At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. All items have been submitted . ............. Plot plans, 3/4 sets, signed by preparer of plans. Complete plans, 3/4 sets, signed by preparer of plans ....................... Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. Hazardous Material Form . .................................. P I I I I * Energy Design Compliance and supporting documentation . .................. Statement of Intent for Non -Heated and A/C Buildings. - * * * * * I ' * ' ' * ' ' * * * ' ' * ' ' Engineered truss details and layout in duplicate (required prior to plan check). Mobilehome data and manufacturer's installation instructions, 2 sets . ........... Feesof $ . ......................................... Impact fees as shown on attached schedule . ..................... <: .-� ...... California Department of Forestry plan approVal/fe'le's ............. � ........ Flood elevation letter (100 year flood) by California Engineer . .................. Sanitation and plot plan approval � . Health Department . ............. City of Chico plumbing permit! ... ; ..................................... Plot plan and business license approval from City of Biggs/Gridley . ............. Planning approval for (A) Use: (B) Parking: . ........ Contact Land Development about (A) Improvements (B), Drainage ............ Driveway permit (construction approval required prior to occupancy) . ............. Prel,spection request Pre -inspection for required. to Building Inspector (Date) Contractor's license information. (No., Name Style, Classification) . .............. rtificate of Workmans Compensation Insurance . ....... * * ' * ' Owner -Builder Verification (Given to owner / Mail to owner ........... Recorded copy of Agricultural Acknowledgement Statement . ................ Letter of signature authorization . ........................................ Copy of recorded deed of parcel creation and 60 right of way to a public road ...... Letter of intent on building use . ......................................... Mobilehome utility clearance . .......................................... Documentation of legal access . ........................................ Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements ................ Existing violations/expired permits . ...................................... Plan check list . ..................................................... When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage ApplicantQ;��YKtW�t e U&T ki ___ 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 _ pholiiiX ( - - _��--i3'k Counte-r­by Date Contractor, designer, owner, was advised of above required data by _ phon� - mail Counter by Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916,"538-7541 APPLICATION �MD PERMIT PERMIT NO. ASSESSOR P��Cql­ NUI,&BER - 4 1 �; 0M ZONING A -S BUILDING PERMIT OWNER tF:�� P ,e� TELEPHONE 111. FT. OCC. BUILDING VALUATION OWNER*S MAILIN�ADDMS &�&� CONTRACTOR'S NAME 7 ITELEF(PONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKN . OWN Total Valuation Is LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 15.00 Permit Fee Plan Checking Fee $ $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty BUILDING ADDRESS Permit fee —F7� 0 PLUMBING PERMIT -�F i i ng Fee 15.00 Each Trap 1 5.00i Solar or heat pump water heatSf" 20.001 LOT NO. SUBDIVISION NAME MAP Water piping 7.00 Each qas water heater'oyvent 7.001 .1 USE OF STRUCTURE SF;?�-Duple.01 Mobilehome[] Other SPECIFY Gas piping system 1 7� outlets 5. 0 Building sewer / 15.00 Mobile Home S I G @ 15.001 TYPE OF WORK New_& AdditionF—1 R emode I E- Uti ies 0 InstallationD Other El Describe work: QA nf,'a 4m- N��v --t- U I I Per—tn't Fee $ Contractor ELECTRICAL PERMIT 15.00 �FilingFee Main service 600V 5—R LESS 200A OR LESS 18.501 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) El 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 200A TO 1000Aj 37.501 NEW CON ST. DWELLING O�CU"-) OR A .NS. ACC. SLOGS. 3.64 q.ft.j NEW CONSTR. MULT I' OU I- T C��NON-RESID. BRANCH R CUITS) @ 5-00 P WEIR AgPARA U IN SINOGLE 0 TLET CIR. 1 Ex. Occup(OUTLE OR FIXTURES T4 20 75d OAL- P Eidi OCCUP. F Ex. OUIXE APPLNS. OR Tt�(T (RESID I EA - 3.00 F Temporary sery/ce 1 15.001 Mobile Homeyacilities 15.001 Misc. Wirinz 15.00 I — I Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): (_] The permit is for $100.00 (valuation) or less. F—I 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. F-� 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./, Fi I ing Fee 15.00 Heating Cooling Hood 6.50 �Ventlation 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 ot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnity 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 F� Contractor 71 Agent F-1 An OSHA permit is rTuired for excavations over 5'0" deep.and demolition or construct- ion of structures over stories in height. Mobile Home Installation Fee 41 Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 3^,. HAZ 1 0 FEES 00 It 1 COF PARCEL I PO HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. WHITE-O.P.W.. YELLOW-ASSE350R. PINK -INSPECTOR. COLOENROO-APPLI CANT "-COUNTY- O'F' BTjTTE _­`Depa-rtment­of' Public Works 7 County Center Drive,-Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: - An "owner -builder" building permit has been applied for in your name and bearing your signatur.e. 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"idsued until this vei:ifica7tion is received. I personally plan to 'Provide the major.labor and materials for construction of the proposed property improvement (yes or no) 2. 1 ( ave ave not) signed an application for a building permit' for t �6proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed con.struction: Name' Jty Address CL Phone Contractors License No.— 4. 1 plan to provide portion's of this work, bLit-I have hired the follo�4in`g persozi to coordinate, supervise, and provide the major work: Name Address. City - Phone Contractors License No. 5. 1 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 COUNTY OF BUTTE Social Secu 't Ni��ber BUILDING DFPT Date V/ OCT 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. RESIDENTIAL 24-08-115 3224-91B,P,E,M ROBERTS, Brad 419 O'Brien Ave, Gridley -(new sf) r OFFICE COPY Address GAS S Meter By Dat ELECTF1 C Meter By� '�FFICE COPY Address GAS Date Meter By—:: ELECTRI i Meter By JOB FINALED (1) Signature L I V=OK O= Not OK = Not Applicable = Not Ready MOBILE 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/0 Concrete 4. Water; Location -Test- Easement Needed (Sketch) _Ij 5. Electricity; Location-Clearences-Grnd-/ /Amp-Concrete� 6. Gas; Location -Test-Wrap: 11 P11t. / P'Nat. or/ P'L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 j Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line J 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test-Crosso ve rs- Brea ke rs-C lea ra nces 5. Drain; MH Test -Fall -Flex Connector , %� I , 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/0 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's-,1.1 Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK excbpt #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils-Size-Depth-Spacing-Connectors-SteeI -3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Seams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg: Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks- Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances -GA 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-Enclosu res -Pane I boards- 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 MISCELLANEOUS's-,1.1 Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK excbpt #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils-Size-Depth-Spacing-Connectors-SteeI -3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Seams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg: Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks- Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances -GA 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-Enclosu res -Pane I boards- Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 *J = OK 0 Not OK Not Applicable Not Rea�y, Date . UNDERFLOOR (Plans) OK excer)t #'s RESIDENTIAL (Single & Duplex) 1. Zon i ng -Setbacks-Easements-Flood -Slope A 2 0 111 R" Ftg. D&V Main; Soils-Elec. Gl �,A. Ftg., Garage; Soils-Steel-Elec. Grnd.