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HomeMy WebLinkAbout025-320-03025-32— .3 ® 514-90B,P,E,M s - GREEN,.'RoVert R. ; • t �, 84 Momj;s 'Lane; Oroville s: (new siny> gle famil _ . Al, ��: a 3 025-320-030 05-1565 PHILLIPS, DALE 84 MOMS LN, PALERMO 1NAL FD Cont: ALLADIN ROOFING RE -ROOF - 025-320-030 99-120 AG GREEN, ROBERT & EMMA AGRICUI T_t AL,EXEIV. P i' PERMIT,. FEED AND AG EQIIIPIENT STORAGE . i. NOTES RESIDENTIAL PERMIT NO. 025-320-030 05-1565 tl PHILLIPS, DALE i 84 MOMS LN, PALERMO Cont: ALLADIN ROOFING RE -ROOF i` SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS 0 VERIFY USE PERMIT CONDITIONS (� SUB -STANDARD HOUSING LETTER JOB FINALED (Date) Signature /�- BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 638-7541 PERMIT NO. BPO51565 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under s Issued Date: 06/16/2005 APN: 025-320-030-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and Site Address: 84 MOMS LN PAL effect._ License Class : Y �oy y License Number: l.� n —3 f 1 Map Index: . Date: 6 —/(0 {Contractor:lc' ,, k, Description: REROOF 35 SQ COMP OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: PHILLIPS DALE D & BOBBIE J permit to construct, alter, improve, demolish, or repair any structure, prior 84 MOMS LN to Its Issuance, also requires the applicant for .such permit to file a OROVILLE, CA signed statement that he or she is licensed pursuant to the provisions of the Contractor's Slate License Law (Chapter 9 commencing with Section 95965-8102 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. -Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): O I, as owner of the property, or my employees wilh.wages as their sole compensation, will do the work, and -the- structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such Improvements are not Intended or offered for sale. If however, the building or Improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or Improve for the purpose of sale:). O I, as owner of the property, am exclusively contracting with licensed contractors. to construct the project (Sec. 7044, Business and Professions Code. The Contractors' Stale License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penally of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation• as provided for by Section 3700 of the Labor Code• for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier:Cz Policy #:_ 7 13 ` 19 % %- O -S— O 1 certify that In the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:(lo�//i Applicant: l ��✓ %2 �d LI * i Lz r� WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), In addition to the cost of compensation, damages as provided for in Section 3708 of the Labor code, interest, and attorney's fees.— CONSTRUCTION ees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued (Sec 3087 Chi.) Address Applicant: ALLADIN ROOFING P 0 BOX 4262 OROVILLE, CA 95965 (530) 533-2934 Contractor: ALLADIN ROOFING P 0 BOX 4262 OROVILLE, CA 95965 (530) 533-2934 License #: 532834 Architect: Engineer: Total Square Ft: Valuation: Census Code: 0 S. F. $0.00 Oc /9aw Sze This permit is hereby Issued under the applicable provisions of the Butte County Code and/or Resolullo t do work indicated ab9A f which fees have been paid. By Date: /1�h P MIT EXPIRES ON: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, , handling and use of hazardous materials..: ; ❑', Notification in accordance with Section 11)827.5 of California Health & Safety Code Is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above Information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with :all county and stale laws relating to building construction. I acknowledge It is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to ente upon the above mentioned property for Inspection purposes_ Print Name: /�I ` �/ /1,K'"V, Signature: Date: O'Owner 01Contractor ❑ Agent for Owner ❑ Agent for Contractor J=OK 0= Not OK - = Not Applicable MOBILE HOMES . =Not Ready Date MOBILE HOME UTILITIES (Plans) OK except fi's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat or/ /" L "ftJ P LPG Date Card B-1 Date Card B-1 Date Card B-1 Date Cana B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except Vs 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing S. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Cana 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, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Cana B-1 Date Cana B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water, MH Test-Regulator-Connectoe 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert of Occupancy Date Cana B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Cana B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except Vs 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing S. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Cana 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, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) )ate UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Fig., Main; Soils-Elec. Gmd.-/ r Fig. Depth 3. Fig., Garage; Soils-Steel-Elec. Grnd.-/ /' Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21.Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral ❑ Yes O No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting: Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One T -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Botts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Dud in Garage -Damper 77. Wtr. Htc; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 83. Following InstldJDrive O Yes O No/Walks O Yes O No/Planters O Yes O_ No_ 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Pibg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (630) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP051555 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under s Issued Date: 06/16/2005 APN: 025-320-030-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and Site Address: 84 MOMS LN PAL effect._ p c7 License Class: 2OK-y/ License Number: 0-3 / Map Index: Dale: �contractor: lc/ill' dC Description: REROOF 35 SQ COMP " OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: PHILLIPS DALE D & BOBBIE J permit to construct, alter, improve, demolish, or repair any structure, prior 84 MOMS LN to Its Issuance, also requires the applicant for .such permit to rile a OROVILLE, CA signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 95965-8102 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees wilh.wages as their sole compensation, will do the work, and -the. structure is not Applicant: ALLADIN ROOFING intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of properly who builds or improves thereon, and who does P 0 BOX 4262 such work himself or herself or through his or her own employees, OROVILLE, CA 95965 provided that such improvements are not intended or offered for sale. It however, the building or Improvements are sold within one (530) 533-2934 year of completion, the owner -builder will have the burden of proving that he or she did not build or Improve for the purpose