HomeMy WebLinkAbout024-180-06424-18-64
E
D NAKAMOTO
ampbell Avenue, Gridley
t#2628-87B,P,E(addition F) Z
Q
0
41
CD
PERMIT NO. 2628-87B, P, E
- • PERMIT EXPIRES v l� ~ 00.
OWNER HAROLD NAKAMOTO
CONTR. Owner
ASSESSOR PARCEL 24-12-64
LOCATION-_-g¢SCagbell, 6r-i4le •
5
i
Temp. Power Pole
Called PG&E
r
Temp.' Elec. Service
Called PG&E
f.
t
Temp. Gas Service
j
Called PG&E
JOB FINALED D
\ .fc
Signature
�ff
T
OK
0 = Not OK
= Not Read'yable MOBILE HOMES MISCELLANEOUS ati ., :-►
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
ate
DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Sewer; Location -Test -Fall -C/O -Concrete
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; Location -Test -Easement Needed (Sketch) .
4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-
Shthg.-Rfg.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
6. Gas; Location -Test -Wrap: / /" L" ft.
/ /"Nat. or/ /"L"ft./ /"LPG
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Utility Clearance
7. Elec.
8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
Card -131
Date Card -131 Date
10. Roof; Shthg-Roofing
Card -131
Date Card -81 Date
11. Ext.; Steps -Doors -Landings
Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
Card -131
Date Card -131 Date
2. Footings; Size -Spacing -Marriage Line
Card -131
Date Card -131 Date
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
Date
POOLS (Plans) OK except #'s
5. Drain; MH Test -Fall -Flex Connector
1. Setbacks -Easements
6. Water; MH Test -Regulator -Connector
2. Soils; Compaction -Structure Stability
7. Water and Sewer. Connected -C/O to Grade -HD Approval
3. Pool Structure; Steel -Connections -Thickness -
Dead Men -Lining
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
4. Elec.; Receptacles and Lighting, Distances-GFI
10. Cert. of Occupancy.
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main in Conduit
Card -81 Date Card -131 Date
Card -131
Date Card -B1 Date
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Card -131
Date Card -131 Date
Card -131
Date Card -81 Date
= OK
0 = Not OK
- =Not Aw'`icable RESIDENTIAL (Single and Duplex)
_ Not Reay
Date UN RFLOOR (Plans) OK except #'s
Zoning requirements -Setbacks -Easements
c2,+fg., Main; Soils-Steel-Elec. Grnd.-/ /"
3. g., arage; Soils -Steel-/ /" Ftg. Deptl
4. s[Tacks; Soils -Steel-/ /111
Stemwalls, Main; Steel- Bloc kouts-Wrapper
6. el-Blocko
7.
C/O -Sewer Test
1 hors
1 Anchors -Regulator -Service Test
12 nd
s; Clearance-Material-Supprt-InsZ..
4. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Insulation
Card -B1 Dated/y, Card -B1 Date
Card -B1 Date Card -B1 Date
Date
PLUMBING (Permit) OK except #'s
t -Access -Combustion Air
g-1R�
ater Pipe; Test & Anchors -Nail Protection
.W.V.; Test-Fttngs & Anchors -Nail Protection
1'9"ShaWBr-Paa-Test, First Floor -Tub Access
ower, 2nd Floor -Tub Access
2 s Pipe; Size & Anchors
Card -B1
Dat , and -61 Date
Card -B1
Date Card -131 Date
Date
ELECTRICAL (Permit) OK except #'s
22. Fixture & Transformer Clearance -Ins. Protection
Elec. Receptacles Spacing -Lights & Switches at Doors
Size Boxes & No. of Conductors -Stapled
5. Romex Installed Close to Edge of Studs & C.J.
LM&1quip. Ground made up w/Mech. Fasteners -Bond Gas & Water
ApptMff-ce7Uffcuits in Kitchen & Conductor Size
28-. e / / ga. Cu or AI-A.C. Wire Size / /ga.