-C/ Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ptg. Depth !�temwalls, Main; Steel -Bloc kouts-Wrapped Stel Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors ,,�5ab; Steel -Wrapped 8,,Piers-Fireplace Ftg.-Steel b,�9. D.W.V.: Fall -Fitting -Test -2 Way C/0 -Sewer Test !��Gas Pipe; Size -Anchors - yard gas piping: size -test L--Ce-i' 'Water Pipe Test -Anchor -Regulator -Service Test ,je -,c--r2-1 Underground Plenums & Ducts; Clea ra nce- Mate ria I -Support- Ins. 1!<�-i Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation 0 W�l 04 Date - rd B-1 Date J��d B-N�je� Date rd B-1 Date 'Card B-1 Date JJAMBING (Perril except ft's at r.Htr.: Vent- ss -Combustion Air -Baffle - - ----- - - ---- - ------------ 2ter :��*-O-D W'V.- 1periFittings & Anchor -Nail Protection wer Pan: Test, -First Floor -Tub A= -Sy 20. Test -Tub & Shower, -Second Floor -Tub Access - -- - --------- ,�-�Gas Pipe: Size & Anchors — - — ---------- Dat e Eae Card B-1 ki---- Date Card B- Card B-1 Date ELECTRICAL Wermit) OK except 4*s Vixture & Transformer Clearance -Ins. Protection lec. Receptacles Spacing -Lights & Switches at Doors Size Boxes & No. of Cond ucto rs- Stapled ��Romex Ins-.alled Close to Edge of Studs & C.J. ---- ------ - ------------------ - - - ------------- - ------- -- --------------- u ip.-Grou nd- made up w/Mech..Fastners-Bon-d -Gas-& Water ----- ------ iance Circu-ts-in Kl & Conductor Size/GFI ------------- Z8. �.�feed-Wire-Size-/-- Tga. Cu -or AI-A.C. Wire Size ga. --------- Cu- ------------------------------- 29. Range Circ. I / ga. Cu or Al -Oven Circ. / / ga. Cu or Al. Insulated Neutral 0 Yes 0 No ii3 �-�a ------------ C -o-n-d --- c -t - -r s- -& --- G -r -o-u-n d -- M--a-i -n- -D -is -co-n-n- e C -1 ------------- --------- 0. ------ u --o ------ ---- - ------- T ------------------- ,--T1._5q-uip. Clear es n L anc Pa els- Motors- Mech. Equip - --------------- -:D lothes Closet Light -Shower Light -Spa Light ---------- . Smoke -Detector ----------------- -------------------------------- ------------------------------- -------------------------------------------- -- --- . Date Card B-1 -,09 D�jl� ....... . ..... Cal 1 .............. Date ard B-1 t e Card B -I 74M Date MEeHANICAL (Permit) OK except #'s ,��4.�;-_R�cts Insulation & Support ----------------------- ---------------------------------- 5.1 Exhaust above insulation ---------------- - --------------------------- 36. Cond ensate Drain & Overflow: Size & Grade ----- - -- ------------------------ ------- ------ �--i��Furnance--V.ent-:-Access-Cornb. Air -Return -Air . V e n t---1 1-5-c-ut-1W.- ----------- ---------------------------------------------------------------- -------------------------------------------------------------- Access & Platform if Furnance in Attic -------------- ---------------------------- -------------------------------------- Date -------------- Card -B-1 -------------- Date -------------- Card_B-1 ............. Date Card B-1 Date C-gard B-1 Date 0;El ING (Plans) OK except 4's Sils. Proper Material & Anchors ­ V%- -1@y -- ------------------------------------------------------------- ------ (��40. Walls Studs -Nailing. Spacing & Bracing-Plates-Sogd ......... 1. earing Walls over Girders & Floor Nailing ---------------------------- - ------------------- 2. Dra I Stop in Walls (rat proof) -------- --- - . - - -- -------------- ---------------- ------------- re Stops: Furred Ceilings -Stairs -Chases -Tub -------------- Headers & Beam -Size & Bearing �L. i Date FRAMING (Continued) ps-Anchors-Connectors L4I5.­CIng."Jpist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng. -4-pl Ties or Type A Flue -Fireplace Throat clearance ttic Access: Size & Romex Protection -Draft Stop -Ins. Baffles L_-­4q--9d-rm. windows or Exiting Doors -Sill Hgt. & Dimensions L--�&l 'Garag. Fire Protection Framing ���--,Pr�-Perty Line Firewall & Openings w-IT2- Fxt n r)c)r.,;-C)n,-- T -Check Gal Story, 2 Exits -Head room-Rise-Run-Landi ng -Fire Protection llz-�Plywood on Roof Overhang -Attic Vents -Rafter Outriggers —Siding -Nailing Veneer Mesh -Drip Scl Vents-Underfll Access Area -Glass Protection -Skylights -Plastic ear Walls: olts 59t. Insu 'on -Walls -Ceilings Infiltirpfion-Walls-Windows ---------------- - --- �Da`te -< ate Card B-1 N� .DateZ;f 1 -7 rd B-1 ��?e - Card B-1 Date I FINAL (Plans) OK except #'s W(61)_E � Steps -Door & Sidelight Protection -Landings .1/noke Detector ------------ !P� --- F nace: Vents-Clearance-CpAti. Air-Connectol n Garage: Above FloorZ)Oj'cts-Mech. Protection --------------- -- --------------- --- Ze, oo.m Exiting --------- - - F. I & Bath Fixtures & Tub Access-4pa-a- -------------- F6.Elec.-Trim-&-Subpanel: Breaker Sizes & Labels -6416-Stairs & Rails ------------ Fireplace or Stove: Clba ra nces- Hearth 69. Elec. Q.Wi4at-s-at Wood Panel:::: x t.Fixt. i��plFance, (irl _��-Cookinq Clearance ---------- VCZIUElec. Outlets & Receptacles a—tKit. Counter Swin -.<�n�-6nioser AC D Ii G amper -V-- U ------- ----- 74. r. I l s learance-Comb. Air-Connectol Gar-- ----ove Flnor-Mech. Protection _I--- --------- :� --- :- i-,-, Fl -c. R Me r h. Equip. Lis_ted_j2LLpeafioq Ejp�­Receptacles in Garage: ome �Orotection J;o�4-�-Iat ion -Foa m- Looked in AtK es/ ------------------ _ii Const ruction- Post Wrs ------------- �F�l �Vents & Crnifvl Hole Doo l Dra i na_geyWood -Earth Clearance Looked under Floor* WYes --------------------- ------ b 80. Following instid.: Drive Yes No: Walks 0 Yes Ko; ----------------- Planters--O-Yes tu!]No— tucco: Brown -Finish ---�ng ilecTrical. �Ium �e---------------- rits Above Roof: Plbg.-Appliance-Fireplace.-Clearance to Openings 84. Water Well: Discon I El Cal, Plumbing -------------- - e,ior 'i� 85. ec. ri eceptacle-Underground ............. ------------- 2 Lect, 6- ca '� &ectE pt m e e a P!f- ),io6P13tion Throughout House Z- ------------- 1P. (Gorass Protection t, I Previous Inspections .;?9 -- - - - ------- -- r _as t -Meters Taagg; &�Ij tp � ��j 5,_ ------------- - --- -------- V - e W U Sewer Connected -C/O to Grade-H&-AVpTUTffr- 4oEnergy Compliance Certificate -Other Certificates ------ ----- .. ---------------------- ------ I ------------------------------ Date Card B-1 Date Card B-1 -6- � V� Card B-1 Pj1tV0,,q­ --- --------- Date Card B-1 Dale Card B-1 Comments at Final: ------- I ------------ - ---------- I 1) permit No.* E Y 1; H V R C E 11 r. C, E R T 419 018r�ien A�ve. �Orov�jjle�Ca�-� A. P. No. I.00ATION DESCatpTION OF INSULATIO" Boor Brent! Hamel Resistance (R value)_-_— glTgR109 WALL F1 - BERGLASS BATTS "Chad 3 5/8z.11 Brand Ham 11,SM&I Re@jst&nce(R Value), CEILING j.pj,,t.,ryj,e FIBERGLASS BATTS llrsnd'"Amd� OWEUS-CORNING I R38 Batt Or -filonvAl Restotauc*(R Vfllu*,--� Ifik Ic I(Aes a lielle 1) 1211 Brand Hsmet—.