of sale.). ❑ I, as owner of the property, am excluslvely contracting with licensed contractors. to construct the project (Sec. 7044, Business Contractor: ALLADIN ROOFING and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed P 0 BOX 4262 pursuant to the Contractors' State License Law.). OROVILLE, CA 95965 ❑ I am Exempt under Article 3 of the Business and Professions Code (530) 533-2934 Date: Owner: License #: 532834 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by Section 3700 of the Architect: Labor Code, for the performance of the work for which this permit Engineer: is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Total Square Ft: 0 S. F. carrier: 7 �'�'— L9 % % ` 0 Sr Valuation: $0.00 Policy #: Census Code: O 1 certify that In the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall/O� f forthwith comply withthose provisions. Dale: /)�//� S� a Applicant: "C,<��' ✓ �BO T ir%iL �i l I , . _ WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation,'damages as provided for in Section 3708 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit Is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the ResoI it t do work Indicated abo f which fees have been paid. performance of the work for which this permit is Issued (Sec 3097 Clv.) BY Dale: &&,l Name: P ' MIT EXPIRES ON: Address: (Datej ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials..: ❑ Notification In accordance with Section 1$827.5 of California Health & Safety Code Is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above Information Is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge It Is unlawful to alter the substance of any official form or document of Butte County. 1 hereby *authorize representative s of Butte County to enter upon the above mentioned property for Inspection purposes. Print Name: �/,1 hlgil L Signature: Date' /(% S O Owner 3kConlractor ❑ Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY* CONTRACTOR OWNER Last Name Address < First Name Addressyq 6m� City m Phone 3-9�` / State Zip Phone 5-3 CI s Fax E-mail State License Number CONTRACTOR Name ` 4 Name Address < /e !State City C VIG�` City Zipp Phone 3-9�` / Fax E-mail Lic. # CI s APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Page Fax E-mail Date Approved: State License Number APPLICANT NAME Name / Address City State Zip Phones 33 ^ �2 9_!� Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning Property Address g14 M>'nS Flood Zone Cross Street w e �e SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BIN # LOCATION 5— Uv - Property Address g14 M>'nS City fa) e rg o Cross Street w e �e WORKER'S COMPENSATION Policy Number /3 -- g 77-,:;5J_ Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: 2�r D Ce 00LO-LD Sq. Footage 3 S17 ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: I9d' S Bldg I Receipt #: SRA SMIP I Other ther Total K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 2-24-05 BUILDING DIVISION COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE — OROVILLE, CALIFORNIA 95965 — TELEPHONE: (530) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT NO. Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. 1 'ZONING J ZONING _ OWNER PHONE NO. OWNER'S ADDRESS LOCATION OF BUILDING S f� USE OF BUILDING SIZE OF STRUCTURE I j x so. FT. TYPE OF CONSTRUCTION: WOOD FRAME _Z-- STEEL CONCRETE OTHER (Specify) TYPE OF SIDING ROOF COVERING FLOOR TYPE co KI I t" Pig tJE.L- C ©'f►'1 to, Cot-3CZE:`TL ESTIMATED COST OF CONSTRUCTION $ AG Buildings shall comply with the minimum front, side, and rear yard setback requirements of the applicable County Ordinances as follows: ��f a 0',44it., 2 b ' �v -5,� SIDES �12 0 D REAR 4100 FRONT -- - AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. AG Buildings must comply with Flood Zone requirements. Finish floor elevation must be at or above elevation USGS Datum. I declare under penalty of perjury that the building will be used as stated above and the purposed use confirms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. / Date .�� / 9� Signature of Owner Permit Fee - $60.00 The above described AG Building is exempt from a building permit. , Receipt No. )-740 if FLOAD I PAR L I P.DF- I R XING ISS Manager Building Divisio By �0'tp Date- White ate White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant f • f� r RESIDENTI1-L' 25-32 514-90B,P,E,M GREEN, Robert R. 84 Mom's Lane, Oroville t (new single family) I , r -�- 91 �7 � r ,4 Y,C Y J lx „� i• _ �� { OFFICE COPY t Address 1 GAS + Meter By Date ELECTRIC ?— _J Meter By Dat JOB FINALED (Date) Signature i i� J=OK O=Not OK Not Applic = Not Readyable MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 1 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /" L"ft. / /"Nat. or/ P L" ft./ /"LPG 7. Utility Clearance ' Date Card B-1 Date. r Card B-1 ' Date Card B-1 Date Card B-1 r Date MOBILE HOME INSTALLATION (Pians) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 - MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel s 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors Shthg: Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing V 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-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater '8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures- Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 'J OK O = Not OK - = Not Applicable Not Ready RESIDENTIAL (; = Date D LOOR Plans OK except #'s Md7zon P�'Ftg., Main; Soils-Elec. Grnd.-/ JJ" Ftg. Depth tg., Garage; Soils-Steel-Elec. Grnd.-O(T' Ftg. Depth 4. Ftg., Porches & Decks. Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped Lle<mwalls, Garage; Steel- Bloc kouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. ' rs-Fireplace Ftg.-Steel W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Dat Card B- Dat b Card B-1 Dat Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 1 . Water Htr.; Vent -Access -Combustion Air -Baffle Water Pipe; Test & Anchor -Nail Protection D.W.V.; Test -Fittings & Anchor -Nail Protection ower Pan; Test, First Floor -Tub Access Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date WCTRICAL Permit OK except #'s 22. fixture & Transformer Clearance -Ins. Protection 3. Elec. Receptacles Spacing -Lights & Switches at Doors Size Boxes & No. of Conductors -Stapled Romex Installed Close to Edge of Studs & C.J. :V -70. -Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral 0 Yes 0 No P.1 -Service -Riser Conductors & Ground -Main Disconnect . Equip. Clearances Panels-Motors-Mech. Equip. 32 othes Closet Light -Shower Light -Spa Light 3. Smoke Detector Date Card B-1 Date Card 8-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s C. Ducts Insulation & Support ent Fan; Exhaust above insulation 3 Condensate Drain & Overflow; Size & Grade 7. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet -L &&-AITIZ-Access & Platform if Furnance in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date F MING (Plans) OK except #'s Sils, Proper Material & Anchors -4,k. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound aring Walls over Girders & Floor Nailing 42. D ft Stop in Walls (rat proof) Fire Stops; Furred Ceilings -Stairs -Chases -Tub 4. Headers & Beam -Size & Bearinq f ,Ingle & Duplex) Date FRAMING (Continued) ngers-Post Caps -Anchors -Connectors g. Joist-Rftr. ties -Pu rlin -roof Brac-Truss-Shthng.-Rfng. irepiace Ties or Type A Flue -Fireplace Throat clearance 8. ttic Access; Size & Romex Protection -Draft Stop -Ins. Baffles drm. Windows or Exiting Doors -Sill Hgt. & Dimensions arage Fire Protection Framing Property Line Firewall & Openings 52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits tairs; Width -Headroom -Rise -Run -Landing -Fire Protection ywood on Roof Overhang -Attic Vents -Rafter Outriggers 1 55. Sidinq-Nailinq Veneer 56. Stucco Mesh- reed -Fd. Vents-Underfir. Access 7. azing Area -Glass Protection -Skylights -Plastic. V--_58. r Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows Dateand B-1 Date Card B-1 Date and B-1' Date Card B-1 Date FINAL (Plans) OK except #'s 61.E feps-Door & Sidelight Protection -Landings Smo etector urnace; Vents -Clearance -Comb. Air -Connector - In age; Above Floor-Ducts-Mech. Protection droom Exiting 65' G.F I. & Bath Fixtures & Tub Access -Spa lec. Trim & Subpanel; Breaker Sizes & Labels 67. Stairs & Rails irepiace or Stove; Clearances -Hearth is at Wood Panel; Int. & Ext. R.Fixt. Appliance; Grnd.-Air Gap -Cooking Clearance e utlets & Receptacles at Kit. Counter G age Fire Door; Swing -Landing -Closer A.C. D n Garage -Damper 7 . tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. I arage; Above Floor-Mech. Protection Plb. ec. & Mech. Equip. Listed for Location je-bec. Receptacles in Garage; (G.F.1.)-Romex Protection ,nsulation-Foam-Looked in Attic 0 Yes ward Rails & Deck Construction -Post Caps 7 . wl Hole Door -Drainage & Wood -Earth C ance Looked under Floor 0 Yes ollowing instld.; Drive 0 Yes 0 No; Walks 0 Yes 0 No; Planters 0 yes 0 No 81. �Aa-1 n -Finish C it; Disconnect, Electric , Plumbing ents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openi s er Well; Disconnect, Electrical, Plumbing xterior Elec. Trim; G.F.I. Receptacle -Underground entilation Throughout House 1,10 Glass Protection 88.,Corrections from Previous Inspections Gas Test -Meters Tad; Gas -E 9o. waiter& Sewer Connected -C/O to Grade -HD Approval nergy Compliance Certificate -Other Certificates Date r1_11 n_Qcard B-1 Date Card B-1 Date Card 8 -'f, -4 -'Date Card B-1 Date 3W Card B-1 `f Date Card B-1 v Comments at Final: (NOTE: An entry must be made each time you visit job site) Owner: Permit No. ENERGY CERTIF ICAT ION 84 Moms Lane, Oroville, Ca. areas• , i i LOCATION f A.P. No• DESCRIPTION OF INSULATION ROOF Material Brand Name Thickness(inches) Thermal Resistance (R EXTERIOR WALL Material FIBERGLASS BATTS Brand Name -NQ Thickness(inches) 3 5/81, Thermal Resistance(R Value CEILING Batt or Blanket Type FIBERGLASS BATTS Brand,Name OWENS-CORNING Thickness(inches) 9;Thermal Resistance(R Value) R730 Looae Fill Type FIBERGLASS Brand Name - Minimum ThicknesW nches)-1'2 3/4" Number of Bags. 27 Wt, per bag ib. Area covered(ft.) 1748 Thermal Resistanee(R.VBlu9) R3.�-e.--., FLOOR, ELEVATED Material Thickness(inches) FLOOR, SLAB Material Thickness(inches) Width(inches) FOUNDATION WALL Brand Name Thermal Reaistance(R Values_"_ ,. Brand Name Thermal ResistanCo W idea) Material Brand Name Thickness(inches) Thermal Resistant8(R Vatu6 I hereby certify that the above insulation was installed in the abgvt building in Conformance with the State of California Energy Requi>rementa• LOERKE INSULATION CO., INC. 499150 "Mr pep on FIRM NAME/OWNER STATE CONTRACTOR'S I.ICE1$$:.NO• February 4, 1991 SIG URE OF INSTALLATION APPLICATOR DATE I hereby certify the above insulation and all required items ae shown on the+ Building Department approved plans and attachments have been ine�gjjod aa, 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 I+ICI$ Noe SIGNATURE OF QE.NERAL CONTRACTOR OWNER DATE THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRT04',.TQ'FLNAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILD. 1Wi;j f.."�iit::�^--tr��'+"`''�3:'-�K��i'�`7��Y�-,6i�V�i.rst•-.I'LL..-r.. -.`r•�t���%SrX�s�'s�=�iYtil�ae+i�fc; COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi I le — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE OWNER / PERMIT NO. A routine insp o6 i d'cate the following violations of County Ordinance exist the a v address an should be corrected. Please notify this office when orrectio f work is completed. If you have any question pertaining to this ,r t r, or need ditional explanation, please contact this office immediately. / o-vt, 01 /&T E d1/l/g--'� 1374 -/4- V 4- -y t L So ,4N D i S o /•a rl &A._ f Date — / _y Inspector1`/ e C-) A) �-: N COUNTY OF BUTTE r 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 �9 f OWN EF PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when c rection of work is completed. If you have any.question pertaining to this matte , or need additional explanation, please 'contact this office immediately. /0A3+ kgNS ON Q1006 S/ AE le F -00 -T %^ALL. AT dV t 5irJa- c 0 -4 —7d Date_ Inspector 1 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE OWNER �, PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you.have any question pertaining to this ' ' ..... COUNTY OF BU'T'TE! . ' " " ' 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 ` OWNER PERMIT A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this Date Inspector COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive-4r6011e, Calilfornia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 25 -32 - ZONI G BUILDING PERMIT OWNER Rnhprt R_ C�rppn 1911-917R TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1'AorIle3 1ONTRACTOR' CS NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace ttit 0n0 CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $400.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 84 t Permit fee $ 625-00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 10 2,00 20.00 Solar or heat pump water heater 20.00 LOT NO. 1 SUBDIVISION NAME - 1 PARCEL MAP 1 117-65 Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF Y Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 s no Mobile Home S I G I W 10.00e TYPE OF WORK New ® Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other ❑ Describe work: 3 BR 2 BATH _ Permit Fee $50.00 Contractor ELECTRICAL PERMIT Filing Fee 11.00 Main service GOOV OR LESS 1 10.00 1(✓R00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1 2.50 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification �] I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) r ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I ash exempt under Sec. , Business and Professions Code for this reason NEW CONST.