HomeMy WebLinkAbout026-040-019i
3
26-04-19
Lila M. Boiin
2380 Bohemia Ave., Palermo
contr: Pryor Contr.-; Oroville
Permit #3835-80B,P,E(add bath, elec.
'sery wiring e
,,r b
X I I I �21- �- p
26-04-19
NEW OWNER
LOUIS JIMINEz.
2380 Bohemia Ave, Palermo
Permit#1700-86B,P,E,M(new single family
- --
r 'r
x � �I �.'i �J';�.
PERMIT NO. 1700-86B.P,E,
PERMIT EXPIRES
OWNER LOUIS JIMINEZ
CONTR. owner
ASSESSORPARCEL _ 26-04=19
LOCATION 2380 Bohemia A e, Palermo
CT
OFFICE COPY
Address
Temp. Power
GAS
e-AC Date1j.k4,(1_
Called p - Meter By—
ELECTRIC., Date
Meter By
Temp. Elec.
Called PG&E
• Temp. Gas Service x,
Cal led PG&E
JOB FINALED (Date)
Signature
J=OK
0 = Not OK
= Not Applicable MOBILEHOMES
'* = Not Ready
MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except q's
1. Zoning Requirements -Setbacks -Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
_
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/0 -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
_
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG
6. Carports; Windows -Doors
7. Utility Clearance
_
7. Elec.
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except k's
1. Zoning Requirements -Setbacks -Easements
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except N's
1. Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
2. Soils; Compaction -Structure Stability
3. Gas; MH Test -Demand -Valve -Connector
3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining
4. Electricity; MH Test -Crossovers -Breakers -Clearances
4. Elec.; Receptacles and Lighting; Distances-GFI
5. Drain; MH Test -Fall -Flex Connector
5. Elec.; Pool Lighting; 15 volts-GFI
6. Water; MH Test -Regulator -Connector
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Water and Sewer Connected -C/0 to Grade -HD Approval
7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater
8. Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test -Water Supply Test
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
•
q
�a/ _ .OK,
0 = Not OK
= Not Applicable
+ = Not Ready RESIDENTIAL (Single and Duplex)
Date UNDE LOOR Plans OK except N's
Date FRA NG Continued
Z Hing requirements -Setbacks -Easements
P,p6perty Line Firewall & Openings
Ftg., Main; Soils-Steel-Elec. Q1- / 'Z L Fig. Depth
l _ -g., Garage, / 'ZyFtg. Depth
4
50
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
1 -Headroom-Rise-Run-Landing-Fire Protection__
4. g0j., Porches & Decks; Soils -Steel- / /" Ftg.epth
_
lywoo n Roof Overhang -Attic Vents -Rafter Outriggers
ir Stemwalls, Main; Steel-Blockouts-Wrad-SI�
-N&' ' g -Veneer
&/Stemwalls, Garage; Steel-Blockouts-Wra' -S
/ 53
creed-Fdn. Vents-Underflr. Access_
7. Piers -Fireplace Ft .-Steel
. ! W. -V.Fall-Fitt gs-Te�2 way C/O -Sewer Test
/
—
tJng Area -Glass Protection -Skylights -Plastic
Shear Walls; Nailing -Bolts
9. ee.Anchors
10. Water : est -Anchors -Regulator -Service Test
-
11. E16,111C,
12. PI rance-Material-Support-Ins.
13. Girders 9419 Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Date �
_
Card -BI
Card -BI 11iff
Datei Card -BI Date
Date '1.' Card -BI Date
Card -BI Date73 Card -BI Date
Card -BI Date Card -BI Date
Date FINA (Plans) OK except k's
Date UMBING (Permit) OK except N'so
xt. Steps -Door & Sidelight Protection -Landings
e Detector
14. W� r Ht.: Vent -Access -Combustion Air
We r Pipe: Test & Anchors -Nail Protection
1 D.W.V.: Test-Fttngs & Anchors -Nail Protection
ower . Test, First Floor -Tub Access
1u 3fiower, 2nd Floor -Tub Access
19. Gas Pipe_ Size & Anchors
/
Card -BI ein Date9_)P--bCard-BI Date
Card -BI V Date Card -BI Date
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor -Ducts -Meeh. Protection
Bedroom Exiting
EFA. 4i,.Bath Fixtures & Tub Access
lec. Trim & Subpanel;'Breaker SizejrLaoff
63.
ireplace or Stove; Clearance Hearth V'e_Ramo v O_
1 Outlets at Wood Panel; Int. & Ext.
Kit. ixt. & Appliance; Grnd.-Air Gap-Cooking'Clearance
let. Outlets & Receptacles at Kit. Counter
Date ELECTRICAL Permit OK except k's
67._Garage-F4- ing-Closer
68. -. tiara - br
20. Fixture & Transformer Clearance -Ins. Protection
F,yec. Receptacles Spacing -Lights &Switches at Doors
Si Boxes & No. of Conductors -Stapled
2>f Mo ex Installed Close to Edge of Studs & C.J.