�,sO�2W. �Por �tbag Louse Fill TYPe Number of go— jiLlijavum Thicv-11les Roslat&nce(il Value) R38 Area coverej(ft. FI.00R' ELEVATED FIBE!F��RGLASS BATTS Th FLOOR, SIAB Material Tilic. Upon a (ble- ---------------------- ---------- FOUN"TION WALL luterimit - Brand Name, OWENS-CORNING R Tilermal Resistance(R Value) -- Brand Ham ITOR4 N"n io-14414tiias(I IV* tioa Vito 10111:0119d to ths OboVe bult4tog- beroby Gortity that tile sbQ COU19VA4 510fty Roquir"*901 with tile state .......... jITATS (:ONrP'A=UjL-D jj111::xHS1 "Dip RH Now October 15,1992 ------ ATOR PATS or INSTAI :i'vii—it 4 INSTA, TURE Or INSTA.IA APPLIC bove insulation 4n4 411 roqutreil Item 44 llhOva-01`1 ths I Iloreby certify tile a plaits &W attocilindIDtf 114ve boon instal1#4 as puiljlllg Department OPP"ved required by tile state of Cati.forais Energy R@quLraaont@'- All squLpment. .. 48V ices slid materials are ot tile quality prescribeti or are specifically Approved by tile state of California, tTATIt CoUr g:TORIS LICYASS yIRH BAHR/MNER please prillt) DATE gi-IGHATURE Or GENERA" -0 —Wr—R, A —CT O—R IMW I t 'fills CERTIVICKrF MUST lie ON FILE WITH T119 BUILDING DEPARTME"'r PRIOR TO YTHAL ArpioVhl. AND A C01?y all&LL Be POSTED WITHIN T119 BUILDING- - . - — 11 Gaz' FRI. SAT. DELIVER CLOSE IFE] PICK-UP I .. NE LUMBER, IN since 1926 LOADED & CHECKED BY HELP ON JOB DELIVERED BY DATE DELIVERED I 1 0 YES 0 NO 26068 I P.O. BOX 438. p 1600 Acacia St. 0 Sutter, CA 95982 Phone: 755-0055 or 800-821-1376 Fax # (916) 755-0254 STORE HOURS STATEMENT COPY MON. � FRI. 7 - 5 SAT. 7 - 4 PAGE 3 Terms: due and payable by the 10th of the month following purchase. If payment is not received by the 25th, a 11/2% monthly service charge (18% per annum) will be charged on all amounts past due. "grolk, W 11VIERCHANDISE. HE RIGHT TO CHARGE A 20% RESTOCKING FEE ON RETURNED INVOICE THANK YOU, PLEASE COME AGAI-N CLOSE LUMBER SOLD SHIP TO: (SAME AS SOLD TO UNLESS NOTED BELOW) TO: _111� Customer Code IsequenceNo.1 Time ROBBRA 1123792 114:-1; Order Date Ship Date A Number Salesman I ISANDY ITEM NUMBER V QUA N. ORD. QUAN.SHPD. DESCRIPTION UNITS PRICE / UNIT EXTENSION GLULAM I MISC GLU LAM REAM 44.40,0/,EKCH 44 _AO� 1./ 2 X_ 10., 1/2 X, in. SUB -TOTAL ransac on age— ore No. S'man. Itten Bv er. 0. 26068 60692 1 3166. 5 11390 Order Date Ship Date A Number Salesman I ISANDY ITEM NUMBER V QUA N. ORD. QUAN.SHPD. DESCRIPTION UNITS PRICE / UNIT EXTENSION GLULAM I MISC GLU LAM REAM 44.40,0/,EKCH 44 _AO� 1./ 2 X_ 10., 1/2 X, in. SUB -TOTAL TAX % A AM' UNT TOTAL 2952.84 .00 "725 T14.08 3166. REC'D. BY DATE: e - TERMS OF SALE All orders, sales contracts, or shipments will be accepted,and 'executed by FRANK R. CLOSE & SON, INC. with the following TERMS and CONDITIONS: 1. Terms: 30 Day Accounts - NET PAYMENT DUE ON THE 10TH OF THE MONTH FOLL OWING DATE OF PURCHASE AND PAST DUE AFTER 30 DAYS. There will be no FINANCE CHARGE if your account balance is paid in full by the next month's billing date. The finance charge, if any is computed on the previous balance before deducting payments or credits. If you fail to pay the new balance by the next rnonth.ly billing date, you will pay a FINANCE CHARGE which will be an amount determined by applying a periodic rate of 1,5% monthly service charge (18% per annum) on accounts duo'; purchaser shall pay attorney's fees and costs incurred in collecting this invoice. A minimum finance charge of $.50 will be a§sessed. Said charges are fixed, agreed and liquidated DAMAGES sustained by such breach because of the difficulty, if not impossibility, of fixing actual damages. The buyer agrees that any LATE CHARGE computed will become part of -his financial obligation to seller. If 'any account is referred to an attorney for collection, said accou-nt will be subject to a re I asonable collection fee or attorney's fee, cost and LATE CHARGE as set forth. above. 2. Shipments shall be inspected upon receipt and if any errors or irregularities exist, they must be reported to..us,'in writing. before using the merchandise and within three days of receipt of goods, 6th6Ws'e'4­1)o* claims 6r adju-stments of any.kind wi[I be recognized. We assume no responsibility in the u s*e of the' me"r66ndise and when placed in, work _con�titutes.'accOpance by th6bustomer. Shortages must be indicated on the Point of Sale invoice at time of deWery.: 3. A 20% handling charge will be made on stock goods returned fo ' r credit..No goods shall be returned without our consent. No returns or exchang�s, regardless of condition, after 45 days. All. returns must be accompanied by our sales invoice. ALL SPECIAL ORDER items, including window units, pre -hung doors, and trusses are not returnable for credit. 4. Anyadjustment for defective material shall be made on a basis of replacement of the. rn�te.rial and no other basis. 5. All materials sold or delivered to curb only. Not responsibld for b.roken sidewalks'curbs or driveways �p or septic systems when delivery is requested on premises. The Purchaser is re onsible for adequate access to delivery location and assumes liability for damages to property or equiprq��dwhen trucks are required to leave highways or accepted streets. 6. For your protection all invoices are subject to price verification. Corrections will be reflected in your monthly statement. 7. If invoices are not paid in full for materi.,�Is ano merp,hanidse, the improved property of purchaser or 'the improved property on which the materials and, merchandise were used may be subject to mechanics liens pursuant to the California Civil Code.. COUNTY OF BUTT E DEPARTMENT -OF PUBLIC WORKS 1469 Humboldt Rorad, Chico, CA - (916) 891-2751 -7 County Center brive, Croville, CA - (916) 538-:7541 747 Elliott Road, Paradise, CA - j916) 872-6307 CORRECTION NOTICE 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 complet9d. If you have any questions pertaining to this matter, or need additional explanation, 09Q"Aact this office immediately. OAIJ I P1 I- - AJ 4 -le 13 &)6�--Yve /2 Ae I A/ t'o S 47-45 - stakr (0.4t -L xws- t2 14 S. (A 7 , j COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 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 Is a -Z -/ -W ER 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 additional explanation, please contact this office immediately. . ' ( x .4 *C' �r-�tv Rece W 0 a Q_zd'— �CV F 619 1i Date 10 - Inspector REV 11191 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 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 L-aoln C;,L sj� OVVNER- I (?/ PERMITINO. 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 correct' f work 10 T is completed. If you have any questions pertaining to this matter, or need additional e:p"/lanation, please contacl�hi5mfice immediately. f h*- Ah - 4251 -07112IN/M W1r.191VAI11IQVA�,0 1111EI LAW ced-7-. Date Inspector REV 11/91 I I It tip liu Lte ofCord"ormance, 2823 9 1. THE UNDERSIONIHM NIANUF-ACTURER HETIE-BY CE.RTIFIES thrAt the structural wood produ identified txiloyti aricl markedwiffi a ,"ollentiv(! rmark of Arnericsin Wood Systems (AWS) were man - 0 ufactured in accordance with 0io sr,:,lecifications indicated bialow. "'tandard A190.1191,1a, for StrijclurM Glijed Larninated Tifter ANS.1 Fvoot 1.o,aded e -fid c)�Lntes (4 GEOR('31A PA Job Name SS A GR j k KE N. TO CA -Job Lopallom 54--B8O2 Cv6iomerls Otdiat No. Date Mf9r's Oroer No. signatufe Control- Boli�etviia 'Er -Lc. Vaiagli:,i, Orsgori 5/7/91 Company Address Date V, IT IS HEREV cinrwili,ci that i!i,e!!vtjctura1 glued larninated timber production of the at>ove-named manufacturer whiCh carriec; a (xHlective mark: ofArrerican Wood Systems (AWS) is subject to regular audit by Amerkw Wood,'.