( DWELLING 0056j � '/z¢sgft 62.50 OR ADDNS. ACC. BLDGS. NEW CONSTR MULTI -OUTLET 2.50 ea, NON.RESID BRANCH CIRC ITS 1 POWER APPARATUS -HP Dom r\SINGLE OUTLET cIR. ) 2.00 Ex. Occup(OUTLETS OR FIXTURES 20050S BALO 30 FIXED Ex. DCCUp. P OUTLETS (RESID,)REA.) 2.00• Temporary service X 10.00 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $97.00 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. rV I shall not employ any person in any manner so as to become subject L"4 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 FiIingFee 10.00 Heating xs100k btu X 6.00 6.00 Heat Pum Cooling 4 Ton 1.00 11.00 g Hood 1 3.00 3.00 Ventilation 3 3.00 9.00 Permit Fee $ 39.00 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 ty in c t e granting of this pe mit. nn p,� X Date X11' O�9 C./ ,L Signature of Applicant - OwnerOV, Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $30.00 c YPE TOTAL F E $ 841-00 Hq2 cuA PARK sc FLo J PA PD HD Is E -� This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been .paid. DI R CTO OF PUBLIC WORKS �/ p By Date PERMIT EXPIRES Date ^ �� Receipt No. 6-(a G7 9 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive--OroViller California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 2$— 32P--2or, ZONING . BUILDING PERMIT OWNER kO A R. GRA ,.I TELEPHONE S 33 _ y373 SO. FT. OCC. BUILDING VALUATION 5. OWNER'S MAILING ADDRESS /39/ Coat LN. O ., V,]/e, C,# CONTRACTOR'S NAME TELEPHONE owd 2'Q• /' • cool, 916-A �j r CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ O Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ,� ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ DQ 0,) Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ A Zs'ico PLUMBING PERMIT Filing Fee 10.00 ( �A L/ NO Each Trap 101 2.00 20,0 Solar or heat pump water heater 20.00' LOT NO. SUBDIVISION NAME PARCEL MAP //7- ((5- Water piping 1 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF Q� Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets ( 5.00 G� Building sewer 5.00 Mobile Home S I G I W 0.00 ea. TYPE OF WORK New f5� Addition ❑ Remodel ❑ Uti lities ❑ Installation❑ Other ❑ Describe work: JIM Permit Fee $ SO, Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8000 1 OR LE AMP ORIS SLESS 10.00 /0.0- a,0Main Mainservice EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.( DWELLING S CUP. OR ADDNS. ACC. BLDGOZ ) , hesgft V NEW CONSTR. ULTI-OUTLET NON•RESID BRANCH CIRCUITS 2.50 ea ER APPARATUS eta + LE OUTLET CIR. 7 OQ 2 Ex. OCCup(OUTLETS OR FIXTURES 20@50¢ SAL@30c FIXED APPLNS. OR EX. Occup. OUTLETS (RESID.I EA.) 1 2.00 Temporary service >1 10.00 is Ew Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee S 17 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑The permit is for $100.00 (valuation) or less. ❑I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I%? I shall not employ any person in any manner so as to become subject WW to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating X-5 /0DAra y1 6 co �v/h Cooling `� f f� Hood 3•00 =j Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte 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, 'udgments, c ts, an expenses which may in any way accrue against sa' ty in of he granting of this permit. X Date Signature of Applicant — Owner X Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ 3® i occ CONST TYPE 00 TOTAL FEE $ in L v HAz cuA PARK scHL FLD PAR PD HD ISSUE I Th;s permit is hereby issued under the appiicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. / -WHINE-O.P.W.. YELLOW -ASSESSOR. PINK•INSPECTOR, GOLDENROD -APPLICANT 2' COUNTY OF BUTTE - DEPARTMENfT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER koseorT A. GRFFi✓ A. P. No. I If- 32 a� Proposed Building Use &w San Building Inspector Date Z %D At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... �:"Statement of Intent for Non -Heated and AC Buildings .............. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 1 • School District fees paid .............. 4 Sanitation approval from ORn Health Department �- 5. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B)•Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) AMPVi r— C-51 2 2s o 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No.; Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. z�Owner-Builder Verification (Given to owner ❑, Mail to owner ❑) ..... __42924. Recorded copy of Agricultural Acknowledgment Statement .........ol) r etter of signatre authorization ................................... 27. When ypu issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone 1.71- 9-5 wand hold for pickup at 600 office. Deliver w/inspector. Other Applicant Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prl er It issuance: (Circle new item not checked above). 1. Index permit for above items No. A Z 2. Additional items required: V0 ave Contractor, designer owner, as advised of above required data by_phone aiI—counter by�>(A^date Contractor, designer, owner, was advised of above required data by—phone —ma il—counter by date Plans checked by �L+� Date 3-2-90 Plans approved by J C Date --4—s � Sets of plans on hold in tfile cabinet AP folder Copy—DPW W ment FROM: Encroachment Permit Section RE: Driveway Clearance elvwma (5�,een /ft ol's. Z-6,7 e. owner location Z�- 3 2- AP # Driveway permit lyon e_ I? e ee4l has been issued for the above property. 90 date si ature TO .Building Department FROM: Environmental -Health SUBJECT: Sanitation Clearance Owner Location Ap# Plan Approved for: Hold final for: Sewage Disposal Water Supply LIell Final clearance O.K. for: Clearance for --3 bedroom mobil home Other NOTE * * * Water Supply Water Supply Sanitarian Date 0 I Rets+rn to,D�YCORD�yGFFQUcSTEDAfRICULTURAL STATEMENT OF ACKNOWLEDGEMENT f 9 0- 0 7 MID VALLEY TITLE FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned 90-007219 ; Rec Fee 00for agricultural purposes, and residents Total' 7.:00 '•' of this property may be subject to incon- � ; R ,'`:;�•' veniences or discomfort arising from the I Official Record s, use of agricultural chemicals, including, County of ` but not limited to herbicides, pesticides, Butte ; and fertilizers; and from the pursuit , Candace J. Grubbs ; of agricultural operations including, Recorder ' but not limited to cultivation, plowing, 8;00am 23 -Feb -90 ; B G spraying, pruning, and rharvesting which � ____ occasionally generate dust,' smoke, noise, and odor. Butte County has established agricul- 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 disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described_ as follows: See attached legal description AP# 25-32-25 (parcel 1) Date: February 23, 1990 PROPERTY OWN S: State of Calif. ) On this the 23rd day of February , 19_U_, before me, ) SS. the undersigned Notary Public, personally appeared County of Butte ) Emma Green DANIEL F. HUNT Personally known to me. ® Proved to me on the basis ° NOTARY PUBLIC-CALMORMA• of satisfactory evidence. Bunecompy td be the person(s) whose name(s) is myco*nis mExpimOd•1,1990 s bscribed to the within instrument d ackn 1 dg d t ONO Boa was now summons m00000 ecuted the same for the purposes th rein co t IN WITNESS WHEREOF, I hereunto set my hand and of ici s a . tet- - �/ Present A.P. No. ar_25-32-25 (pl , .,1y Notary Public v A 0-072.1 9 DESCRIPTION ALL THAT' CERTAIN REAL PROPERTY SITUATE IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, DESCRIBED AS FOLLOWS: PARCEL I• PARCEL 1, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON FEBRUARY 1,.1990,.IN BOOK 117 OF MAPS, AT PAGE(S) 65 AND 66. RESERVING THEREFROM A NON-EXCLUSIVE EASEMENT FOR INGRESS, EGRESS AND PUBLIC UTILITY PURPOSES OVER MOM'S LANE, AS SHOWN ON SAID PARCEL MAP. PARCEL II: A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES OVER MOM'S LANE, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON OCTOBER 19, 1977, IN BOOK. 62 OF MAPS, AT PAGE(S) 92. PARCEL III• A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES OVER MOM'S.LANE AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE .OF CALIFORNIA, ON SEPTEMBER 13,-1979, IN -BOOK -73 OF MAPS, AT PAGE(S) 12. EXCEPTING THEREFROM ALL'THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED HEREIN. PARCEL IV: A NON-EXCLUSIVE EASEMENT FOR INGRESS, EGRESS AND PUBLIC UTILITY PURPOSES OVER MOM'S LANE, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON FEBRUARY 1, 1990, IN BOOK 117 OF MAPS, AT PAGE(S) 65 AND 66. EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED HEREIN. END OF DOCUMENT RESIDENTIAL PLAN CHECKING GUIDE 4 MISCELLANEOUS IMIS TO LOOK OUT FOR (CONY D) —4' Exterior plaster - weep screeds (Sec. 4706). ,5— Proper roof pitch for roof covering (Chapter 32). _-6: Roof covering type - (fire hazard). —7i Rafter ties or bearing ridge beam. 8. Garage door or porch header sizes. Adequate bracing. Living area over garage - complete 1 -hour separation required on garage side including supporting walls and posts, etc. .kl'-' Two exits on three-story dwellings (Sec. 3303 & see Mezannines - 1716). � ttic access and ventilation (Sec. 3205). Underfloor access and ventilation (Sec. 2516). combustion air for fuel burning appliances. ,1-55�.Noise requirements on duplexes. 1 -6 ---Adobe soils - special foundation design. 1-7: Retaining walls requiring design. Unusual shape, size, or split level house requiring lateral design. Flashing a xterior openings. Z_ t S O E= .� � �, `� � ill ii�t�c'� � '� '� � � • 5.GUS ,.� t—ocJ I iO"I �T i v-65 Sty LL I l i �Oj r6 1 o AAD �A 3 - '57-c(C) c7<i` 3-G- t:�L�r� 5/89 r RESIDENTIAL PLAN CHECKING GUIDE (S.F., DUPLEX & MISC. ONLY) Bldg. Permit # 5/4-40 OWNER -fes A.P. # 2 "3 0 GENERAL Zoning requirements: (sideyards Valuation. Plans signed by designer. Energy Design and Compliance. Existing violations on property. 6. Items on data sheet. PLOT PLAN and number of permitted living units). Complete parcel size and dimensions. Setbacks, sideyards, easements, etc. Other buildings or structures. Grading, fills, drainage. Flood hazard. Special conditions on creation map or FAU & FAS road setback. FLOOR PLAN compliance document. Complete to scale plan with dimensions. Required windows for light and ventilation (Sec. Required windows for second exit (Sec. 1204). Skylights (Chapter 34 & Sec. 5207). Human impact glass (Sec. 5406). `.1205). Required room sizes, ceiling heights (Sec. 1207). GFCIs in baths, garage, and exterior outlets (Article 210-8). Light.fixtures, switches, receptacles, and exterior receptacles; -for 5/89 maintenance ,of mechanical equipment. -=_ Locations of water heater, heating and cooling equipment, other electrical or gas equipment, and plumbing fixtures. Garage firewall, door size, and closer (Sec. 503(d)(3)). 1 - vni, exterior exit door (Sec 3304(e)) 11 Fireplace and wood stove location, alcoves, and' Smoke detectors (Sec. 1210). clearance. T STRUCTURAL DETAILS 1. Foundation plan complete enough to construct building. 2. Floor construction details complete enough to construct building. 3. Elevations and wall construction details complete enough to construct building. 4. Roof construction details complete enough to construct building. Fireplace construction details and talcs if necessary. MISCELLANEOUS ITEMS TO LOOK OUT FOR Stairway details: landings, rise and run, head clearance, handrails (Sec. 3306). Guardrail details (Sec. 1711 & 3306(j)). Brick or stone veneer (Chapter 30). BUTTE COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SEWAGE DISPOSAL PERMIT 196 MEMORIAL WAY7 COUNTY CENTER DRIVE PARADISE, CALIFORNIA 95969 CHICO. CALIFORNIA 95926 747 ELLIOTT ROAD OROVILLE, CALIFORNIA 95965 Phone: 891-2727 Phone: 872-6308 Phone: 538-7281 Date Issued - EXPIRES ONE YEAR FROM DATE OF ISSUANCE Permit Issued to L- •ice` i '3'5 r I-V\ To construct a sewage disposal system for: Located at: ✓I'"� %�� �✓y''`A'� SEPTIC TANK SYSTEM REQUIREMENTS Septic Tank (Inside Measurements) Leaching Field Length: . . . . . ?. . . . ft. Total Length:. lt&<'. ft. Width: . . . . . .y . . . . ft. Trench width: ZY . inches Liquid depth: y. ft. Minimum No. of lines . Liquid capacity: ` . gals. Rock under tile �94 inches Special conditions: Additional leaching field will be required if experience shows it to be necessary. No part of the system may be located within 50 feet of the center line of any County Road. NOTE: Satisfactory inspection by the Health Department is required before backfilling or putting the system into use. Occupancy of a new building is not permitted until the system is approved. �= Permit Fee. S L Gr Penalty Fee S Total Fee S.- Building Sewer Fee S Issued By: J Nle an i to ri an Receipt No. S31 -278R ti - - BUTTE COUNTY DEPARTMENT OF HEALTH DIVItION OF ENVIRONMENTAL HEALTH 196 Memorial Way 7 County Center Drive 747 Elliott Road Chico, California 95926 Oroville, California 95965 Paradise, California 95969 891-2727 538-7281 872-6308 APPLICATION AND PERMIT TO CONSTRUCT OR DESTROY A WELL Application for: Public Water Supply ❑ Individual Well Well Destruction ❑ Type of Construction: ❑ New Construction ❑ Repair or Deepen 2-5 Owner's Name: OL^C� i iP ����C _Assessor's Parcel No. Z_-" Z— Applicant's Name: 0,, 1m AF_E J Phone No��! �•�; 5� ' - 7 Mailing Address: Ctx. L-C4e- C P-0 ✓ I 1 Jr Site Location: l�on1S LaI14z - CQKOVAe- T. R. S. i SKETCH ON HOW TO LOCATE PROPERTY WORKMEN'S COMPENSATION INSURANCE 1 have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I am aware of the provisions of Section 3700 of the California Labor Code Which requires every employer to be insured against liability for Work- I certify that in the performance of the work for which this permit men's Compensation. is issued I shall not employ any person in any manner so as to be- come subject to the Workmen's Compensation Laws of California. COMPLETE FOR NEW CONSTRUCTION Driller's Name: t 11C[' �� Q-� �F =1o2- Well Driller Contractors License Number J75� Driller's Address: Proposed Depth L Proposed Usage C MPLETE FOR WELL ABANDONMENT Name of individual responsible for work: Address: Scale Plot Plan is to be furnished on reverse sides of both applications. I hereby state that the information above and on the reverse side hereof or attached hereto is correct and true to the best of my knowledge. I understand that the permit must be obtained before any construction is begun. I further state that I am the owner of the property, ❑ the owner's authorized representative, ❑ a Licensed Well Drilling Contractor Date Signed: PERMIT To be completed by the Health Department. 