Ip. Ground made up w/Mech. Fasteners -Bond Gas & Water
2��g/2Z�Appliance Circuits in Kitchen _& C nductor Size
C__ o A�4.C_Wire Size / / ga. Cu or At
il-lubteed Wire Size /�g'r
ay/I�ange Circ. /, / gaAI-Oven Circ. / / ga. Cu or At,
Insulated Neu nal �No
rvice-Riser Conductors & Ground -Main Disconnect_
29. Equip. Clearances: Pane ls-Motors_Mech. Equip.
30. GIntJ3esLleeel-Light-Shower Light
--- - -
�y
Card B-1 Date �� 0� Card BI Date - -
9
Card B-1 Date Card -BI Date
m
Date MEC ANICAL (Permit) OK except s's
1
7
Wtr. Htr., V learance-Comb. Ai Cori o P.F )/�
In Ga1.rage; Above Floor -Meth. Protection
b.,, E ec. & Mech. Equip. Listed for Location
7
ec. R ceptacles in Garage; (G.F.I.)-Romex Protec.
7
ulation-Foam-Looked in Attic ❑Yes
73.
coon -Post Caps
74.
.4 le Door -Drainage & Wood -Earth Clearance
Looked under Floor Yes
75.
Following instld.: Drive ❑ No; Walks ❑ Yes o;
Planters ❑Yes
76
cc w7'BfS`n"Fintsli
-
A.C.nit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
_
7
ent bove Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
_ 7
ater Well; Disconnect, Electrical, Plumbing
80.�xtEer'Eec.---T
m; G.F.I. Receptacle -Underground
✓�ntilation
throughout House
ass Protection
_ 3
_
orrections from Previous I ctions
G a --est-Meters Tagge s let ri
94 A. ucts. Insulation &Support
Vent Fan: Exhaust above Insulation
33. Condensate Drain & Overflow: Size _& Grade
34. Furnace -Vent: Access -Comb. Air -Return Air Vent -115V outlet
35. Attic Access & Platform if Furnace in Attic
Card -BI Date Card -BI Date
Card -Bi Date Card -BI Date
VI
-later & Sewer Connected- C/O to rade-HD Approval
q
nergy Compliance Certificate -Other Certificates
—'-
-- --' -
- — - -
Card -BI
Date - Card -BI Date
Card -BI (j
_
')ate - Card -BI Date -- _-_.
Card -BI
Date Card -BI Date
Date FR N (Plans) OK except p's
Com lents at Final:
3 Is; Proper Material & Anchors
W s: Studs -Nailing, Spacing & Bracing -Plates -Sound
ringWalls over Girders & Floor Nailing
I Stop in Walls (rat proof)
�w Stops: Furred Ceilings-Stairs_Chase;..J- ----
yam -
� /er & Beam -Size & Bearing
42 ngers-Post Caps -Anchors -Connectors
g. Joist_Rftr. T" urlin- Roof Brac.-T-Shthnp.-Rfng.
a ireplace Ties or Type A Flue -Fireplace Throat
4 c Access: Size &Romex Protection -Draft Stop -Ins Baffles
--.
drm. Windows or Exiting Doors -Sill Hgt. & Dimensions _
1 Vat, 4 . arage Fire Protection Framing
-= i-
-- - --
--- - - — - — -
- T
- Yk
- - --- --- - - - -- --
(NOTE Anentrymust be made each time youvisit jobsite)
Owner: I rn 2n e -z L U t(.t� _ Permit No.
ENERGY CERT IF ICAT ION
Bohemia, Palermo
LOCATION A.P. No.
DESCRIPTION OF INSULATION
ROOF
Material
Thickness(inches)
EXTERIOR WALL
Material
Thickness(inches)
CEILING
Batt or Blanket Type
Thickness(inches)
Loose Fill Type Fiberglass
Minimum Thickness(Inches) 104"
Area covered(ft.2) 1,320
FLOOR, ELEVATED
Material
Thickness(inches)
FLOOR, SLAB
Material
Thickness(inches)
Width(inches)
FOUNDATION WALL
Brand Name
Thermal Resistance (R Value)
Brand Name
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)
Brand Name Manville
Number of Bags 31 . Wt. per bag 40 lb.
Thermal Resistance(R Value) R3n
Brand Name
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)
Material Brand Name
Thickness(inches) Thermal Resistance(R Value)
I hereby certify that the above insulation was installed in the above building
in conformance with the State of California Energy Requirements.
LOERKE INSULATION CO., INC. #432518
FIRM NAME/OWNER STATE CONTRACTOR'S LICENSE NO.
_ October 20, 1986
SIGNAT'UR& 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 N E/OWNER (Please print) STATE CONTRACTOR'S LICENSE NO.
_ 3- Z2?X
SIGMATURE OF GPIRAL CONTRA OWNIER DATE
THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL
INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING.
January 1984
" :Al -
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 53411541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
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
matter, or need additional explanation, please contact this office immediately.