-TsIerns, cuch audit consisting of the Inspectlon-with-feamiabk) frequency of the man U NIVILI ring proceb.,.�% wilh adequate carnpling to verity the quality of glulam construction and the adequacy of glue loond. I (vr "I AA%,*FtICAN VV(;WX 4'MXM!; — A RELATE0 COAPOAATION OF AMERICAN PLYWOOD ASSOCIATION COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Cahforni� 95965 - Telephone: 916/538-7541 X_2% 4 APPLICATION AND PERMIT PERMIT NO. 3224-91 Wa ASSESSOR PARCEL NUMBER 024-080-115 ZONING A 5 BUILDING PERMIT 14- OWNER 1286 BLOCK RD GRIDLEY TELEPHONE 101/110 SQ.FT. 0 CC. BUILDING VALU^OV J . F_ 2531 R 129,081 OWNER'S MAILING ADDRESS V. I OWP9 BRAD ROBERTS 934 M 16,812 CONTRACTOR'S NAME QWNFR ONE C 5,265 CONTRACTOR'S MAILING ADDRESS Fireplace 1 MAS 3,500 CONSTRUCTION LENDER NONE UNKNOWN Total Valuation $ 154,658 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee QU05 $ 570.05 ARCHITECT OR ENGINEER NONE LICENS NO. Plan Checking Fee $ 285.00 Energy Plan Checking Fee $ 15.00 ARCHITECT OR ENGINEER's MAILING ADDRESS Penalty $ BUILDING ADDRESS !//R O'BRIEN AVE GRIDLEY Permit fee $ 880.05 PLUMBING PERMIT FilingFee 10.00 Each Trap 131 2.00 26.00 Solar or heat pump water heater 20-00 LOT NO. 'Z. 1 SUBDIVISION NAME PARCEL MAP 1 V& - I -) Water piping 5.00 5.00 Each qas water heater or vent 5.00 5.00 USE OF STRUCTURE SF [j] DuplexR MobilehomeR Other SPECIFY Gas piping 'system 1 - 5 outlets 5. 5.00 Building sewer 5.00 5.00 Mobile Home Is 10-00 ea� TYPE OF WORK. New �] AdditionEj Remodel[] Utilities[] InstallationEl Other E-] Describe work: SF 4 BPD -M Permit Fee $ 56.00 Contractor ELECTRICAL PERMIT FilingFee 10.00 main service 6001 OR LESS 100 AMP OR LESS 10.00 10.00 Main service �EA. ADD -L 100 AMP 2.50 2.501 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El 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. cerise No. Classification. 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 cOnnaut- ors. (Sec. 7044) I am exempt under Sec.-, Business and Professions Code for this reason NEW CONST DWELLING OCCUP.ad) OR AODNS. ACC.BLOGS. 21/2 Osq ft 86.60 NEW CONSTR M ULT"OUTLET NON-RESID, BRANCH CIRC.ITS) 2.50 ea PO ER APPARATUS &I SINWGLE OUTLET CIR. I Ex. Occup(OUTLETS OR FIXTURES 1.20@50C ALO 300 OCCUP. FIXED APPLNS. OR I Ex. OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 1U.UU Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 119.1 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): f-] The permit is for $100.00 (valuation) or less. E:] I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate z,'@ Consent to Self -insure. Rr tl shall not employ any person in any manner so as to become subject 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 Fi ling Fee 10.00 Heating SPLIT SYSTEM 6.00 Cooling 4 TON 11.00 Hood 3.00 3.00 Venti lation - 4 3.Oq 12.00 Permit Fee $ 42.00 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 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 Count in .7n§equence of the granting of this PeFit*01 X Date 31R&N Si gnalum of A p cant Owner �� Contractor El Agent ?V 0,, - i re An OSi for excavations over 5'0" deep and dern ion r c n r t- Vic ov. yiui,ed ion of struc,.r.. r stories in height. 0& Mobile Home Installation Fee $ Energy Inspection Fee $ 30. 00_ oc PE 0"T TOTAL FFE $ 1127.15 _F -K �THAZ. 1,CUA-1 AR SC FLO COF I P�Wj. PD This permit is hereby issued uncer tne applicable provi- si ons oi the Butte County. Code - and/or resol utions to do work indicated ab ve or which fees have been paid. 0 :�UBLIC WORKS A, N 7, -7 Z__ By Date FIE MIT EXPIREV Date Receipt NO- 1-0- 0-2- 24 340 00 PC FF.F.1, 7 -j ­o- WHITZ-O.P.W.. YELLOW -ASSESSOR, PINK-1-N-SPECTOR. GOILIDENROD-APPIL I CANT I,/ Contractor, designer, owner, was advised of above required da Contractor, designel, owner, was advised of above,requjred_4a Plaft� g �'OeMy Date —Sets of plans on hold in —File cabinet _AP folder Copy—DPW ---jnai I —counter by date —mail—counter by— date by Date / Zf COUNTY OF BUTTE - DEPARTMENT7\0'R PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILRE"p. �ORNIA 95965 - TELEPHONE: 916/538-7541 �_T PERMIT #P-L'F'CAT'I'0'N DATA SHEET 4 Permit No. ?1�4D OWNER A. P. N o. 0,2- t/ o eo Proposed Building Use 5r 4941 Building Inspector Date --- 'At time of permit application, I was advised the followir�g data must be submitted prior to permit processing and/or issu ance:, DATE RECEIVED 1 . All items have been submitted . .................................... APPROVED 2. Plot plans in duplicate/tliplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans e 4. Complete engineered plans and caics, 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) IZ- 91 9. Mobilehome installation data including manufacturer's installation ,,' instructions . 5 ....................................... *�(0) Fees of $ .......... t 1-1. Chico Urban Area fees paid ....................................... .:�l 12. Paar feeyf aid ................................................... ir ecf 3. SC OOIjDjis rict fees paid ............. : 2Z 461 14. Sanitation ap"proval from Health Department 15 C,+t y df (� h iF e��u n .1blinpermit.- ............ A.:5 ............ -16. R)Z' pl ��_Cc�qnse approval from City , �t p4a Nd vt,P ;16 k (tee , i't` If r oth L 0 . er) requiremen 17. Plab Inel �ov�: cl ifil a O�p 0),Pa� ...... 18"1 p'rovements; pp�y,be required. Contact Land Developme'rit Sectioh DPW 19, [miveway permit (construction approval required prior to occupancy) ZLIF- 2Z 20. Pre -Inspection for required ... Pre-Inspec. request to Building Inspector (D a—t e) 21. Contractor's license information (No., Name Style, Classification) 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner 11, Mail to owner 0) ..... 24. Recorded copy of Agricultural'Acknowledgment Statement ......... j —25. Letter of signature autho.rization ................................... I 26. ee —27. When you issue the permit, process as follows: — Mail to owner. —Mail to contractor.� Telephone 65IL6716 and hold for pickup at 6'40V"f(coff ice. —Del.iver :��-Ailhs$&ctor. Other Applicant Z/-K�_.Date . Cop )f Hlaz-Mat iorm sent —Health Dept. —Fire t. ----Air Pollution Date Co?y1*C Vp ofplanssent ---HealthDept. —FireDept. "Other— Date— By The owing data must be submitted prior to permit is C e: (C new/ item n edLIkUyel., le. Index peri s, N o,�, i re mit Owop i te 2. 'Additional items i Contractor, designer, owner, was advised of above required da Contractor, designel, owner, was advised of above,requjred_4a Plaft� g �'OeMy Date —Sets of plans on hold in —File cabinet _AP folder Copy—DPW ---jnai I —counter by date —mail—counter by— date by Date / Zf TO: Building Department FROM: Encroachment Permit Se-c-tio.n. RE: 'Diiveway Clearance Z!Z— 0 go �el location AP owner Driveway permit has been issued for the above propertyl. n b Asign �Xre date TO Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance b - .. P-6, + c 1) —Ie Owner Location. AP# Plan Approved for: Sewage Disposal Water Supply,. -- Hold final for: Water Supply% Final clearance O.K. for: Water Supply Clearance for 4— bedroom b4)14,� home. Other NOTE * * * ganit4.