Cu or Al
29-Rmige-efrc` - / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral Yes No
30 r onductors & Ground -Main Disconnect
3 . p. ear s Panels-Motors-Mech. Equip.
a r l^fha¢ closet Light -Shower Light -Spa Light
Card -B Da - Card -B1 Date
Card -131 Date Card -B1 Date
D MECHANICAL (Permit) OK except #'s
33. A.C. Ducts Insulation & Support
34. Vent Fan; Exhaust above insulation
35. Condensate Drain & Overflow; Size & Grade
36. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet
37. Attic Access & Platform if Furnace in Attic
Card -B1 Date Card -B1 Date
Card -B1 Date Card -B1 Date
Date FRAMING (Plans) OK except #'s
Sills, Proper Material & Anchors
9_Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
fXBearing Walls over Girders & Floor Nailing
-'4'1. Praft Stop in Walls (rat proof)
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
Header & Beam -Size & Bearing
Date FRAMING (Continued)
4 ps-Anchors-Connectors
Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng.
46. r Type A Flue -Fireplace Throat
ize & Romex Protection -Draft Stop -Ins. Baffles
AQ ws or Exiting Doors -Sill Hgt. & Dimensions
49. lection Framing
ewall & Openings
51. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
Broom -Rise -Run -Landing -Fire Protection
53. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
4. Siding -Nailing Veneer
5 rip Screed -Fd. Vents-Underflr. Access
Glazing Area -Glass Protection -Skylights -Plastic
Nai ' g -B is
B.Insulation-W s -
L -W. Inf4tration-Walls-Wndws
Card -B1(!2 Dat > and -B1 Date
Card -B1 Date Card -B1 Date
Date FJMAL (Plans) OK except #'s
60_Ext. Steps -Door & Sidelight Protection -Landings
61. Smoke Detector
- learance-Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
6 : a ix ures & Tub Access -Spa
Elec. Trim & Subpanel; Breaker Sizes -Labels
6
67, Eimplaro or -At Clearances -Hearth
80. Elec. od Panel; Int. & Ext.
6 ; Grnd. -Air Gap -Cooking Clearance
7 eptacles at Kit. Counter
71 Garaae Fire Dnnr Swing -Landing -Closer
7 e -Damper
78-V4tp.-H4,,-Vents-Clearance-Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
4. Plb., Elec. & Mech. Equip. Listed for Location
75 El='Receotarlea In Garaae: (G.F.I.I-Romex Protec.
CW. Insl.�)a4en-Foam-Looked in Attic ❑ Yes
78.' dn. Vents ravel Hole -1393 rainage & Wood -Earth
Clearance Loo oor O Yes
79. Following instld.; Drive es O No; Walks D Yes O M
Planters o Yes GWU
80.
814 - nnect, Electrical, Plumbing
2. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to
Openings.
81JUatez_.lAla1.1;-�nnect, Electrical, Plumbing
84. ; G.F.I. Receptacle -Underground
85�dF6attfatica ihr}tughout House
86. ss Protection
7. Corrections from Previous Inpections
; Gas -Electric
ila6w Sewer Connected -C/O to Grade -HD Approval
nergy Compliance Certificate -Other Certificates
Card -61 Dat and -B1 Date
Card -61 Date Card -B1 Date
Card -B1 Dat rd -B1 Date
Comme is at Final:
(NOTE:. An entry must be made each time you visit job site)
s
COUNTY OF BUTTE
lot , DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
R
A routine Inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correct n of work iso completed. If you have any question pertaining to this
matte, or eed additional explanation, please contact this office immediately.
11
Inspector. Date r ��
� r•,`
+�, �"�
��
�4 N
August 19, 1988
Harold Nakamoto RE: Building Permit No. 2628-87
895 Campbell Ave. Expiration Date 8/13/88
Gridley, CA 95948 (A.P. No. 24-18-64)
Dear Mr: Nakamoto:
With reference to the above subject, our records indicate that your Building
Permit expired on the above date. Building permits are valid for one year
and should construction be started but not completed by the expiration date
of the permit, the permit shall be renewed for a the original Building Permit
Fee (plus a $10.00 "Filing Fee"). The renewal permit will extend the Building
Permit for an additional year from the original expiration date.