4l t /� Permit to Begin Work Approved by 1�t-0-yyt�b jy Additional Permit to Destroy Dry Hole Prior to Site Abandonment ❑ Special Conditions Fee received: �l I p Receipt No.: Date Issued 3- 3,f Expires one year from date of issuance NOTE: 1. Provide a minimum twenty-four (24) hour notice prior to installing or placing sanitary seal or drilling a well expected to be completed in less than twenty-four (24) hours. 2. A satisfactory inspection by the Health Department and receipt by the Health Department of a Driller's Report or a satisfactory abandonment report and a disinfection statement is required for final approval of work. Copy 1 -Applicant Zone & Req. SB _. Copy 2-- Health Department Pcl. Status PREPARE IN DUPLICATE Certificate of Compliance: -Residential Protect Address t©AU U t C L-� eA • DocumenLadon Author BUILDING DATA ditioned Floor Area SI 'sed Floor jj< Single Family Detached (SFD) [ ] Single Family Attached (SFA) [ ] Multi -Family (N Climate Zone 11 14-9 o - Building Permit # 1 - -1 tAG 2 -"3 -ALSO eciced By/ Date Enforcement Agency Use Only Glass Area % Glass North 13 Number of Stories East Number of .Units _� South . 2 [ ] Addition Alone West 2_s� (] Existing Building Skylight -_ (] Existing -Plus -Addition Tom ALZ.A I7.2 BUILDING SHELL INSULATION Component Insulation I affon/Cpmments Type R -Value (atdc, to garage t;/-pi=L etc.) Wall .............. cA%<il-c /04 Roof ............. A=t:iS J� Roof ............. - f Floor ............. Floor ............. I `Slab Edge..... GLAZING Shading Devices Glazing Area Glass Type Interior Exterior Overhang Framing Type Orientations (single, double) oller blind etc.) (shadescreen, etc.) es/no) (metal(wood) 1 North ( bor Ise L e /JV PC At— Nor-Lh ( )� .East East ( ) South (WT _ South ( )— ' West (vi_ West Skylight....... i THERMAL MASS h' Type/Covering Area Thicl rndss . (slab/e sed, tile, etc.) s inches Locadon/Descri cion Itchen, bath, etc. :tE OR�iA�L 31�S M+ KIT cK AENr� Gf�v HVAC SYSTEMS Minimum Duct i Type (furnace, air Efficiency Loeaaori: , , Duct . - Output Manufacturer / Model # r j conditioner, heat um ' SE, SEER,HSP attic, etc. Value tela P p) ( F) ( )4 .°�- ) ora roved equal) ( pp s . RE f� INA P - — _glta`s�r 5• 25 • A i. Maximum Furnace Heating Output: Btuh HOT WATER SYSTEMS Tank Manufacturer/Model # System Type (storage gas etc.) Capacity (or approved equal) Special Feature(s) • r 4 "1 SPECIAL FEATURES[REMARKS (Add extra sheets if necessary) Mandatory Measures Checklist: Residential _ MF -IR NOTE: Lowrie residential buildings sub*1 to the Standards mug contain these meaaucs regardless of the c=Pli2= _ approach used. Items markrd wth an mwmsk (*)may be supasedod by more suingenl c(xng[ Wnct rcquucmrsts lilted on the Cutirmax of Compliance When this checUst is incorporated into the permit documents. the features noted sh" be considered by all panics u binding minimum component pafrxmanct spwrx ioru for Use mandatory meastru whether they are shown clsewhas in Use documents or on this checklist only. DESCUFT10N DESIGNER WFORCE.MENT Building Envelope Measures 12.5352(a): Minimum ceiling insulation R-19 weighted avenge §2.5352(b)r' Loose rill insulation manufacturer's labeled R-V31ue §2.5352(0: Minimum will insulation in framed walls R-1 I weighted average (does not apply to catmor mus walls). - §2-5352(k): Slab edge insulation - wale absorp6o;r= no greater than 03%, water vapor transmission rate no grcatu than 2.0 perm/inch. §2.5311: Insulation specified or installed meets California Energy Commission (CZC) quality standards. Indicate type and roan. 1 2.5352(x): Vapor barriers mandatory in climate Zones 14 and 16 only. §2.5317: Infiltration/Eafilc ation Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Doors and windows ce rimed_ c Doors and windows wnlhcrunpped; all )oiru3 and pcnc=ou caulked and scakd. - §2.5352(e): Special infiltration barrier installed to comply with §2.5351 meets CEC quality standards. 12.5352(d): Irutal(alion of Replaces I. Masonry and factory -built ftrcplacts have x Tight fitting, closable metal or glass door b. Outside air intake with damper and control c Flue damper and contra 2. No continuous burning get pilots allow HVAC and Plumbing System Measure 4 §2-5352(g) and 2.5303: Space conditioning equipment sizing: attach calculations. 12-5352(h) and 2.5315: Setback 0wrmmn: res all applicable besting systems. • §2.5316(a): Ducts consructrd, installed and insulated per Chapter 10, 1976 UMC. §2-5316(b) Exhaust systems have damper controls §2.5314(c): Gas -recd space hating equipment has intermittent ignition devices. §2-5314: HVAC equipmeru, waterAwns- showerheads and (aunts entified by the CHC. 52-5352(1): Water he= insulation blanket (R-12 or grin) or combined interiorkatcrioc insulation (R-16 or gscacr): first 5 feet of pipes closest to tank insulated (R-3 or grraw). §2.5312(Eaccption I): Pipe instdadon on steam and scam condensate retum do recirculating '• piping. §2-5318(d): Swimming Pool Heating II. System has: a. On/off switch on hater. b. Weatherproof instruction plate an hater. e. Plumbed to allow for solar. 2. 75 percent thermal efrieieney. 3. Pool cover. 4• Time clock. . I S. Directional wale inlet. 1 ' Lighting and Appliance Measures §2.53520): Lighting - 25 lumens/- int of greater for general Lighting in kitchens and bathrooms. §2.5314(c): Gas feed appliances equipped with intermittent ignition devices. §2.5314(2): Refrigerataz, refrigerator-0cezers. freezers and fluorescent lamp ballasts entified j by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This ctr ficate of compliance lists the building features and performance specifications needed to comply with Title 24, Chapter 2-53 and Title 20. C haptrr2. Subclu;, r 4. Article 1 of the Calit`ornia Administrative code, This certificate has been signed by the individual with overall design respcnsibtlicy and the building owner, who shall retain a copy of it and transmit the c en fic= to any subsequent purdlaser of the building. Designer Building Owner Name Name: ' ratkJFirrm rttlerrum; Address: Address: Tekpfwrse Tckptwne ( lac. (signature) - (date) (signature) (date) Documentation Author J Enforcement Agency_ N Name < - _ _ a., . tinse - �'-�. Titk./Firrr ... Agency:`'' j 'Address: TcL-oh nc - 1. Ceiling Insulation -4 3 -1 0.80 Number of stories ' R -value One Two Three R-0 -103 -49 32 R-19 -8 -4 -2, R-30 .2 -1 -1 R-38 0 0 0 U -value -121 -53 -39 0.50 -176 -84 -54 0.30 -102 -49 32 0.10 -26 -13 -8 O.C8 -18 -9 -6 . 0.C6 -11 -5 -4 0.104 -4 .2 .1 0.02 4 2 1 O.CO 11 5 3 2. Wall Insulation -18 -10 .2 Single- Single- 27 -52 Famlry Family Multi - R -value Detached Attached Family R-0 -68 -51 -34 R-11 0 0 0 R-13 2 2 1 R-19 8 6 4 U -value 8 14 23 0.80 -153 -114 -76 0.50 -91 -68 .46 0.30 -47 36 -24 0.10 0 0 0 0.08 4 3 2 O.C6 9 7 5 0.04 14 11 7 0.02 19 14 10 0.00 24 18 12 3. Raised Floor Insulation 2 7 Insulation in Floor 17 -23 Number of stories 8 R -value One Two Three R-0 -17 -8 -5 R-11 3 .2 -i R-19 0 0 0 R-30 3 1 1 U -value 14 18 13 -- 0.60 -144 -70 -46 0.50 -120 -58 38 0.40 -95 -46 30 0.30 -69 34 -22 0.20 -t3 -21 .