�ian 13 a t- e Id �)9043'06" � — 145-5� f jr, C�Ij V 0 0", �b9'44'17"W -- 1�5,5(0 )=LAN I F: 7 A) T Y\ c- T vy\ r i rN �I APPROVED Butte County Environmental Health Date ur. j jin a 1/�e CIO f jr, C�Ij V 0 0", �b9'44'17"W -- 1�5,5(0 )=LAN I F: 7 A) T Y\ c- T vy\ r i rN �I APPROVED Butte County Environmental Health Date ur. j jin a 1/�e COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - OrovIlle. C alifornila 95965 - Telephone: 916/538-7541 APPLI,�,O-,- T1014 AND PERMIT PERMIT NQ. ASSESSOR PARC9L NUMBER L9,2 oeo - /I _,g-- ZONING A —5— BUILDING PERMIT OWNER T EL WZ H *� �1,6 SO. FT. OCC. BUILDING VALUATION OWNER'SMAILING A ESS 126KIARW OXicy-4 ec) Gr4bey 9-5 e-1 CONTR�oy TELEPHONE C CONTRACTOR'S MAILING ADDRESS Fireplace WWO2, 315C)Z> CONSTR�;�TION LENDER lye—, UNKNOWN Total Valuation $ 1.5!�4 Filing Fee f $ 10.00 LENDER'S MAILING ADDRESS Permit Fee 5-76, 6_5 T OR ARCHITEC E G EER a/) LICENSE NO. _.$ Plan Checking Fee $ 28S. oo Energy Plan Checking Fee $ ARCHITECT OR ENGINEER*S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ .5 ee -0 PLUMBING PERMIT FilingFee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME I PARCEL MAP I Water piping 5.00 OC> Each qas water heater or vent 5.00 0,=, I USE OF STRUCTURE SFP DuplexF� MobilehomeF� Other SPECIFY Gas piping 'system 1 - 5 outlets 5.00 5 . C>O Building sewer — 5.00 .57- CDC>1 Mobile Home I S I G JWT 0.00ea TYPE OF WORK New Addition F� RemodelEl Utilitieso InstallationEl Other Describe work: 514-- -,/ A-3 le - I I Permit Fee $ -5 6 - Contractor ELECTRICAL PERMIT Filing Fee 10.00 main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. AOC -L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El 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. D 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) 0 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) r] I am exempt under Sec.—, Business and Professions Code for this reason NEW CONST. 0 ELLING 0 1 . OR AODNS. ACWC. BLOGS. 21/,Osqft (00 N _v" ';0 N5T11_ MUL T'.. UTLE 7 NON -RE "0' BRAN CH CI RCUITS) - 2.50 ea POWER APPARATUS.&) SINGLE OUTLET CIR I Ex. Occup( OUTLETS OR FIXTURES 0@50C 1.2AL9 30l FIXED APPLNS. OR Ex. OCCUP- OUTLETS (RESIO.) EA.) 1 2.00 Temporary service 10.00 /D. 0 ____ Mobile Home Facilities - 15-00 Misc. Wiring 15.00 Permit Fee 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. E] 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 Fi I ing Fee 11 10.00 Heating -T 1,4_- 1 (0 1. co Cooling It/ I ff I'D Hood 3.00 Ventilation 12-001 Permit Fee $ 0 0 Contractor I certify that I have read this application and state that the above information I s correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County ot Butte to enter upon the above-mentioned property for inspection purposes. st I also agree to save, indemnity and keep harmless the County of Butte again 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 ED Contractor Agen I t An OSHA permit is required for excavations over 5'0" deep a demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ :3 0 -Q-Q- occ I CONST TYPE ITOTAL FEE $ 7 - HAZ I CUA I PARK_F�� I FLD —ICOF -PAP I I JP0 IIHO T.his permit is hereby issued unaer sions oi the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By __ PERMIT EXPIRES Date tne applicable provi- resolutions to do have been paid. WORKS Date t Receipt NO. 3L1 6 L10 V6 �, L, __.� v / '1 11 _8 NHITE-O.P.W.. YELLOW-ASSE3SOR. PINK -INSPECTOR. GOLDENROD-^PP.L! CANT COUNTY OF BUTTE - D4artment of Public Works 7 County Center , Drive, Oroville, CA 95965 Phone� 916-538-7541 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. 1 personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) WZ�2 1" , - I . V 2. 1 (have/have not) signed an application for a building permit for the proposed work. 3. 1 have contracted -.with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. )1 plan to provide portions of th ' is work,.but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. 1 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 Social Secur#,t umber Date 7/o f ell V 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 ate per- mitted to issue the permit. BUTTE COUNTY --SCHOOLS DEVELOPMENT FEE CERTIFICAT-ION--FORM (one'Form per Building) A.P. Number B�ilding Department No. School District ity County F-7;� Ju diction AM/// Property Owner a e 6,/7, Project Location/Address Subdivision Lot Number Residential Development: Sq. Footagez-9/ # of Living MHI Addition (Group R) Units Commercial/Industrial: 9q. Footage New Addition (Including Exterior Roofed Areas) Building Department Rep�re,sentative Date., District Id No. z I 4 // r plicant Name). Street Address City School Di"strict certifies that State) F9140 Qlt"_t_tb01zy4 (Zip Co has complied with the requirements of Resolution No. by the pa ent of $ ML representing square feet. Schooy 01strict Representative "Date ' REMARKS:* 'o" BANK NO PAID BY CASH white -applicant, yellow -building department, pink -school district SCHOOL.FEE (5/88) 04 0 -/0 jp . . . . . . . . . ... . . . . . . . . . . . -.1 '/.) X4,,F':/-i 1Zr '01 . 7 o ?,?o F ES n ESSI H18 0 P, L r -- .,-2L037, A Z" Q� '112.. -CIVIL 1517E WUNN BUILDIN G-' 6 EPA�TMWT -7. -4PPAOvtb 117-1 Sii. L + Ile' ej 04 0 -/0 jp . . . . . . . . . ... . . . . . . . . . . . -.1 '/.) X4,,F':/-i 1Zr '01 . 7 o ?,?o F ES n ESSI H18 0 P, L r -- .,-2L037, A Z" Q� '112.. -CIVIL 1517E WUNN BUILDIN G-' 6 EPA�TMWT -7. -4PPAOvtb 117-1 Sii. L + Fv F7X7 -7 L; z' J; '\- Z- , 0. CC r 1�'7' 0 r- / -7? 0, . . .. . . . . . . . . '3 Fy . . . . . . . . . . ... . . . . . . . . -0 7 4f 9 X 4 ESS/0 NO. 21,037 J) CIVIL "�-OF C . . . . . . . . ... e tu i to DP'.v' AGRICULTURAL ST.��&T'_'g OF AMTOWLEDGEXEN-T l" f FOR RESIMITIAL DEVELOPIMEINT Section 26-8.1- of the Butte Countv Code requires this acknowledgement be recorded prior to issuance of a building permit. 0 9 1 —46956 1 4W I I Rec Fee I Cash I XX 5.00 5.00 I but not- 11mited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte Countv has established a2ricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept� such inconvenience or discomfort from normal,,necessary farm operations. All that real property -situate in the County of Butte, State of California, described as follows: Parcel 2, as shown ' On that certain Parcel map, being a portion of parcel 4 of Parcel Map 75 at page 38, filed in the office of the Recorder, County of Butte, State of California, on August 22, 1981 in Book 86 of Parcel Maps, at pages 17 and 18. Date: PROPERTY OWNERS: hoae_[*,to� Kqs-kr-n r�lc,6cr--L5 State of he day of 19'? before me, the On this t SS. undersigned Notary Public, personally appeared County OF��) 4� Personally known to me. Proved to me an the basis 0 OFFICIAL SEAL of satisfactory evidence. U. ... D REBERA L. BLEDSOE to be the person(s) whose name(s) 6�,� N OT BU LI 0 = subscribed to the within instrument and acknowledged that__t6k�___ OTARY PUBLIC - CALIFORNIA �C BUTTE COUNTY C mm xP e 1 19 executed the same for the purposes therein contained. I N F4 I fT'l S- W Comm. Upires Feb. 1. 1993 EQQW00�P' , 4,;-1 I ...