Inspector_ Date ~ j
• , COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise -- Phone: 872-2961, Ext. 57
CORRECTION NOTICE
nwNiFryi 77
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
matter, or nee&Addyional explanation, please contact this office immediately.
1�0 t / qtr if 17- - Z)
ii
"111. .rte' . ► , ,
y/�
Inspector_ v r �i Date��
- COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 -Telephone 916/534-4541
APPLICATION AND PERMIT
ASSE Oft PARf.,E}.,NUMB ZO BUILDING PERMIT
OWN_ R/Cl UUE EPH NE S0. FT. I OCC. 1 BUILDING VALUATION
MAILING ADDRESS
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
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.1c, enter upon the above-mentioned property for inspection purposes.
I als ree to save, indemnify and keep harmless the County of Butte against
all li b lities, judgm9'S\costs, and expenses which may in any way accrue
again said County i cc sequencerof the granting of this per it.
X Date G 2 0A�
Signature of Applicant — ' Own., (*Z Con trac r ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" dgtp and demolition or construct-
ion of structures over 3 stories in heia4t.
Receipt No. f -'0
WHITE-D.P.W.. YELLOW -..8[19011, P)4. -INSPECTOR. GO -ROD-APPLICANT
Contractor
MECHANICAL PERMIT Filing Fee 10.00
Heating In
e
ff
oling Lod 3.00
Ventilation
Permit Fee
Fireplace I sA /I i
Contractor
.f . ovqf9
Mobile Home Installation Fee
CONPIIRUCTION LENDER
11JIr
MAILING
UNKNOWN
Total Valuation $
TOTAL PERMIT FEE
1
$ W /L
OC CU P, CON ST.TYPE FLOOD
Filing Fee
$
10.00
LENDER'S ADDRESS
Permit Fee
$
ARC ECT OR ENGINEER
LICENSE No.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT R ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
U�
Permit fee
$
0
PLUMBING PERMIT
Filing Fee
10.00
Each Trap2.00
e rrn p
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
�L,7
Each qas water heater or 5.00
5-.00
USE OF STRUCTURE
SF CK Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5
5.00
Building sewer 5.00
,ot
Mobile Home S I G I W 0.00ea
TYPE OF WORK
New [X Addition"❑ Remodel ❑ UtilitiesM Installation[] Other ❑
Describe work: QQQQ�,�
Permit Fee $
Contractor
G+�
ELECTRICAL PERMIT Filing Fee
10.00
Main service 8001 OR LESS
100 AMP OR LESS
10.00
,
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
1 declare under penalty of perjury (check one):
El am licensed under provisions of Chapt. 9, Div. 3 of the BuSlnesS
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 con
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCC
OR ADDNS. ACC. SLOGS.
, h2SQft
Z. 615
NEW cONSTR ULTI.OUTLET 2.5s
NON.RESID BRANCH CIRC ITS
(POWER APPARATUS 6
(SINGLE OUTLET CIR. I
Ex. OCcu 20®sot
P OUTLETS OR FIXTURES BAL030
FIXED
Ex. Occup. OUT —LETS PR
RESID )EA.7 2.00
Temporary service 10.00
Mobile Home Facilities 15.00tract-
Misc. byirin g 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 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.
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.1c, enter upon the above-mentioned property for inspection purposes.
I als ree to save, indemnify and keep harmless the County of Butte against
all li b lities, judgm9'S\costs, and expenses which may in any way accrue
again said County i cc sequencerof the granting of this per it.
X Date G 2 0A�
Signature of Applicant — ' Own., (*Z Con trac r ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" dgtp and demolition or construct-
ion of structures over 3 stories in heia4t.
Receipt No. f -'0
WHITE-D.P.W.. YELLOW -..8[19011, P)4. -INSPECTOR. GO -ROD-APPLICANT
Contractor
MECHANICAL PERMIT Filing Fee 10.00
Heating In
e
ff
oling Lod 3.00
Ventilation
Permit Fee
3 ��
Contractor
Mobile Home Installation Fee
$
Energy Inspection Fee
$ 774 a
TOTAL PERMIT FEE
1
$ W /L
OC CU P, CON ST.TYPE FLOOD
ARCE PD No
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.
DIRECTOR OF P LIC WORKS
By. Date
PERMIT EXPIRES Date ?�
COUNTY OF BUTTE - DEPARTMENT gf-Pi'OBLIC WORKS - BUILDING DIVISION j
7 COUNTY CENTER DRIVE - OROVILLE, ffALIFd NIA 95965 - TELEPHONE: 916/534-4541
PERMIT APPLICATION DATA SHEET
Permit No.
OWNER �0 U I s 1 `✓I rl P Z A. P. No. �(� ' 0 L ` u
Proposed Building Use
Y{,
Permit Fee Based Upon: Complete Contract Price DPW Valuation
Other (E plain)
Building Inspector Date AV g6
At time of permit application, I was advised the following data must be submitted prior to permit processing
and/or issuance: DATE RECEIVED APPROVED
All items have been s-ubmitted. .� .�
PI ans in up vacate iplicate. . L5 r)�} fo S or,
Complete plans In cLpllcate/ rl.pllcate.