-14 0.10 -17 -8 .5 0.08 -11 -6 -4 0.06 -6 -3 -2 0.04 -1 0 0 0.02 4 2 1 0.00 10 5 3 Controlled Ventilation Crawlspaee 1 _0 0 0 Number of stories IE None R -value One Two Three R-0 -11 -7 -5 R-5 -4 .4 3 R-11 -2 .2 -2 R-19 -1 .2 - _ -2 4. Slab Edge Insulation - Number of Stories R -value One Two Three ' R-0 0 0 0 R-5 8 5 2 R-7 8 6 3 F2 factor 0.90 -4 3 -1 0.80 -1 .1 0 0.70 2 2 1 0.60 6 4 2 0.50 9 6 3 0.40 12 8 4 5.•Infiltration (Air Leakage) SPecifimiton Points Standard 0 6. Glass Heat Lass Interior Slab Floor Raised Floor Mass Total /CFA One Two Three One Two Three 0.0 -8 .5 -4 •2 -1 -1 (perernt &frit x St) U -value Effective Percent Giass Single Double .51 to .41 to .31 to 0.30 or 18 16 5 4 1 4 1 2 5 1 .60 .50 .40 less 50 -121 -53 -39 .24 .10 4 40 -90 37 -26 .14 3 8 35 -75 -29 -19 .9 1 1.0 30 31 -21 -13 -4 4 12 29 -58 -20 -12 3 5 12 28 -55 -18 -10 .2 5 13 27 -52 -17 .9 .2 6 13 26 -49 -i5 -8 -1 7 14 25 -46 -14 -7 0 7 14 24 -13 .12 -5 1 8 14 23 -40 -11 -4 2 8 15 22 37 -9 3 3 9 15 21 -34 -7 .2 4 10 15 20 31 -6 0 5 10 16 19 -29 -4 1 6 11 16 18 -26 3 2 7 12 16 17 -23 -1 3 8 12 17 16 •20 0 4 9 13 17 15 -17 1 6 10 14 17 14 .14 3 7 10 14 18 13 -12 4 8 11 15 18 12 -9 6 9 12 15 19 11 3 7 10 13 16 19 10 3 9 it 14 17 19 9 .1 10 13 15 17 20 8 2 12 14 16 18 20 7..Shading (Shade Open) Interior Slab Floor Raised Floor Mass Efrectlre Ptrctnt Class /CFA One Two Three One Two Three 0.0 -8 .5 -4 •2 -1 -1 (perernt &frit x St) -8 -5 3 .1 0 0 Effective -7 -4 .2 0 1 1 0.5 -6 3 -i 1 1 2 %Glass North East South West Shyyfight 18 16 5 4 1 4 1 2 5 1 na 14 4 2 5 1 na na 12 3 3 5 2 na - 11 3 3 5 2 na 10 2 3 5 2 1 9 2 3 5 2 2 8 2 3 5 2 2 7 1 3 4 2 2 6 1 3 4 2 3 5 1 2 4 2 3 4 0 2 3 1 3 3 0 1 2 1 3 2 0 0 1 0 3 1 -1 -1 -1 .1 2 0 -1 -2 -4 .2 0 na = not allowed 10 12 12 200 - �3. Shading (Shade Closed) 11. Heating System 12.0 30 Errectire pts ent Class - (assumes ducts In attic) 29 24 20 15 (percent gtass x SC) Zonal Control Adjustment Elective SE HSPF less -15 -5 +5 +15 more 0.72 6.60 0 0 0 0 0 0 %GIass North Eat South West Sky%ht 18 -14 -48 39 -64 na 16 -12 -42 -59 -55 na 14 -to 35 -50 -46 na 12 -8 •29 -40 37 na 11 -7 .26 36 33 na 10 3 •23 31 .29 -74 9 -5 .20 -27 -25 35 8 -5 -17 -23 -21 -56 7 -4 -14 -19 -18 -47 6 3 -11. -15 -14 38 5 -2 -9 -11 -10 -30 4 " -1 -6 3 -7 .23 3 0 -4 -5 -4 -16 2 1 -i .2 -1 -9 1 1 1 1 1 -4 0 2 3 4 3, 0 na . not allowed 9. Interior Thermal Mass Interior Slab Floor Raised Floor Mass Stories Sees /CFA One Two Three One Two Three 0.0 -8 .5 -4 •2 -1 -1 0.1 -8 -5 3 .1 0 0 0.3 -7 -4 .2 0 1 1 0.5 -6 3 -i 1 1 2 0.7 -5 .2 -1 1 2 2 0.9 -5 -1 0 2 3 3 1.1 -4 -1 1 3 4 4 1.3 -3 0 2 3 4 5 1.5 -3 1 2 4 5 5 2.0 -1 2 4 5 6 7 2.5 0 3 5 7 7 8 3.0 1- 4 6 8 8 g 3.5 2 5 7 9 9 10 4.0 3 6 8 9 10 .1 0 4.5 3 7 8 10 11 it 5.0 4 7 9 11 12 12 5.5 5 8 9 11 12 12 6.0 5 8 10 12 13 13 6.5 6 9 10 12 13 13 7.0 6 9 11 13 13 14 7.5 6 10 11 13 14 14 8.0 7 10 11 13 14 14 8.5 7 10 12 13 14 15 10. Exterior Wall Thermal Mass Exterior Single- Single. Wall Family Family Muth Mass Detached Attached Family 0.00 0 0 0 j 0.20 3 2 1 0.40 5 4 3 0.60 8 6 4 0.80 10 8 5 1.00 13 10 7 120 13 12 8 1.40 12 13 9 1.60 10 13 11. , 1.80 10 12 12 200 - 10 11 13 - 11. Heating System 12.0 30 SE or HSPF - (assumes ducts In attic) 29 24 20 15 Sum of 1.6 Zonal Control Adjustment 725 or -24 to -14 to -4 to +6 to 16 or SE HSPF less -15 -5 +5 +15 more 0.72 6.60 0 0 0 0 0 0 0.75 6.88 3 3 3 2 2 1 0.80 '7.33 8 7 6 5 4 3 0.85 7.79 13 11 10 8 7 5 0.90 8.25 17 15 13 11 9 7 0.95 8.71 20 18 15 13 11 8 3 2 2 2 Effective SE or HSPF (SE or HSPF x duct efficiency) Effective -25 or -24 to .14 to .4to +6 to 16 or SE HSPF less .15 .5 +5 +15 more 0.30 Z75 -73 34 -56 -47 -38 .30 na 3.41 -45 -39 -34 -29 .24 .18 0.40 3.67 -34 x .26 -22 -18 .14 0.50 4.58 -10 .9 -8 -7 .5 -4 0.56 5.13 0 0 0 0 0 0 0.60 5.50 5 5 4 3 3 2 0.70 642 17 15 13 11 9 7 0.80 7.33 25 22 19 16 13 10 0.90 815 32 28 24 20 17 13 1.00 9.17 37 32 28 24 19 15 It Zonal Control Adjustment System Type -12 Resistance 10 9 7 6 4 3 Other 6 5 4 3 2 2 12. Cooling Syst.:m 7. S x_ SCORE CARD SEER -) (assumes duets In attic) .44e). Measures Stm of 7.10 1, -25 or -2410 -14b .410 +6 to 16o( SEER less 15 35 +5 +15 more 8.0 -14 -12 -10 .8 -6 .4 8.5 -9 .7 .6 -5 -4 3 8.9 -5 .4 -4 -3 .2 -2 9.0 -t .3 .3 .2 .2 -1 9.5 0 0 0 0 0 0 10.0 4 3 3 2 2 1 10.5 7 6 5 4 3 2 11.0 10 9 7! 6 4 3 - 12.0 15 13 11 9 7 5 13.0 20 17 14 12 9 6 ERective SEER (SEER xduct errlciency) F2 facwr 10.771 Sun of 7-10 ' InfiItratioii Effect" -25 or -24 to -14 to -4 to +6 to 16 or SEER: less -15 -5 +5 +15 more 5.0 30 •25 .21 .17 -13 .9 6.0 - -12 .11, -9 -7 3 4 6.6 -5 -4 -4 3 .2 -2 7.0 0 0 0 0 0 0 8.0 9 8 6 5 4, 3 9.0 16 14 12 9 • 71 5,v: 10.0 22 19 16 ' 13 10 7 11.0 26 23 19 15 12 8 12.0 30 26 22 18 14 9 13.0 33 29 24 20 15 10 Zonal Control Adjustment 10 8 7 6 4 3 No Cooling System Installed 15% 207. Stories 3076 35% 40%:15% 50% 55% 60% 65x 70% '75X One -5 -4 -1 3 .2 -2 Two 3 3 2 2 2 1 Single -Family Detached and Attached Unit Sizei ' d1700 (s Water Heater Credit i 199 12M 2200 2700 Type Type or , ; to to to less 2199 2699 or SG None _1699 0 0 0. 0 more 0 or Solar 12 ' 8 6 5 4 HP HWR 8 5 4 3 3 WSS 5 3 '3 2 2 POU 8 5 14 3 3 SE None _ .37 -24 -18 15 -12 Solar -1 .1 .1 0 0 HWR -18 .12 .9 -7 -6 WS8 -25 .16 .12 .10 .8 POU -18 _-.12 -9, ,, -7. • .6 . IG None -5 -3 -2 .2 -2 Soar 7 5 4 3 2 POU 3_ 2 1 1 1 IE None -28 -19 .14 -11 .9 Solar 8 5 4 3 3 POU .10 3 -5 -4 .3 Multi-Fsmlt7 (individual units) 1.4 Water Unit Sita (so 699 700 1200 1700 2200 Healer cmdrl or b lo to 21 Type Type less 1199 1699 2199 or mare SG None 0 0 0 0 0 or Solar 14 7 5 4 3 HP HWR 9 5 3 2 2 WSS 9 4 3 2 2 POU 9 5 3 2 2 SE None 45 -23 -15 -11 .9 'Solar 2 1 1 0 0 HWR -23 -12 -8 -6 --5 WSB- -25 -13 .8 -6 -5 QU None -- 3 -23IG .5 48 -8 i�-e- - f 2 S2 •Solar 6 3 1 0.7 0.7 0.9 POU.. 1 _0 0 0 0 IE None 3o -is .10 - -8 .6. Solar 18 9 6 4 4 POU -8 4 .3 .2 .2 X-Ulllt ayshem Summary: climate Zone 11 7. S x_ SCORE CARD AREA - 9 -) --�-- x .44e). Measures 1, 1. Ceiling Insulation Interior Mass/CFA d.' West 1. x R -value 1381 U -value [0.0301 e. Skylight � TTK } IMSS Wall Insulation - I I or Effective SEER [V031 9. Interior Thermal Mass _ TYPE 1 MASS R=value J 11 IJ=value 10.0981 Type IsGI 3. Raised Floor Insulation or AREA 10. Exterior Wall Mass R-value(191 U -value [0.0371 AREA on 4. Slab Edge Insulation 'Q or 11. 1•VIK•.. 21 R -value (01 F2 facwr 10.771 5. InfiItratioii 1S tanda& 6. GIass Heat LossL • ' Type (double] U -value (0.65] 90 Total Glass 161 7. Shading (Shade Open) le•rpet.a .l_el t TTPE 1 MASS (UtM 1}1.2, 1'e: ea003ed slab) 0% 5% 10% 15% 207. 2S% 3076 35% 40%:15% 50% 55% 60% 65x 70% '75X 80% 8s% t10X 95% 1007. 105Y. 110% list 120 O% 10% 0 0.2 0.2 0.4 0.4 0.6 0.6 0.8 0.6 1 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.9 1.9 21 21 23 23 25 25 2.7 12.9 • 3.2 3.4 3.6 3.8 1 !,2 1 < 4.6 t.8 5 20% 0.3 0.8 0.8 1 1.2 1.4 1.6 1.8 2 '22 24 21 2.7 29 2.9 . 3.1 - 11 "3.3 3.3 3.5 3.5 3.7 21 3.9 4 4.2 4.4 t 6 t.8 5 5 2 30% 0.7 1.1 a L4 1,6 1.8 2 22 21 26 Z8 3 32 3.5 3.7 3.9 4.1 4.1 4.3 43 4.5 48 5 S2 5t 40Y. 50% 0.7 0.7 0.9 0.9 1.1 1.1 1.1 1.3 1.3 15 1.5 1.7 1.7 1.9 1.9 21 22 24 26 2.8 3 3.2 3.4 3.6 3.8 t t.3 <.5 4.5 4.I 4.7 /.9 4 9 5.1 5.1 5 3 5 3 5.5 5 6 23 ZS 27 3 32 3.! 