­­­ ,!,HEREOF, I hereunto set my hand and official seal. Present A.P. Nocary Publi, END OF DOCUMENT � The property described herein is adjacent 91-046956 to land or included within an area zoned for agricultural purposes, and residents 'incon- Recorded of this property may be subject to official Records veniences or discomfort arisina from the 0 County of use of agricultural chemicals, including, 0 Butte but not limited to herbicides, pesticides, Candace J. Grubbs and fertilizers; and from the pursuit- Recorder of agricultural operations including,-., 2:38pm 8 -Nov -91 9 1 —46956 1 4W I I Rec Fee I Cash I XX 5.00 5.00 I but not- 11mited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte Countv has established a2ricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept� such inconvenience or discomfort from normal,,necessary farm operations. All that real property -situate in the County of Butte, State of California, described as follows: Parcel 2, as shown ' On that certain Parcel map, being a portion of parcel 4 of Parcel Map 75 at page 38, filed in the office of the Recorder, County of Butte, State of California, on August 22, 1981 in Book 86 of Parcel Maps, at pages 17 and 18. Date: PROPERTY OWNERS: hoae_[*,to� Kqs-kr-n r�lc,6cr--L5 State of he day of 19'? before me, the On this t SS. undersigned Notary Public, personally appeared County OF��) 4� Personally known to me. Proved to me an the basis 0 OFFICIAL SEAL of satisfactory evidence. U. ... D REBERA L. BLEDSOE to be the person(s) whose name(s) 6�,� N OT BU LI 0 = subscribed to the within instrument and acknowledged that__t6k�___ OTARY PUBLIC - CALIFORNIA �C BUTTE COUNTY C mm xP e 1 19 executed the same for the purposes therein contained. I N F4 I fT'l S- W Comm. Upires Feb. 1. 1993 EQQW00�P' , 4,;-1 I ...­­­ ,!,HEREOF, I hereunto set my hand and official seal. Present A.P. Nocary Publi, END OF DOCUMENT � RESIDENTIAL PLAN dECKING GUIDE (S.F., DUPLEX-& MISC. ONLY) Bldg. Permit,# _��Z OWNER A. P. # 77F - 7 J -2; - GENERAL Plan Checker 8/91 on . n -g - requirements: (sideyards and number of permitted living units). l 1 ua.tion. ��.��ans signed by designer. r ron oper description of work on application. Existing violations on property. ems on data sheet. (W.C., fees, Health, Developer Fees, License law, etc). co Recorded notice of violation. PLOT PLAN mplete parcel size and dimensions. etbacks, sideyards, easements, etc. mp e �b I er buildings or structures. rading, fills, drainage.' o 0, d hazard. S Sp c pecial conditions on creation map, ".t eb1e, and foundations). & FAS road setback. (noise, CDF, fire sprinklers, non -comb - Building or utilities across lot lines (Record form). FLOOR PLAN omplete to scale plan with dimensions. equired windows for light and ventilation (Sec. 1205). Required windows for second exit (Sec. 1204). kylights (Chapter 34 & Sec. 5207). Human impact glass (Sec. 5406). R q-uired room sizes, ceiling heights (Sec. 1207). G Is in baths, 2arage, kitchen, and exterior outlets (Article 210-8). Light fixtures, ;witches, receptacles, and exterior receptacle -s for main- hance of mechanical equipment. Locations of water heater, heating and cooling equipment, other electrical r gas equipment. rage firewall, door size, and closer (Sec. 503(d)(3)). 3'0" exterior exit door (sec. 3304 (f). eplace and wood stove location, alcoves, and clearance. S oke detectors (Sec. 1210). Plumbing fixtures, water closet clearances and shower size. STRUCTURAL DETAILS �.,�_tandard bracing or engineered design (Table 25V) Unusual shape, size, or split level house requiring lateral design. erestory requiring balloon framing and/or engineering. Three story building requiring engineered calculations and plans. Foundation plan complete enough to construct building. oeFloor construction details complete enough to construct building. levations and wall construction details complete enough to construct Roof construction details complete enough to construct building. Fireplace construction details and calcs if necessary. i a,'-kaf ter -t les- or bearing ridge beam. arage do or porch header sizes.,, -�Tdfie­ights. Adobe soils - special foundation design. Retaining walls requiring design.' cial Inspection required. building 8/91 RESIDENTIAL PLAN CHECKING GUIDE MISCELLANEOUS ITEMS TO LOOK OUT FOR -..--Stairway details: landings, rise and run, head clearance, handrails (Sec. 3306). Guardrail details (Sec. 1711 & 3306(j). 'Bri ck or stone veneer (Chapter 30). --Exterior plaster - weep screeds (Sec. 4706). �_�Proper roof pitch for roof convering (Chapter 32). �__Roof covering type - (fire hazard). ;,::�oam insulation - protection. * 36" halls and stairways. * —Living area over garage - complete 1 -hour separation required on garage side including supporting walls and posts, etc. 51_-�o exits on three-story dwellings (sec. 3303 & see Mezannines - 1716). 1-.' A ,,tt-ic access and ventilation (Sec. 3205). 2-'. gaderfloor access and ventilation (Sec. 2516). 3 -.'-Combustion air for fuel burning appliances - L.P.G. requirements. 1"--?b5I-se requirements on duplexes. 5,'. -Energy design. fiing at all exterior openings. TE. DF responsible area requirements. RW 1-1-5- 1?/ FORM J- I A , — . C&Imm"on Piccecuies A, 8, C4 0 copyright by me .At Condipcom Cxintraclors .11= 1513 tM StmK ".W. Washhqton, D.C. Privited M USA 1984 Plan 11 Da'. Calculated WORKSHEET FOR MANUAL J LOAD 6ALCULATioNS FOR RESIDENTIAL AIR CONDITIONINO for. "gym AcIdnISS and State or F owe me C--octor Design Conditions Wirav Summer Outsidedb 15/ -F Insidedib F Outside do AO/ -F Insideft :F VAnter Design Temperature Difference -F Summeir Design Temperature Difference Room RM Daily Range Heating Samimm Total Heat Logo tor Entire HOLM@ (Uns 15) S-Uged Stith VentitstionCFM Winter Design 7��.arature Difference -F HIM Required for Ventilation Air . 1.1 X CFM X F Stuh Design Heating Load Illoquimm-ar-I - (house) (V&nt) -5� Stuh TOW soma" 001,13 e 7,0/ Edis, cabling summary Melculation Procedure 01 D&xIgnT*rnp@gat!�Sw1n0 TolialLoter"Gatri+ BUM (Calculatim Procedure D) MMM13-4 P14.5-11 ) 7-5— Total . Sains. , Let .���Stuh Ventilation CFM Eq -IF 'SUMM-Y g) Mete, �'� Model 6 " —Type LA_) Hearing input (at _/z7&tPC9-C2 61 -m -Ing output Wtuhl Sensible Cool LatieviCooling(Btuh) jDaiR - // 91:::�41 Total (Stuh) COPIEEftlfEEI�lliPF 9,,3 _,Cco0ngCFM Zc� msatingCFM 1'9�Mk_ro space TWIfirwtat I I Cool( Heiwcooi edightsetbacit( L-r- Conabuclilon Data Q windo- Floor Ae 'A,,f IC IL wanit easernem wall, Row S,0A,,e_XA1Z,9 Groundshib Gaging In a k, A Calculation Procedur'es A,B,C,D Procedure A - winter intimation riim L;aicutatioi-� 1. W1 I fit ation CFM 1_� ACIHR x. 9,072_9Cu. FT. x 0.0167 =4fg.,4s CFM Volume 2. Winter 1 6 I., .19191MI-OCIPM x Winter TO c: -2<5 Ell.h 3, ;Va!� _yt! n HTM Total Window Stuh - Z 2- H T M & Door Area 'Procedure 8 - Summer Infiltration HTM Calculation 1. Itration C ACINR x 2 2 Cu. FT. x 0.0167 CFM Volume 2. Summer InIll Btuh IsrVIV2; 4&s-1, Stuh CFM x Summer TO 3. "MInl4ation KTM Stuh Total Window=//,' HTM Door Area Procedure C - Latent Infiltration Gain Summer r. I Btuh Proceaure u - tquipmeni wzinq Loaas 1. Sensible Sizing Load Ecure Kau" 2 Running Ft Exposed swstl Sensible V ptilation Load 3 Room Dimensions. Ft 1.1 it 2S' Vent. CFM x SummerTD Stuh Sensible Load for Structure (Line 19) T_ Stuh Sum of Ventilation and Structure Loads C19 Slut, Rating 9 Temperature Swing Multiplier g: RSM Equipment Sizing Load - Sensible aA;7_4�'/ Btuh 2. Latent Sizing Load ParUdims d Latent Ventilation Load 6F - 0.68 it — Vent. CFM x gr diff Eltuh Internal Loads .. 230 x _!jL7N.. PeopI'e + stuh Infiltration Load From Procedure C + k" Btuh : I Equipment Sizing Load - Latent = �� _ _Z -o tuh Refer to Table 6 I IN.. of R. Ecure Kau" 2 Running Ft Exposed swstl 3 Room Dimensions. Ft 4 Ceiling HL Ft DirecLitins Room Fa.� .9, T_ TYPE OF C411111. EXPOSURE 0.. I.CrICLh C19 5 Gross 'I - Exposed b Wall, and C ParUdims d 6F d Glass b C Heating ) d 7 Windows N orth h* 7 and Glass E & IN or NE A ?NMW Doors Southor SE A SW_ -Coolingo Other /0 _127,a_7 /0,91 /6 S-)3 1 G 0— D.- 110-e-, 5, 16 Lc!j 3) 4, 9 Net '11LD 2Z& M4 b walis and C - Partiti=9 d � & It 11 Fl�s a b 12 Infiltration HTM I//_? 