Should you not renew your permit within thirty days of the expiration date,
it cannot be renewed and all work must .cease until a new building permit is
issued.
If your construction is completed or should you have any questions concerning
this matter, please contact the Oroville office.
For your convenience, we are enclosing a renewal application form and owner -
builder form to be completed and signed by you where indicated and returned
to this office together with the fee shown. Please return all copies of the
application form.
Thank you for your prompt attention concerning this matter.
Yours very truly,
William Cheff
Director of Public Works
Glander
JFG:aam Arief Building Inspector
Attachments: Permit Application
Owner -Builder Information
Owner -Builder Verification
cc: Building Inspector - Oroville/538-7541
Chico - 196 Memorial Way/891-2751 Paradise - 745 Elliot Rd./872-6307
c,�,�
owner:_""L__0 --i� /Vy��'.�-+�Z���lP 0 U Permit No.
E N E R G Y C t R T IFI C A T I 0 1.K
eN5-- Z =- 4::� 4_ F-1� =
LOCATION A.P. No.
DESCRIPTION OF INSULATION
ROOF
Material
Thickness(inches)
EXTERIOR WALL
..Material
Thickness(inches)- - 7',j—
CEILING
Batt or Blanket Type
V Thickness(inches)
Loose Fill Type
Minimum Thicknes�(Inches)
Area covered(ft. )
FLOOR, ELEVATED
Material
Thickness(inches)
FLOOR, SLAB
Material
Thickness(inches)
Width(inches)
FOUNDATION WALL
Material
Thickness(inches)
Brand Name
Thermal Resistance (R Value)
Brand Name
Thermal Resistance(R Value) _
Brand Name
Thermal Resistance(R Value) -
Brand Name
Number of Bags Wt. per bag lb.
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)
I hereby certify that -the above insulation was installed in the above building
in conformance with the State of California Ener&.Requirements.
j� �- ,92oLA f✓,�i9�� d7c�
FIRM NAME/OWNER STATE CONTRACTOR'S LICENSE NO.
�IGNATURE OF INSTALLATION.APPLICATOR DATE
I hereby certify. -the above -insulation and all required items as shown on the
Building Department approved plans and attachments have been installed -as
required by the State of'California Energy Requirements.
All equipment, devices and materials -are of the quality prescribed or are_ -
specifically approved by -the State of California. _
FIRM NAME/OWNER (Please print) STATE CONTRACTOR'S LICENSE NO.
SIGNATURE OF GENERAL CONTRACTOR OWNER DATE
THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR.TO FINAL
INSPECTION APPROVAL AND COPY SHALL BE POSTED WITHIN THE BUILDING.
January 1984
M
10
I'
COUNTY OF BUTTE - DEPAATMAT OF PUBLIC WORKS P RMIT NP.
7 -County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
,E SOR PA CEL BER
ASS
f
ZONI}yG
X/�7
BUILD"ING PERMI
ow
%{? t
T L PHONESO.
6,273
FT. 0 C. BUILDIN ATION
OWE 'S MAI NG ADDR�SS / �f
P
CON,PRIA�CgTO /Ry'S NA LEPMONE
W
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONS R CTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCH ECTCOR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$ .-.
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS �7 —Permit
fee
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
(t I
Solar or heat pump water heater
20.00'
LOT NO.
SUBDIVISION NAME
PARCEL AP
Water piping '
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00 Q
Mobile Home JSFG W
10.00ea
TYPE OF WORK
New Addition Remodel[] Utilities❑ Installation❑ Other E]
Describe work: _
Permit Fee
$it
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 AMP ORV OR SLESS
10.00
Main Service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
ElNON.RESID
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
(, 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
(Sec owner, am exclusively contracting with licensed contract-
❑ I am exe4t under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP —
OR ADDNS. ACC. BLDGS. 'h2Sgft
NEW CONSTR. MULTI-OUTLET'2,50 ea
BRANCH CIRC ITS
POWER APPARATUS S.
SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 2ALO 30
eL0
FIXED APPLNS. OR 1
Ex. Occup. OUTLETS (RESID.) EA./ 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
The permit is for $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 subjectLHH6od
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subjectm)ee
to the W. C. provisions of the Labor Code, you must forthwith comply with suchprovisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERM
Filing Fee 10.00
Heating
Cooling
g
3.00
tilatioPK
$
tractor
I certify that I have read this application and state that the above informationile
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 5aid County in co quence of the granting of this permit.
X 9, S _ p
Date !��
Signature of Applicant — Owner] Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3,,fIsttoories in height.
Home Installation Fee $
Energy Inspection Fee $
`
TOTAL PERMIT FEE $ tp
occuP.
CONST.TTPE
FLooD
RCEL
n
ND
seu
This permit is hereby issued under
sions of the Butte County. Code and/or
work indicated above for which
I ECTOR OF PUBLIC
By
By
PERMITWIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date}^�y1�3'
--13 v(/
Receipt NO. ���
WHITE-D.P.W.. YELLOW-ASOEe SDR. PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive,,Oroyille, 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. I personally plan to provide the.major labor and materials for construction of
the proposed property improvement (yes or no) 'fermi
2. I (have/have not) %,4Yr' signed an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
,Name
Address City
Phone Contractors License No.
I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5.- I will provide some of the work'but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
=01Y eq
Signed:
Property Owner A/�a �/J AI ICA.-" ou
Social Security Number --
Date - 7
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.
r'�:rv`"''�•4i rs''.a'1�7N'�'cY'7•' `�Y' •��''"p��/vdy�X;r.[--�ieT .,Sj�F.r�R•� , 7: ?� •,�.�. + +.`,.
Z,.tK✓'• +7' �' ''.+fir! r�t`�'br., `� cwt �f . ter.' • � .�;:A►
COUNTY OF BUTTE - DEPARTMENT�017 �•� IBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT APPLICATION DATA SHEET
Permit No.
OWNER �` ' 'v ' `070/0 P. No. &;9 -
Proposed Building Use 45A II in ns ector / Date
P g 7� 3 P44��
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 be p-srub itted.
/ 2: Plot plans in a -t
g6p.0 e' - ate, signed by preparer of plans. _
3. Complete plans 4iju;Lplica�t;e/ iplicate, signed by preparer of plans.
4. Complete engineered plans and calcs, with wet signature on plans.
5. Plans with Energy Design Compliance Statement. . . . . .
6. School District "Fees Paid" Stamp on Floor Plan.
8Statement of Intel t f r N ated and AC Buildings.
. Fees of $ ` �� . . . . . .
�
j 9. Letter of signature authoriz on.
"'� —10. Sanitation approval fromrHealth Dept.
11 Planning approval for (A) Use: (B) Parking:
_ Certificate of Workmen's Compensation Insurance. . . . . . Ma g
/I3. Contractor's License Information (no., name style, classif.)
14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ )
_.—_..-_15. Improvements may be required. . . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . . . . t1,
Pre-Inspec.request to (Dot%)
17. Pre -Inspection for__.___ _ . _ ..._ _. _ Required. Building Inspector
18. Recorded copy of Agricultural Acknowledgment Statement.'
19. Driveway Permit, —
j�` 20. PloSptan approv�L.from city of _
21. JJ _ —
22 . — --
r, you issue the it, process as follows: Mall o owner; + Mail t -o contractor.
Telephone � X37 and hold for pickup 4WJ_W7d4ffice, Deliver w/inspector.
Other _ _--
Applicant 7! Date s
Copy of plans sent Health Dept., Fire Dept., Other Date
The following data - must be submitted ri r to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by—phone ____nail—counter by date —
Contractor, designer, owner, was advised c? above required data by—phone—mail counter by date
Plans checked by Date -'Plans approved b
Z_
Sets of plans on hold in File cabinet AP folder
Copy—DPW
,VO Building Department
FROM: � Environmental Health
SUBJECT: Sanitation Clearance
---
Owner Location
Plan Approved for:
Hold final for:
Sewage Disposal C- Water Supply
Final clearance O. -K. for:
Clearance for _ _ _ bedroom mobile home.