4. Complete engineered plans and calcs. . . . . . . . .
5. Plans with Energy Design Compliance Statement. . . . . .
6. CUSD "Fees Paid" Stamp on Floor Plan
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . . . . . .
.AOet ter of signature authorizatio )
OA' Sanitation approval from �✓� U t f Health Dept. Y
Al. Planning approval for (A) Use: (B) Parking:
= '2. Certificate of Workmen's Compensation Insurance. . . . . . ✓� 8
13. 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. . . . . . . . .
•Pre-Inspec. request to
y . Pr spection for Required. Building Inspector (Date)
OtheRecor
- �A�f�tf8onstructionmapproval required prior to occupancy
Other
W7you issue the perrnit cess as follows: Maij,19 owner. Mail to contractor.
Telephone, and hold for pickup at office. Deliver w/inspector.
Other 4
��� G l n . iD r emo iS u�or 'ol�P E o�
do. weI �6
(� Applicant Date G
Copy of plans sent Health Dept., Fire Dept., Other Date
During the plan checking process, the following data must be .submitted prior to permit issuance:
(For required items not checked above at time of application, circle item.)
1. Index permit for above Items No.
2. Additional items required:
(Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other
By Date
Plans checked by Date
Plans approved by Date
Other:
Copy—DPW
TO: Building Department
Jt
FROM: Encroachment Permit Section
RE: Driveway Clearance
ov1's .Ji',Ineo7ez 2-',7000 I36/%ve
owner location AP #
Driveway permitgod — has been issued for the above property.
sign ure date
TO: Building
From:
Subject: Sanitation cl,
C
r Locatd,on AP.;/
Plan Approvod for: ply
Hold final. for:
i1-inad clearance 0.;,". 1C, I': eaaler supply
Clearance for 'hecroom !�ga_Ppt-k, 1101";(
D7OUE1, J.
Sa ni t a r n Dab,
�sa o SS o r a e . A re
x s io rz �9- 6- e r v o L � 1 7—e ►-►� S
I ..c
DEPARTMENT OF PUBLIC WORKS
WILLIAM (Bill) CHEFF, Director
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965
Telephone: (916) 534-4541
RONALD D. McELROY
Deputy Director
RE: Building Permit No.
Expiration Date
(A. P. No. )
With reference to the above subject, our records indicate that your Building Permit
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 1/2 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 unit not ranaw vnur nermit in a timely manner_ it cannot he renewed and all
__
RESIDENTIAL ENERGY PLAN CHECK/INSPECTION SUMMARY FORM
Owner I M kl 7 Climate Zone Permit No. 7elo 016
Floor Area �� =
Compliance path: Package ❑ A ❑ B ❑ C Voint System ❑ Budget ❑ Other %R
MIN R -VALUE DESCRIPTION
REQ'D
INSTALLED ITEMS (1) INSULATION:
Roof/Ceiling
M. Wall
❑ Slab Floor Perimeter
❑ Raised Floor
(2) INFILTRATION•
❑ (A) A vapor barrier is required in climate zones, 1, 14 & 16.
(B) All manufactured windows and sliding glass doors shall meet the
1972 ANSI Air Infiltration Standards and shall be certified and
labeled.
(C) All swinging doors and windows leading to unconditioned areas
shall be fully weatherstripped.
Tight - the above standard features plus:
❑' (D) Continuous infiltration barrier
(E) Electrical outlet plate gasket
❑ (F) Air-to-air heat exchanger
'. (3) GLAZING:
(A) Location
Area Glazing %,Floor Area Single Double Triple
(� Total Bldg -c'mc -S�
North
Qa East 2�
South
West
❑ Skylights
(B) Shading
Shading
Coeffici nt Description
East r
South
West
❑ Skylights
(� (C) South Overhang
Length of projection _ ft. Description
❑ (D) Moveable insulation: Area ftz Description
(E) Thermal mass
13Type - Area Ft.2 HC= R=
MC= Location
❑ Type - Area Ft. HC= R=
MC= Location
❑ Type - Area Ft.2 HC= R=
MC= Location
❑ Type - Area Ft.Z HC= R=
MC= Location
❑ Type - Area Ft.2 HC= R=
MC= Location
❑ Type - Area Ft.z HC= R=
MC= Location
7/83
FORM 1
❑ (4) MASONRY AND FACTORY -BUILT FIREPLACES shall be equipped with tight
fitting closeable metal or glass doors covering the entire opening
of the firebox; a combusion air intake equipped with a readily
accessible, openable, and tight fitting damper to draw air from the
outside of the building; and a tight fitting flue damper with a
readily accessible control.