3.6 3.8 4 42 4,41 4.6 4.8 S.1 5.3 5.5 5.7 5 J 5.9 SS% 60% 0.9 1 1.1 1.2 1.4 1.4 1.6 1.7 1.8 1.9 2 21 2.2 23 24 25 26 2.7 28 29 3 3.1 3.2 35 3.7 3.9 !.I 4.3 4.5 4.7 4.9 5.1 53 56 58 6 65% 1.1 1.3 1.5 1.7 1.9 22 24 2.6 28 3 3.2 3.j 3.4 3.5 36 3.8 t 3.8 4 4.2 4.3 4.4 4.5 4.6 4.8 ' 5 52 5.4 5.6 5.9 6 1 M 75% 1.2 1.3 1.4 13 1.6 1.7 1.8 1.9 2 21 22 25 27 29 3.1 3.3 3.5 3.7 3.9 ti4.1 4.3 4.8 4.7 4.8 4.9 5 5.1 52 53 5.4 55 56 5.7 58 5.9 6 1 23 2.3 21 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6 6.1 62 6.3 807: 8571. 1.4 1.4 1.6 1.7 1.8 1.9 2 2.1 22 2.3 2.4 25 26 2.7 2.8 29 3 3.1 33 33 3.5 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 54 56 58 6 62 64 907:' 95% 1.5 1.5 1.1 1.8 2 2.2 24 26 2.8 3 32 3.4 3.6 3.8 38 4 4.1 42 4.4 4.3 4.5 4.6 4.7 48 4.9 5 5.1 52 53 S! S6 t59 6.1 63 65 1007. 1.7 1.9 2 21 22 2.3 25 25 21 28 2.9 3 3.1 3.2 33 3.5 3.7 3.9 1.1 4.3 !.6 t.d S 5.2 5.t SS 5.5 5.7 5.8 S9 6 62 6.2 64 6.4 66 3,4 3.6 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 5-5 5.7 5.9 6.1 6.3 6.5 6 7 6.7 105% 110% 1.8 2 2.1 22 2.3 2.4 2.5 2.6 21 28 29 3 3.1 3.3 33 IS 38 3.7 38 3-9 4.1 4.3 4.5 4.7 4.9 5.1 5.! S 6 S 8 6 6.2 6.1 6 6 6 8 ; 115% 0% 120% 2 2 2 22 2.1 2.6 28 3 3.2 3.4 3.6 3.8 4 4.1 4.2 4.3 4.4 4.5 4.5 4.8 4.7 4.9 5 5.1 5.2 5.3 5.4 5.5 5.7 5.7 5.9 6.1 6.3 6.5 6.7 69 125% 21 2.3 2.3 2.5 25 2.1 28 29 3 3.1 3.2 3.3 3.4 3.5 3.8 3.7 3.8 3.9 4.1 4.4 4.6 4.8 5 5.2 54 5.6 58 5.9 6 6.2 6.2 6.4 6.5 6.6 8.7 6.8 6.9 7' 7.1 4 4.2 4.4 4.6 4.9 5.1 5.3 5.5 5.7 5.9 6.1 63 6.5 . 6.7 7 7.2 X-Ulllt ayshem Summary: climate Zone 11 7. S x_ SCORE CARD AREA - 9 -) --�-- x .44e). Measures 1, 1. Ceiling Insulation -30 or d.' West 1. x R -value 1381 U -value [0.0301 e. Skylight 2. Wall Insulation - I I or Effective SEER [V031 9. Interior Thermal Mass _ TYPE 1 MASS R=value J 11 IJ=value 10.0981 Type IsGI 3. Raised Floor Insulation or AREA 10. Exterior Wall Mass R-value(191 U -value [0.0371 AREA on 4. Slab Edge Insulation 'Q or R -value (01 F2 facwr 10.771 5. InfiItratioii 1S tanda& 6. GIass Heat LossL Type (double] U -value (0.65] 90 Total Glass 161 7. Shading (Shade Open) Point Scores -2 0 Sum 1-0 % Glass SC Eff. % Glass a. North x.i7 = �5,7-% -i1s- b. East --� x = /-, e4 - C. South x d. West �-�-Z -�_ x = 1,07 - e. Skylight x = r 13ta - 8.. Shading (Shade'Closed) % Glass SC Eff % GIass a. North 7. S x_ ND. L OR AREA - 9 b. East --�-- x .44e). �7 CSouth .Z x .4 l = 2 d.' West 1. x e. Skylight x SEER 11931 Dun Efficiency [0.74] Effective SEER [V031 9. Interior Thermal Mass ' TYPE 1 MASS AREA i'�� '4�= Type IsGI Credit [none] Interior Wus/CFA COND. FLOOR AREA 10. Exterior Wall Mass 11`1 TYPE 2 MASS AREA on 11. Heating System Zonal Control? ( Y / N ) 12. Cooling System Zonal Control? ( Y / N ) 13. Water Heating Exterior Wall plus ND. L OR AREA - 9 Sum 7-10 . x �7 +3 SE (0.71/6.61 Duct Ef6cienry, 10.781 Effective SE or HSPF 10.54/5.151 SEER 11931 Dun Efficiency [0.74] Effective SEER [V031 Type IsGI Credit [none] ,I� •-! COUNTY OF BUTTE-- beartment 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. I personally .plan to provide the major labor and materials for construction of j the proposed property improvement (yes or no) 2. I (have/have not) _Ac_ ✓ d✓ signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors. License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name- Address . Phone Type of Work Signed: Property Owneri�'Q�G� Social Security Number Date D 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. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Centex Drive, Oroville, CA 95965 PHONES 916-538-7541 Robert Green DATE March Z lAgfl 1391 Cox lane _ Oroville,CA 95966, Permit application #514-90 for A.P. # new single family 25-32-30 With reference to the above subject: L� Attached is: Application for permit -Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet Engr. Calcs Typical Plan Sheet Owner -Builder Verification Form List of Codes Enforced OTHER We need the following information: Permit application signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement. Complete plans in , including plot plans. Plot plans in Structural details in Complete plans and calcs in by registered engineer or architect. Energy design including Street and drainage improvement.plan approval from Land Development Section (DPW). sets of plans in accordance with the changes marked in red. XXX Sanitation approval from Butte County Health Department at: 196 Memorial Way,' Chico XXX 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville, for Completed Owner -Builder Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. /77 OTHER 1. Truss details are required before a plan rhprk ran be started. 2. Lateral design is re011irpd nn frnnt Glal l of thin hnt2cM f i t riree ..�♦ NUPE: If a cut and stack roof is to be usedprovide rafters exterior walls and provide sunoorts for _purlin struts c„rh as ear ng wal and foundation. Should you have any questions concerning the above, please contact Dan Kirin (538-7.541) of this office. between 3--5pm Yours very truly, JFG/aj William Cheff Director of Public Works /J- F. GlanderCief Building Inspector y COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovlllet California 98983 - Telephone; 919/538.7541 APPLICATION AND PERMIT A33 , NUMBRA 7KQ ZONING BUILDING PERMIT W" e. WN '>tI' AD A �. 95966 CON TZLILP" B E HONK SO, FT. OCC. BUILDING VALUATION CONTRA MAILING AODRESS Fireplace CONSTRUCTION LENOER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'! MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking FieF $ e Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS ` Penalty $ BUILDING ADDRESS t n Permit fee $ PLUMBING PERMIT Filing Fee 10.00. Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF❑XDuplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S.1 G JW I 1 1-0.0-0 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other []SX Describe work: st; ren BE P#514 90 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 800V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license Is In full force and effect. License No. Classification, ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.a OR ADONS. ACC• BLDGS. ,�2¢sgft NEW CONST R. MULTRANCH TLET CIRCUITS) NON•RESID BRANCH CIRC ITS 2.SOea _ .. POWER APPARATUS e ( SINGLE OUTLET CIR. Ex. Occup(OUTt.ETS OR FIXTURES 20050C SALO 309 FIXED APLNS, Ex. OCCup. OUTLETS PIRESIO )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit'Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $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 Certificase of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date" Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over S'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEES G- i 'Po HA2 CUA PARK scHL FLO' I cDF PAR I Ho. IssuE This permit is hereby issued unser the applicable provi- sions or the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date i►.-fi.-92 Receipt No. WHIT[-D.P•W.. YELLOW-A�eC»OR, PINK -INSPECTOR, GOIOCNROa-APrLICAm s u, Lg 1- M _1 r 2 rrrd UM4 rro 1 HT1 if i►' . « �e TML f�n-Bat„ oie Ct►or�'Q; « . B,n ta# va,w k6 c u» ¢ -fritnv w o+ ..... .... . 41