3o2, Yr 13 _52_2 Sub Tot. Stuh Loss ,6 + a * 9 + 10 + I I + 12 14 Duct Btuh Ldw L/0, 13+14 1fiTotaJBtuhLc@*- 16 Pfo* 6 300 and Appliances IWO 171 - 1. 9. so. .. Sans" Sixth Gain - I 2� i 18 Duct Both Galo 19 7�otsl Sensible G. 11-ir- I LA A I%-" ". %J& I.- %J AAA ki jt9 01 Zye. - Documentatlon AuLhor BUILDING DATA Condi . one-&Floo;;-��-ea Kse� Floor M--S%i—njl-eFim-ily Detached (SFD) Single Family Attached (SFA) Multi-Farnfly(MF) Number of Stories Number of Units Addition Alone Existing Building Existing -Plus -Addition B UILD LNG SI-IELL INSULA170N Component Insuladon Locaflon/ccomm=ts Tyr -,e R -Value (attic, :0 EURRe. etc. WaU .............. WaU .......... — Roof .......... Roof ........ . Floor'...'. .... Fioor ........... Slab E,-4ge ..... G L AJZ I NG Gizzing Orientation Shnding Devices Building Permit, 0 CheckedByl.Dto -- — i Enformnetit Agency Use 0* Glassk ...... wo Glass North 14o(? -Fop- NO r-"11 East g. 5 /-5 South Ar < West 0 S0UL'h Skylight Total West 4 West Area Gl= Type Ira&-ior Exterior Overt=g Framing Type (SI) (singir- double) (ToUer blk4 etc-) (shade=em em.) (yeshio) (Metaliwoocn ,v o rz, -h /J`7 NO r-"11 East East S o U'Uh 0 S0UL'h West 4 West Skylight ....... I THERMAL MASS Type/Covering Area T'hickness (slab/ex-josed. tile, em) (sf) (inches) Location/Description (kitchen. bath. etc.) HVAC SYSTEMS Minimum Duct Type (fjrnw,- sk Efficiency Location Duct Output Manufacturer /Model # condiEianer.,heAt aumv) (SF- SEER.HSPF) (attic, etr-) R -Value (B ruh) (or anproved equal) 7P -7 opol. 6 fl 3-65 Maximum Fumace Hearing Output: 1W Nf.) N4 NO HOT WATER SYSTEMS Tank Manufacrurert�fodel # Systern Ty 'FeavnQ pe (storage g3s. etc.) Capacity (orapprovedeaual) SPECIAL FEATURESIREMARKS (Add extra sheets if neccssary) I Nland2tory Measures Checklist: Residential MF -IR NOTE: Lowruic rcndeno." buildings jubicet to thc5andards mug caumn dX=V,%c2==M- 11 at the compliance awcd Itonsmamcd -ita an asLouk (,)may W wmrndcd bymomwngc�tcornoivuscr onvwCou(vc=co(Comq%Lwx= whmtbnchotkALULSoicargamwAinoucper-da=un=m%Lftfcmumnomdm%md be conudered by all Varucs as buiding muumurn compol perf— fi�vjcns (or the mandatory memo= whether V" arc shown cLwwncrc in the docamous or an Otis 'hwklLst ohly. t)Es=PT1o" DESICXU ENFQXCEMD#T Building En"lope Measures • 17-5352(a): Minsmum cajin% fnsuLatmon 9.19 watmed swngc. 17-53SM)r Loose rill insutatmon manuiacturo's Lzbeled R-Valuc. • 12-5352(c): Minunurn wall insulaaan in Icuned walks R-1 I --ghod average (does ax apply 0 camnor nun -WLS� J2.5352(k): Slab edge ii� - -wer absoramn rat no VcaLer thah 03%. water vapm trwumusion raic no grcaicr VLan 2-0 povWknclL 12-5311: Lnn-',umspcorscdorinmalledmwuCaidamiaEjwVCanunis6m(C=quwiry UandxdL Lndcm type and form 17-5352(f): vapor bw = mm4awy in CUmgc Zones 14 and 16 only. J2.5317: Infiluzu0n&zralvationConvoks a. Doors am wvwo-s between corwuuwvcd and uncondiuoned spaces d=pcd to 6MU Aw leakage. b. Doors and -i co- courted. c. Doom — wv-o-s -vzuw=pput A josm and pawaumns caulked and scak& §2-5352(er Special infilumuon barrier --fled &* comply wids 12-5331 shmst CZC quality nandard%. 12-53=d): InstalLationo(Futoiaces 1. Masonry and Umory-busa rucpta= havc L & ignt fuung. clo=ble mcc&J or Sian door bL Ouusde aw imakc with damper and conad c. Flue *mnow and control 2. No Conn.— ourTung ps pilots allowed. HVAC MW Plumbint System Measures 12-5352W and 2-M: Space coriditionint - pi; SiZing: 2,_#. ;2-5352(b)and2-5311- Sczbar-kawnro=rnagapOkabichcaLintsy==Ls. *-§2-5316(a)., Ducts constructed. inscUbcd and insuLawd per Chapter 10. 19176 tIMC. 12-5316(b): sysionz have dampmcomots. 12-53WO Gas-fired space heating equipment has intermittent ignition devices. 12-531A- HVAC equipment. water hcau=showcftads and fa—cotifiedbytheCF.C. V-5352ts): WaLcrhexcrinsuia6onbl�ni=(R-12orptucr)orcomb4bedinwriorftzmrior insulatton (R. 16 or pcucr)-. rim 5 feet o( pipes cioscsz to tank insulawd (R-3 or Smater). §2-5312(Ezccpuan 113: Pipe insuLauan on si=un and s&cam condensam return ractmuLaLing 12- 53 1 R(d): S -imoung Pool! Hc=ing 1. SyUcrn h= a. 0"(f 5"Tch on hcater. b. Wcuncroroof umnanson plate on hcv=. c. Plumbed to alkow for solar. 175 percent thermal efficicncy. 3. Pool cc-cr. 4. -jjmcClocL 5. Duccoonai w2ta inict. Ughtint and Appliance Measures 12-5352(D- Ughunt - 25 boommaiw= or Vcaur for jencral lighting in kischoss and badmooms. §2-5314(c): Gas And appliances cqwvW with intornincut ignition davices. 12-5314(a): Rcfrigcmurs. reffigaazar-fteczas. (mc=ws and fluorcxctsu Larnp ballasts cotified by Ift C'EC. inawase make ana model nuntact. CONeLLA.NC:E STATEMENT This cerdfir,=of complianceliststbe buildlagf=, - s and performance specificationsnecded to comply with Tide 24, Chapter 2-53 and Tide 20. Cmpw 2. Subchapter 4. Article I of the California Administrative code. 7 Itis cerdficate has been signed by ft individual wid2 overall desiga respicr%sibility and the bufiding owner. who shall retain a copy of it and =n=it the cardficate to 2try subsequent purd-se of the building. Designer Building Owner Narnc: 6 6 Nunc Addre= Addrc= Tck*wr.,c-- Lic. j: (sign&DAM) (da-) Documentation Author Ntn%= Addx=: Tck*vonc (sagnscum (date) Knt Agency Name: ACcncr. TIL--- 1. Ceiling 2- W211 IUSU1211OU .70 Numoer at s=nes Single- R-yajue One Two Three R-0 AM -4 krniiv R-19 -8 -4 .2 R-30 .2 .1 .1 R-38 R -i 9 .-1 .2 U-Vaiue 4. Slab Fdge Inmiation 0 S3 0.!0 -176 -84 -54 0.20 -102 .49 -32, 0.10 -26 -13 -8 O.C8 .18 .3 -6. Us -11 .5 -4 O.C4 4 .2 .1 0.C2 -3 2 1 O.Co -1 5 3 2- W211 IUSU1211OU .70 Stab Floor Single- Single. R-vaiue Famity Famiiy Mufti. R-vWue Det=ed A= --.ed krniiv R-0 -68 -51 -14 R-1 I a -S R-'.3 2 -4 R -i 9 .-1 .2 U -Value - 4. Slab Fdge Inmiation 0 S3 =-7 0 -co -;I 10 -As =0 _zs -24 0.10 0 3 0 0.08 4 3 2 Us 9 7 5 0.04 14 6 7 0.02 .14 10 O.Co. :4 0.90 12 -3 .1 7 a - -.3. Raised Floor Twulation, Inmiadan in Flow Number of smiries One Two Thme 0 3 R-Vaiue R-0 R-1 1 R-1 9 R-30 U -Value OM 0.40 0. 2 0 0.zo 0.10 0.08 0.06 0. CA 0.02 O.Co -144 .70 Stab Floor Number of swries -52 R-vaiue -95 _46 _30 -69 _U .22 _L3 .21 -14 .17 -8 -S -2 .2 -4 R -i 9 .-1 .2 .2 4. Slab Fdge Inmiation 0 A 2 Number of Stones 10 5 One Controlled Ventilation Cravw"ace speoficawn Stab Floor Number of swries oints R-vaiue One TWO Three R-0 -11 .7 -S R-5 -4 .4 3 R -i 1 -2 .2 .2 R -i 9 .-1 .2 .2 4. Slab Fdge Inmiation 5 .5114 .41 to Number of Stones Glass R -value One TWO Three R-0 0 0 a R-5 -M S 2 R-7 40 6 3 F2 'acmr .14 -3 8 0.90 4 -3 .1 0.80 .1 -1 30 0.70 2 2 -A 0.60 6 A -58 0.50 9 6 5 0.40 12 8 A S. Infiltratioa (Air Leaka-c) 7..Shading (Shade Open) (pervwtgIzsxxSC) speoficawn Stab Floor Raised Roor oints Fwnd* % G;ass Norm East South West 0 is 6. GL='de2t L4w 1 4 1 To'61 16 4 2. 