FAI
*1(5) HEATING. VENTIIATING, AIR CONDITIONING SYSTEM
(A)...Heating
Central Gas Furnace
13
Btu/hr
*1
(cooling capacity at 95°F)
❑
7/83
(brand and model number)
Btu/hr
(heating capacity)
Heat Pump. U II k p (y h
(brand and model number)
Btu/hr
(heating capacity at 47°F)
Active Solar
type (liquid or air) Collector brand and
•ft2
model number solar fraction collector area. collector
ACOP
o�
SE
orientation collector tilt rated y -intercept
rated slope
Other
(describe)
(B) Cooling
Electric Air Conditioner � Jo n(q,/ h
(brand and model number) (seasonal EER)
Btu/hr
(cooling capacity at 95DF)
Electric Heat Pump
EER
Btu/hr
(cooling capacity at 95°F)
❑
Other
(describe)
®
(C)
A TWO-STAGE THERMOSTAT, which .controls the supplementary heat on
its second stage,'shall be required for heat pumps.
Q
(D)
AN AUTOMATIC SETBACK shall be provided for all thermostats, except
those controlling heat pumps.
(E)
AN INTERMITTENT IGNITION DEVICE shall be provided for -all gas-fired
fan type central furnaces, gas-fired fan type wall furnaces and
gas cooking appliances.
(
(F)
BACKDRAFT DAMPERS shall be provided for all fan systems exhausting
air to the outside.
(G)
DUCT CONSTRUCTION & INSULATION. All transverse duct, plenum, and
fitting joints shall be sealed with pressure sensitive tape or
mastic to prevent air loss and shall be insulated to conform to
the provisions of Section 1005 of the UMC, 1976 Edition.
2
N.
FORM 1.
1 (6)
DOMESTIC WATER 'SYSTEM "
'-(A)=
'
Gas Only jig G1 yj 0 Gallons
(brana and model number) (tank size):
"❑
Heat Pump w/Electric Backup
(brand and model number)
Gallons
(tank size)
❑ * 2
Active Solar
(collector brand and model number)
(rated y -intercept) (rated slope) (solar fraction)
ft2
:(backup heater type, brand and model number) (collector area)
(collector orientation) (collector tilt)
❑
Location of Solar Panels
❑
Other
(Describe)
:(B) TANK INSULATION. Storage type water heaters and storage and
backup tanks for solar systems shall be externally wrapped with
`
R-12 insulation or greater.
l�
(C) PIPE INSULATION. The five feet of pipe closest to the water
heater and outside conditioned space shall be insulated with a
minimum of R-3. Steam.and steam conditioned space shall be
insulated with a minimum of R-3. Steam and steam condensation
return piping and recirculating hot water piping outside the
building envelope shall be insulated in accordance with
T20 -1408(d).
®
(D) FLOW RESTRICTORS shall be provided for showerheads and faucets
as outlined in the new appliance efficiency standards and shall
be certified to the Energy Commission.
(7)
LIGHTING
Q -
(A) Lamps used in luminaries for general lighting in kitchens and
bathrooms shall have an efficacy of not less than 25 lumens per
watt (usually florescent).
*1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing
charts (form #4) or other approved methods, section 2-5352(g), and fill out the
following.
Heating: Winter design temperature,�0 °, elevation400 � heating load�BTU
elevation factor _� x heating load = maximum outlet capacity gas furnace
)d BTU
Cooling: Summer design temperature4MABE
cooling load BTU
(USE ONLY AS A SIZING GUIDE, COOLING INADEQUATE)
*2 Submit T.I.P.S.E. chart or other approved system (form #5) to document sizing of
solar panels.
® DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of
Title 24, Part 2, Chapter 2-53 of the Califo a Administration Code.
7/83
SIGNATURE OF BUILINt DESIGNER OR APPLICANT
3
ZONE 11.
OWNER LOC&S c-TMcAw& POINTS
PERMIT N0. -1-700 ASSIGNED ACTUA
1. SLAB - INSULATION
2. RAISED FLOOR - R-19
3. CEILING - R-30
4. WALL - R-19
tZ 5. NORTH GLAZING - 2.4-3.6%
6. EAST GLAZING - 2.5-3.6%
7. SOUTH GLAZING - 1.6-3.6% a7.7 7
S. WEST GLAZING 2.9-3.6% 3.30
9. SKYLIGHT - 0-1.3% "'�- 6 40
10. SHADING (Exclude Overhang)
EAST Y si f - .66 - (. `t9-' O
SOUTH ?.y7 - .19-.42 8 -
WEST 3.3 - .13-.36
SKYLIGHT $ '- .37-.57 -
11. HORIZONTAL SOUTH OVERHANG 2'
12. :[OVABLE INSULATION - NONE
13. INFILTRATION (Standard=0)(Tight=+12)
14. THERMAL MASS SF
15. GAS FURNACE (SE) 71-76%
16. 4EAT PUIIP (EER) 7.5-7.9% .3
17. DUAL PACK (SE, SEER) 8,0-8.3/71-76%
WOOD STOVE
S L E C -G _ WATER HEATER'
ATTIC /0 %_t�
OTHER
-able 3-1. Slab Floor Points
Table 3-3a. Ceiling Insulation
Points
Glazing Type
R -Value of Insulation I
I I
Points I
I
I 19 I
-4 ' I
" 22 I
-1
30
0I
I 38 I
+2 I
49 I
+4
Table 3-4a. wall Insul
I R -Value of Insulation
9 1 0 I
i 30 I +3 I
Table 3-5. North -Facing Glazing Pti
I I Glazing Type
I Total '1
Z of ST, Dbl, Trp1, 1
I Floor l U- I U- I U- I
Azea 10.66 ! 0.42- 1 0.41 1
I 11.10 i 0.65 1 down I
+q +
S_ , +4
I 0.1- 1.2 I +4 ! +4 I +4 !