NOTE * * *
Sanitarian /
Water Supply
Water Supply
Other 1�
Date
\1
Certificate of Insurance
Calftrm Insurance Company
SACRAMENTO. CALIFORNIA
E'
THIS IS TO CERTIFY THAT THE INSURANCE POLICY AS SPECIFIED BELOW HAS BEEN ISSUED BY A CALFARM INSURANCE COMPANY TO THE
INSURED HEREIN, EFFECTIVE AS OF THE DATES AND FOR THE LIMITS AND COVERAGES SPECIFIED BELOW. THIS CERTIFICATE OF INSURANCE
DOES NOT IN ANY WAY AMEND, EXTEND, ALTER OR VARY THE COVERAGE AFFORDED BY THE POLICY OR POLICIES REFERRED TO HEREIN.
IT IS SIMPLY A SYNOPSIS, OR SUMMARY OF THE ACTUAL INSURANCE CONTRACT.
INSURED:
NAKAMOTO, HAROLD & BOBBY.
DBA: NAKAMOTO BROS.
*895 CAMPBELL AVE
GRIDLEY, CA 95948
SERVICING TERRITORY
STATE
CO.
TERR.
04
07
TYPE OF INSURANCE
POLICY NUMBER
POLICY
EFFECTIVE DATE
LIMITS OF LIABILITY
EACH OCCURRENCE
AGGREGATE
GENERAL LIABILITY
BODILY INJURY
$ ,000
$ +000
❑ COMPREHENSIVE FORM
❑ PREMISES -OPERATIONS
PROPERTY DAMAGE
$ ,000
$ ,000
❑ EXPLOSION AND COLLAPSE
BODILY INJURY AND
PROPERTY DAMAGE
$ ,OOO
$ ,OOO
HAZARD
❑ UNDERGROUND HAZARD
PRODUCTS/COMPLETED
❑
COMBINED
'
OPERATIONS HAZARD
❑ CONTRACTUAL INSURANCE
❑ BROAD FORM PROPERTY
PERSONAL INJURY
$ 000
DAMAGE
❑
+
INDEPENDENT CONTRACTORS
❑ PERSONAL INJURY
AUTOMOBILE LIABILITY
BODILY INJURY
(EACH PERSON)
$ ,000
❑ OWNED
BODILY INJURY
❑ HIRED
(EACH ACCIDENT)
$ ,000
❑ NON -OWNED
PROPERTY DAMAGE
$ 1000
UMBRELLA LIABILITY
BODILY INJURY AND
❑ COMMERCIAL
❑ FARM & RANCH
PROPERTY DAMAGE
$ ,000,000
$ ,000,000
❑ PERSONAL
COMBINED
FARMERS COMPREHENSIVE
BODILY INJURY
LIABIL'I`TY
(EACH PERSON)
$500 ,000
$500 ,OOO
kiFARMOWNERS
FO 588717
0 1-11- 8'7
BODILY INJURY
❑ FCL
(EACH ACCIDENT)
$ ,000
$ ,OQO
PROPERTY DAMAGE
$966 ,000
$500 ,000
OTHER
WORKERS COMP
FO 588717
01-11-87
INCLUDED
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES
�� Cs.— C C2 ( Pa Piw.s:1 F -(3 -7
THIS CERTIFICATE SHALL EXPIRE; 30 DAYS FROM THE DATE SIG ED BELO)N.