5 1 U -value 14 perwt 2 5 .5114 .41 to .21 to 0.30 or Glass Single Double .60 M .40 lew 50 -121 -53 -M .24 .10 A 40 -90 -37 -26 .14 -3 8 35 -75 -z9 -is .9 1 10 30 -61 -21 -13 -A A 12 29 -58 -zo t2 -3 5 12 28 -55 -is .10 .2 5 13 27 .52 .17 .9 .2 6 13 .S 2 2 -is -is _a .1 7 14 25 -!S .14 .7 0 7 14 24 -4 -12 .5 1 a 14 23 -Ao -ti -4 2 a is 22 -37 -9 -3 3 9 is 21 -34 -7 .2 4 10 is 20 -31 -6 a 5 10 16 19 -29 -4 1 6 11 is 13 13 -3 -2 - 7 12 16 17 -23 .1 3 8 12 17 16 -20 0 4 9 13 17 :..is 47 1 6 10 14 17 14 -14 3 7 IQ 14 18 13 -12 4 a 11 is is 12 -9 6 9 12 is 19 11 -6 7 10 13 16 is 10 -3 9 11 14 17 19 9 .1 10 13 15 17 20 a 2 12 14 Js 18 20 7..Shading (Shade Open) (pervwtgIzsxxSC) Shading (Shade Closed) 1 sinqw- . Stab Floor Raised Roor Effectiv* Pei c t GIs= Fwnd* % G;ass Norm East South West Skyright is 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 a 2 3 5 2 2 7 1 3 4, 2 2 -5 1 3 A 2 3 -4 1 2 4 2 3 -3 0 2 3 1 3 2 a 1 2 1 3 2 a a 1 a 3 1 .1 .1 .1 .1 2 0 .1 -2 -1 7 9 na = not allowed 10 1 1 6 Shading (Shade Closed) 1 sinqw- . Stab Floor Raised Roor Effectiv* Pei c t GIs= Fwnd* sw" Muhi - (Pa c t stass X SC) Stones; AMxhW r_FA One Two Three One %as" mom am South wed stykitt 18 -14 -is -69 _64 .5 16 .12 -12 -59 -55 na 14 .10 -as -50 -46 na 1 2 -a .29 -4 .37 na 11 -7 .215 -36 -XI na 10 -6 .23 -31 -29 -1-4 9 -S . _20 -27 _zS -65 a -5 .17 .23 -21 -SG 7 -4 -14 .19 ..Is .47 6 -3 -11 -is .14 zo -1 2 4 5 6 7 4 .1 -6 -8 .7 .23 3 0 -34 -5 -4 .16 8 9 3.5 -2 -1 7 9 9 10 1 1 6 0 9 110 4 3 0 ng . not ak-ad 9. Interior Thermal MaSS Intanor 1 sinqw- . Stab Floor Raised Roor Uass Fwnd* sw" Muhi man Stones; AMxhW r_FA One Two Three One Two Three 0.0 -a -S .4 -2 .1 .1 0.1 -a .5 -3 .1 0 0 0.3 .7 .4 .2 a I I U -6 -3 .1 1 1 2 0.7 -5 .2 .1 1 2 2 0.9 -S .1 0 2 3 3 1.1 4 .1 1 3 4 A 1.3 -3 a 2 3 A 5 1.5 -3 1 2 4 5 5 zo -1 2 4 5 6 7 zS -47 -U 5 7 7 a 3.0 -34 -29 6 a 8 9 3.5 2 5 7 9 9 10 4.0 3 6 a 9 110 10 4.5 3 7 a 10 11 11 5.0 4 7 9 11 12 12 5.5 5 a 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 1A 14 8.5 7 110 12 13 14 is 10. Exterior Wall Thermal Maw Ezwr;cr 1 sinqw- . 1-arvie. Sum of 1 -6 wag Fwnd* Family Muhi man Detached AMxhW Fwily 0.00 a 0 0 0M 3 2 1 0.40 s A 3 0.60 8 6 4 0.120 10 a 5 1.00 13 10 7 IM 13 12 a' 1.40 12 13 9 1.60 10 13 11.. i.ea 10 12 12 Uo 10 11 13 11. Heating System SE or EESPF ' (sssusues ducts In attfc) Zonal Control Adjustment System Type Resistance 10 9 7 6 A 3 Other 6 S .4 3 2 2 1_' Cc�ofittg SySVM SEER (sasomes ducts in attic) SLm o(7-10 -2S or -24 Is e-114 b -4 to Sum of 1 -6 16 or SEER jus -IS 1 -6 -25 or -24 to -14 to -L to +ito is;� SE HSPF less -*, 5 -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. 779 13 11 10 8 7 5 0.90 US 17 15 13 11 9 7 US 8.71 20 18 15 13 11 a 17 14 12 Vrective SE or HSPF 6 3 (SE. or HSPF x duct esTicienc.7) 2 Effec:ive -2S or -24 to -14 lo -A to +6 to 16 or SFE HSPF less -15 -S +5 15 mom CL30 7-75 - 73 -64 -56 -47 -U _M na 3.41 -is -,^is -34 -29 -24 .18 0.40 3.67 -34 -30 -26 -22 -is -14 Uo 4.sa -10 -9 -8 -7 -5 -4 0.56 rL s 3 0 a 0 a a a 0.60 S-za 5 5 4 3 3 2 0.70 6.42 17 15 13 11 9 7 0.80 7.33 2S 22 19 16 13 10 0.90 8.25 32 28 24 ZO 17 13 1.00 9.17 37 32 28 24 19 15 Zonal Control Adjustment System Type Resistance 10 9 7 6 A 3 Other 6 S .4 3 2 2 1_' Cc�ofittg SySVM SEER (sasomes ducts in attic) SLm o(7-10 Zonal Control, Adjustment 10 a 7 6 4 3 No Coodw,-Sysum Installed -Stories -2S or -24 Is e-114 b -4 to +6 to 16 or SEER jus -IS 1 -6 +5 +15 mom 8.0 .1i .12 -10 -8 -6 .4 1. 5 -9 .7 -6 -5 -A -3 8.9 -4 .3 .2 .2 9.0 -3 -2 .2 .1 9.5 Heater 0 0 a 0 10.0 4 3 a 2 2 1 10.5 7 6 5 4 3 2 11.0 10 9 7 6 4 3 1zo 15 13 11 9 7 5 13.0 2o 17 14 12 9 6 3 3 2 2 POU 8 5 Effadve SEZR 3 3 SE (SEER:rduct efflcienc7) -37 -24 -is .%v of 7-10 -12 Effect�esz or -24 to -iA in -4 In +6 to is or SEER less .15 -6 +S +15 more 5.0 .30 -25 -21 -17 -13 -9 6.0 -12 -11 * -9 -7 -6 4 6.6 -9 -A .4 -3 _2 -2 , 7.0 -3 a .2 0 0 8.0 7 : 5 .4 3 2 9.0 16 IA 12 9 7 5 10.0 - 22 19 is 13 10 7 11.0 226 23 19 15 12 8 MO ^;a ^46 22 18 14 9 13.0 33 29 24 20 IS 10 Zonal Control, Adjustment 10 a 7 6 4 3 No Coodw,-Sysum Installed -Stories North b. East c. South d. One -5 .4 .4 -3 .2 -2 Two + 3 3 2 2 2 1 Sing(e-Familly aftached and Attached I UrA Size (so '12M Water :109 1700 2200 2700 Heater Uredit or - 10 to to - or Type Type WSS 16M 2199 26N more SG None 0 a 0. 0 0 or Solar 12 8 6 5 4 KP' HVIR 8 5 4 3 3 WS3 5 3 3 2 2 POU 8 5 4 3 3 SE None -37 -24 -is -15 -12 Saw -1 .1 .1 a a 0% HWR -is -12 -9 .7 -6 IJ WS3 -2S -16 -12 -',0* -a 23 POYL -14 _42 -9 .71 -6 0 None -5 -3 -2 .2 -2 CL411 Solar 7 : 5 .4 3 2 1.1 POU 3 2 -:Tg-. 1 1 1 E None -28" A I Z' -11 .9 -48 1- Solar 8 . 5 A 3 3 1 POU -10 , -6 -5 .4 -3 fil Mulu-173014 (Indl,idual units) 11 13 25 17 Unit Size (sq 4.1 Water 4.1 699 700 1200 1700 22M Hester Crq* or 10 to 110 are Type Type less 1199 1Mq 219g 42 33 None 0 ' a a a a .SG or SO* 14 7 5 4 a Hp HWR 9 5 3 2 2 ZI WS13 9 4 3 2 2 4 POU 9 5 3 2 2 SE N-0 Sclar -45 -23 -15 -11 .9 1.1 Hy'R 2 -23 1 .12 1 -a a -6 0 -5 12 WSR -Z5 .13 .8 -6 .5 4,4 - PQU -23 -a -6 .5 IG None Sclar a .3 .2 -2 6 3 2 1 1 POU 1 0 - 0 a 0 IF None _co 51 &9 53%. CL9 1.1 Safar C is 9 6 A Z4 Z6 FOU A -1 .3 1 -2 Interior Mas.VCFA ------ Point System Summary: Climate Zone 11 SCORE CARD 1. Ceiling Insulation 2- Wall Insulation 3. Raised Floor Insulation 4. Slab Edge Insulation 5. Infiltration 6. Glass Heat L= -7. Shading (Shade Open) a. North b. East c. South d. West e. Sky.Ught rrPe I PAS3 (UTAC b 4.2. Isit evoczed SL&bl o% s% i(m IS% 2m 2S%..3D% 3s% W�. 45y' 50% SS% W% aft M% 73% W% a% 90% SM "My' 103% t 1 IM 11115% 120% 1 0% 0 CL2 0.4 0.6 (18 1.1 IJ Is 1.7 1.9 '21 Z3 25 23 2.9 14 16 18 4 k2 44 107. U CL411 116 0.6 1 1.2 1.4 1.5 1.1 11 U 2.5 ZY 11 11 .22 13 23 27 A &2 t4 46 -48 1- .4.8 5 20% 0.3 as a's 1 1.2 1.4 1.6 1.8 2 12 fil IT 19 11 13 25 17 19 4.1 43 4.1 4.8 .L 5 5 52 X% Q5 dl 0.9 1.1 1.4 1.6 1.2 2 Z2 U Z5 Z8 3 42 33 17 33 4.1 42 4.5 4.1 49 5.1 52 5.4 40T. 0.7 09 1.1 12 I.S 1.7 1.2 12 Z4 ZI XS 3 12 14 16 3.8 4 43 4.5 4.7 k 55*1 S-3 5.3 Se 50% CLS U IJ I.S 1.1 IJ V Z3 Z5 V 3 12 14 Is 18 4 42 4.4 4,4 4,11 &91 5.5 5.1 .3 Is 51 &9 53%. CL9 1.1 1.4 1.1 1.3 2 22 Z4 Z6 Z8 3 U 13 17 IS 4.1 4J 4.5 4.7 4.9 it 53 56 5.1 6 60% 1 1.2 1.4 1.7 1.9 2.11 V ZS U 19 11 13 3.5 18 4 &Z 4A 4.4 4.8 5 5.2 5.4 54 5.2 at I 65% 1.1 U 1.5 1.7 1.9 Z2 U ZS Z11 3 12 24 36 22 4 4.3 AS 4.7 4.2 11 53 55 5.7 5.2 61 7M 1.2 1.4 1.6 1.5 2 Z2 is U zi 21 3.3 is 17 319 4.1 4.3 4.9 411 5 5.2 5.4 5.4 58 a 52 75% U 13 V U ZI Z3 LS V 3 12 3A 15 U 4 4.2 4.4 AS U S., 5.3 15 5.7 is &1 &3 MY. 1.4 1.6 1.8 2 X2 2.4 %a 2.8 3 13 IS 11 12 4.1 k3 tS k? to 3.1 54 Sg S.g a 62 64 45Y. 1.4 1.7 1.9 It Z3 ZS LY 29 3.1 23 15 It 4 4.2 4.4 46 4.2 3 52 SA 39 59 9.1 63 as 90T-'. 1.5 1.7 2 12 Z4 Z5 Z111 3 22 14 14 IS 4.1 4J 4.5 4.7 41 S.1 s2 55 V 5.9 6.2 64 a& 2S% 1.5 LA 2 22 Z5 1 7 2.9 1 1 33 15 11 19 4.1 43 4.6 tl 5 12 5.4 5.6 19 6 &2 6.4 6.7 1001r. 1.7 U V 23 ZS L& 3 22 3A Is It 4 4.2 11,41 4.6 4.9 It S,3 5.5 L7 &S &1 &3 S.5 6.7 105% 1.8 2 22 V Z6 ZI 3 23 IS 17 19 4.1 4.3 4.3 4.7 4.9 11 SA So it 0 9.2 6.4 86 as 1110% 1.9 zi Z3 ts 11 Z9 11 13 as 3.8 A 4.2 L4 4.9 4.8 5 52 5-4 5-7 5-9 &1 U 6.5 6.7 69 115% 2 Z2 24 2. Z3 3 12 14 3.5 13 4.1 t3 4.5 4.7 4.9 5.1 13 5.5 5.7 5.9 6.2 6.4 &6 g.l 7 120% 2 V zS Z; 19 11 23 15 IT 19 4.1 4A 4.6 4.8 5 5-2 5-4 5.6 54 4 &Z &S a.? 6.9 7.1 125% zi V 2.5 Lit 3 3.2 U 16 18 4 4.2 " 4.4 42 &1 13 5.5 17 5.9 &1 &3 &s &7 7 7.2 Point System Summary: Climate Zone 11 SCORE CARD 1. Ceiling Insulation 2- Wall Insulation 3. Raised Floor Insulation 4. Slab Edge Insulation 5. Infiltration 6. Glass Heat L= -7. Shading (Shade Open) a. North b. East c. South d. West e. Sky.Ught 8. Shading (Shade Closed) a. North b. E= c. South d. - We= e. Skylight 9. Interior Thermal Mass 10. Exterior Wall M= 11. Heating System Zonal Control? ( Y N 12. Cooling System Zonal Control? ( Y N 13. Water Heating Me2s:ures R -5c or R-vWnc 1381 U-VlLiuc (0mol or aiuc(IIT- U.vaiuc (0.0981 7R 19 or R-vWuc J 191 U-Valuc (0.0M or R-Valuc (01 F2 f=cr [0.771 Standard Point Scores . 0. Type idonalci U-vaiw J0.651 % TOUL Glass ( 161 % GLIss SIC - Eff. % Glass x 7 X 400 M.'s X 3. V7 0?4L X cc G 0 _X or % Glass SIC Eff. % Glass ly X -.% 4_3 3- X -Ito !q X X X 0 TYPE 1 KASS AREA COND. FLOOR AREA TYPE 2 KASS AREA COND. FLOOR AREA X - JP -3 - = SE or HSPF Duct Efficicsicy (0.781 Effectivc SE or 10.7k6A HSPF 1G.W5. 151 X SEER 19.51 Duct F_ffio 41 EffecuveSEMMI Type (SGI Credit, (Ocxbcj 0 3 -t-5 Sum 1.4 0 / - S L Pnint 7ntal." t3