1 1.3- 2.3 I +1 I +2 1 +2 I
I, 2.4- 3.6 I -2 I 0 ( +1 I
3.7- 4.8 1 -4 1 -2 1 -1
I 4.9- 6.1 I -7 ! -4 1 -3 I
1 6.2- 7.3'1 -9 1 -6 I -5 1
1 7.4- 8.2 1 -12 1 -8 I -7 I
1 8.3- 9.7 1 -14 1 -10 1 -8 I
9.8-10.8 1 -17 1 -12 I -lo 1
110.9-12.0 I -19 1 -14 I -12 I
112.1-13.2 I -22 1 -16 I -13 1
1 13.3-14.5 I -24 1 -18 I -15 1
14.6-15.3 i -27 1 -20 i -17
TOTAL 'POINTS -� 0k Table 3-6. East -Facing Glazing Ptsi•
-��
I Tn=ula- I R -Value of Insulation I
I tiun i I
I Depth, _T
I inches 10-2 1 3-4 ! 5-6 I 7t I
I 0- 11 i 5 1 -5 I -5 I -5 I
I 12 - 15 -3 1 -2 I -1 I
116 - 19 I -5 I -2 i -1 I 0 !
I 20 + I -5 i -1 10 I +1 I
I I I I I I
7/7/83
Table 3-2. Raised Floor Points
T_
R -Value of I
I Insulation I oints
I I
( below 3 1 -12
I - 3-4 I -8
I S 1 I -6
I - i2
I 13 - I8 I T2
I •19+ I 0
I I
I Glazing Type I
- "-I Total I I
Z•of I Sngl, I Dbl, Trpl,
I Floor I (U - I (U - I (U - I
Area 1 1.10) 1 0.65).1 0.41)1
I I�I!o!nts (points I ointsl
I o I
I I up to 1.3 1 +3 1 +4 1 +4 1
-T I 1.4- 2.4 1 +1 1 +2 1 +2 1
I ! 2.5_ 3.6 1 _2 1 -2 I -0
-3 I
I I 5.7- 6.7 1 -10 1 -6 1 -5 I
! I 6.8- 7.7 1 -13 1 -8 1 -7 I
I 7.8- 8.7 1 -15 1 -10 1 -8 I
I 8.8- 9.7 I -1.7 1 -12 1 -10 1
I 9.8-11.2 I -21 1 -15 1 -13 ;
111.3-12.7 I -25 1 -18 1 -15 I
i 12.8-14.0 I -23 I -21 I -18 I
14.1-15.3 I -32 I -24 1 -20 I/
e 3-7. South -Facing Glazing Pts Table 3-10. Shading Coefficient Points
_ u
Glazing Type
I I
SC by I -
Total
I
I I
Orien- I Z Floor Area `
Z of
I Sngl, Dbl,
Trpl, I
talion I
Floor
I (U - I (u - I
(U - I I
1
Area
1 1.10) 10.65) 10.41)1
I
-4
1 '
!points I oints I
ointsl I
East 1 1 3.2 1'
o
+! 1 +9 1
43 1 1
1.0-3.1 I -to -I. 6 4
I up to 1.5
1 +2
1 +2
1 +2 1
I
I
I 6.3 I
P
I 1.6- 3.6
1 -1
10
I 0 1
1
I
I
I
I
-4
1 '
i -2 1
I
I 5.3- 6.5
1 -6
,�z
1 -4
I -3 1
( 0 -.19
1 0
' I
+1 1
+2
I 6.6- 7.7
1 -9
1 -6
I -5 I
I .20-.36
I. 0
I
0 1
%
1.8- 8.9
1 -11
1 -8
(.-7 1
1 .37-.66
I 0
I
0 I
0
I 9.0-10.01
-13
1 -10 .I
-9 1
1 .67-.82
I 0
1
0 (
-1
110.1-11.5
1 -17
I -13
I -11 !
1 .83 up
i 0
I
-1 I
-2
i 11.6-13.0
I -21
I =16
I -14 I
1
1
!