VK+Gdit� � Gt�,V��
CANCELLATION: SHOULD ANY OF If ABOVE DESCRIBED POLICIE E CANCELLED BEFORE THE EXPIRATION DATE SHOWN ABOVE, THE ISSUING
COMPANY WILL MAIL TEN (10) DAY RITTEN NOTICE TO THE BELOW NAMED CERTIFICATE HOLDER,
THIS CERTIFICATE ISSUED TO:
CalFarm Insurance
BUTTE COUNTY DEPT. PUBLIC WORKS
#7 COUNTY CENTER DRIVE DATE
OROVILLE, CA 95965
BY
AUTHORIZED R tOENTATIVE
GEN 10907 B (REV. 7/87) CERTIFICATE HOLDER
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quILOING DEPARTMENT
WES7 \oIA L L IA
APP[�OVED,:
U-riLi-rY �M-
?95 tAMAOClt
in-------------
FORM 7
ADDITIONS TO RESIDENTIAL BUILDINGS ENERGY SHEET
PACKAGE "A" (Additions)
Owner /i��4M Q T a Climate Zone
Permit # Floor Area ,/0
The following data showing mandatory and required features of Package "A" shall
be installed for additions to dwellings. Additions to dwellings include room
additions, converting garages and patios to living areas, house moves that add
footage and attic conversions, and any space that is existing non -conditioned
space that is converted to conditioned space. Remodeling of existing conditioned
space is not included.
ZONE 11 ZONE 16
APPLIES TO NEW AREA
CEILING R-30 -38
WALL R-11 R 19
FLOOR R-11 R-1
SLAB y" 1-7 R-7
GLAZING U-.65 (Dual) U-.65 Dual)
SHADING
SOUTH - OPTIMUM OVERHANG
or .36 Shading Coefficient
WEST - .36 Shading Coefficient
LOOSE FILL INSULATION (Density)
INFILTRATION CONTROL (Weatherstrip doors, certified windows, caulking)
-1616....�rr INE;-F.14GH-E 1-& BATH NOT i:ESS THAN 25 l l my 1S/WATT
MAXIMUM GLAZING 16% OF -AREA PLUS REMOVED GLAZING
NEW HEATING, VENTILATING, AIR CONDITIONING AND HOT WATER SYSTEMS IN
CONJUNCTION WITH AN ADDITION SHALL BE INSTALLED AS SHOWN ON BACK
OF THIS SHEET.
OTHER
BUTTE COUNTY
BUILDING DEPARTMENi2/s5
APPROVED
*1 - HEATING, VENTILATING, AIR CONDITIONING SYSTEM
(A) Heating _
❑ Central Gas Furnace 7
(brand and model number) �iSE
Btu/hr t
heating capac•ity1"
❑ He Pump
(brand and model number) ACOP
Btu/hr
(heati capacity at 47°F)
❑ Active Sol
type (liquid or air) Collector brand and
ft2
model number solar fraction collector area collector
orientation ollector tilt rated y -intercept
rated slope
❑ Other
(describe)
*1. (B) Cooling
E3Electric Air Conditioner
( and and model number) (seasonal EER)
to/hr
(cooling capacity at 95°F)
❑ Electric Heat Pump
EER
to/hr
(cooling capacity at 95°F)
❑ Other
(des•-cr ibe
DOMESTIC WATER SYSTEM
❑ . (A) Gas Only Gallons
(brand and model number) (tank size)
❑ Heat Pump w/Electric Backup
(brand and model number)
Gallons
2 (tank size)
13* Active Solar
(collector brand and model number)
(rated y -intercept) (rated slope) (solar fraction)
ft
(backup heater type, brand and model number) (collector area)
(collector orientation) (collector tilt)
Q Location of Solar .Panels
❑ Other
(Describe)
*1 it documentation of sizing heating and cooling equipment by Manual J, sizing
chart form #4) or other approved methods, section 2-5352(8), and fill out the
following.
Heating: Winter n temperature °, elevation ', heating load -BTU
elevation fa ' r x heating load = maximum outlet capacity gas furnace
BT
Cooling: Summer design temperatur ', cooling load BTU
*2 Submit T.I.P..S.E. chart'or other approved stem (form #5) to document sizing of
solar panels.
® DESIGN COMPLIANCE STATEMENT: The above building des i meets the requirements of
Title 24, Part 2, Chapter 2-53 of the California Administration Code..
�NATZ�ZESIGNER OR APPLICANT