I
i 13.1-14.5
i -25
i -19
I -16 I'
114.6-16.0
i -28
I -22
1'-'.9 1
1 South
I D
13.2
16.4 18.0
19.6
I
I
I
I I
I
1 to
I to.
I' to I
to
I up
Table 3-8.
West-F3CIng Glazing Pts.
i
1 3.1
16.3
17.9 19_
I" Glazing
Type I
I 0 -.18
I .19-.42
1 0
I' 0
1 +1
I. 0
I t2 I
1 0 1
+2 I
+3
I Tatal
I
I 43'•66
I 0
l -1
I -2 I
0 1
-2 I
0
-3
I' Z of
1 Sn 8 1.
Dbl,
Tr P 1,1
I
l o
f -2
i -e I
-b I
-6
I Floor
I (u -
I (u -
I (u - I
I' Area
1 1.10)
1 0.65)
1 0.41)1
-
i
Iolnts
I oints
I ointsl
West
i .1
11.6
1 3.2 16.4
19.0
o
+6
+6
+6 1
I to
I to
J to I
to I
up
I up to 1.3
I. +5
1 +6 1
+6 1
11.5
1 3.1
1 6.3 1
7.9 1
1 1.4- 2.2 I
+3
1 +4 1
+5 1
I
I
I I
I
2.8 I
I 2.9-
0
1 +2 1
+3 1
2.9 3.6-
I -3
1 e l
+1 1
0-.12
i 0
1 _+1
I +3 I
+6 I
+7
( .7- 4.2
-5
1 -4
0 1
,13-.36
1 0
1 0
1 0 1
0 1
0
I 4.3- 5.0 I
-8
I -4 I
1
-2 1
.37-.57
I 0
1 -1
! -3 1
-6 I
r' 7
I 5.1- 5.6 1
-10
1 -6 1
-4
6
1 5.7- 6.2 1
-13
1 -8 1
-6 I
���
'
_ 2 1
-4
j
-
I6 I1
-75
1 6.3- 6.9 I
-15
1 -10 1
-7 I
I
I I
I
I 7.0-"7.6 I
-18
I -12 1
-9 i
I 7.7- 8.2 I
•-20
i -14 1
-11 !
Skylight
1
.8
1.6
2.1
I 8.3- 8.8 I
-22
I -16 1
-13 1
to (
t
to
1 to 1
toto
to
too
I 8.9- 9.5 I
-25
I -18 I
-15 I
1 .7 I
_
I I
I
5.2
I 9.6-10.1 !
-21
� -20 I
-16 I
'
�
110.2-11.0 (
-29
I -23 1
-17 !
0-.12
I 0 !
+1
I +3 I
+6 1
+7
111.1-11.8 I
-35
I -26 I
-21 I
.13-.36
1 0 1
0!
0 1
0 1
0
111.9-12.7 I
-38
1 -29 1
-24' !
.37-.57
10 I
-1
I -3 I
-6 I
112.8-13.5 I
-42
I -32 I
-27 I
.58-.82
I -1 I
-3
I -6 I
-12 I
-.
( 13.6-14.3 I
-46
I -35 1
-29 I
.83 up
1 -2 I
-4
I -8 I
-16 I
-20
114.4-15.2 I
-50
I -33 1
-32 I
I I
I I
I
I
I
Table 3-11.
Horizontal
South
Overhane.
Points
Table 3-9. Skylight
Points
South Glazing
Length Out
I Area,
Z of Floor
I
Glazing Type
I
1 from Wall
I
I
I Total I
I
I ft
r
I %10 f Sngl.
I
1 0-6.)
1 6.4
upFoor
l
U- II
U -Area
10.66-
110.41
/Dbl,Trpl,
I
0- 0.5
-2
-
1.10 II
down 1
10.6 - 1.0
1
-2
1 -3
1
11.1 - 1.9
1
-1
I -2
I up to 1.3 I
-1 I
0 1
0 1
I .2.0 up
I
0
i 0
I
I 1.4- 2.2 I
I
-2 I
-1 1
I
I
-e
I
I
I 2.3- 2.8 I
-6 I
-4 1
-3 1
Table 3-12.
Movable Insulation
I '2.9- 3.6 I
-9 I
-6 1
-5 1
Points
1 3.7- 4.2 -11
1 4.3- 5. 1 -14
I 5.1- .6 ( -16
I 5.7 6.2 1 -19
I 6 - 6.9 I -21
I .0- 7.6 I -24
1 7.7- 8.2 I -26
8.3- 8.8 I -28
8.9- 9.5 1 -31
9.6-10.1 1 -33
-8 I -6
. -10 1 -8
-12 I -10
-14 I -12
-16 I -13
-18 I -15
-20 I -17
-22 1 -19
-24 I -21
-26 I -22 I
- ---1--
I Moveable Insulatlon'l,/
I Area, Z of Floor / Points
0 - 5.
I 0
5.6 - 1 S
I +2
11.6 - .5
1 +4
17.6 23.5
I +6
3.6+
I +8
►.
I
Table 13• Intllttation Control
Fer.tvres Points
+
I Control Features I Points I
I I I
T-
I Stands 1 0
I
0.9 air changes per hr I I
T-
I Tight I +12 I
I I I
10.6 air changes per hr I 1
1 I I
Table 3-15. Gas Furnace Without
Refrigeration Cool!r. Points
I !
I Seasonal Efficiency I Points I
I (SE), L I I
i I (
j 71
- 76
1 0 1
1 77
- 82
i +2 I
I 83
- 88
I +•6 I
1 89
- 94
I +6
j 95
I
up
I +8 I
I I
2
0
0.
Table 3-!6.
Neat Pume
Points
r
2
2
1 Energy Effie!eney
I Points 1
I Patio
(EER)
; 1
I 7.5 -
7.9
I +3 i
I S.0 -
8.3
1 +6 1
I 8.4 -
3.7
I +9 I
I 8.8 -
9.1
I +12 1
1 9.2 -
9..6
I +15 I
I 9.7 -
10.2
I +18 I
I 10,3 -
10.8
I +21 I
i 10.9 -
11.5
I +24 I
i 11.5 -
12.3
I +27 1
I 12.4 -
I
13.2
I +30 I
I I
2
2
2'
Table 3-17. Gas Furnace With
Refri¢eration Cooline Points
!Refrigeraciod Gas Furnace I
I Cooling I SE % I
(171-117- 1 a 3- 5-9-79-5--T
i 1 761 821 881 941 u I
I 8.0 - 8.3 1 01 +21 +•41 +61 +8 1
1 8.4 - 8.7 1 +21 +41 +61 +91+10 1
1 4.8 - 9.2 1 +41 +51 +8I+101+12 I
1 9.3 - 9.7 1 +61 +81+101+121+14 1
1 9.8 - 10.3 1 +31a101+121+141+16 1
1 10.4 - 10.9 j+10j+L2j+14j+L61+18 I
1 11.0 - 11.6 1+121+i:1+1614.181+20 1
I I ! I I I
7/7/83
ZONE 11
TABLE 3-14 (ADAPTED) INTERIOR THERMAL MASS POIRTS
4ASS _ DUELLING ARFA SQUARE FOOT
AREA 1,000 1,500 2,000 I 2,500I 3.00.0 I 3,S00
so. FT. I A 8 C D A 8 C D A 6 C D A 6 C D A 8 C D A 8 C 0
50 2 2 2 2 2 2 2 0 j 2 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0
100. 4 4 4 2 2 2 2 2 2 2 2 2 2 2 2 0 2 2 2 0 2 2 0 0
ISO 6 6 6 4 4 4 4 2 2 '2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
200 .8 8 6 4 6 6 4 2 4 4 4 2 4 4 2 2 2 2 .2 2 2 2 2 2
253 10 10 8 6 6 6 6 4 6 6 4 2 4 4 4 2 4 4 2 2 2 2 2 2
300 12 12 10 6 8 8 6 4 6 6 6 4 6 6 4 2 4 4 4 2 4 4 2 2
350 14 14 12 8 10 1G 8 6 6 6 6 4 6 6 6 2 6 4 4 2 4 4 4 2
403 14 14 12 8 10 10 8 6 8 6 6 4 6 6 4 4 6 - 6 4 2 4 4 4 2
500 18 18 16 10 12 12 10 6 10 10 8 6 R .8 6 4 5 6 6 4 6. 6 6 2
603 22 20 18 12 14 14 12 8 12 12 10 6 10 10 8 6 8 8 6 4 8 C 6 4
700 ' 24 24 20 14 18 16 14 10 14 14 12 0 10 10 10 6 10 10 8 6 8 8 6 4
230 26 24 22 16 70 16 16 10 14 14 72 0 12 10 10 6 10 10 a 6 10 R B 4
500 28 28 74 16 22 20 18 12 16 16 14 10 14 14 12 8 12 12 10 6 10 10 3 6
1,010 30 70 26 18 ?2 20 20 14 18 18 16 10 14 14 12 8 12. 10 6 12 10 10 6
I..Ou .32 32 28 20 24 24 22 14 20 20 18 10 16 16 14 8 112
14 14 12 8 I2 12 10 6
1,200 34 32 30 22 26 26 22 16 22 20 18 12 18 18 14 10 14 14 12 8 14 12' 12 8
1,100 34 34 32 22 28 26 24 16 22 22 20 12 18 18 If 10 lu 14 14 8 14 12 12 8
1,400 34 34 32 24 28 28 26 18 24 24 20 14 20 20 18 12 18 16 14 10 14 14 128
1,500 1 36 34 34 24 30 30 26 18 24 24 22 14 (22 20 18 12 18 18 16 10 116 16 14 8
2,000 34 34 32 22 30 30 26 18 26 26 22 16 22 22 20 14 20 20 18 12
2,507 I 34 34 30 22 I30 30 26 18 26 26 24 16 124 24 22. 14
J.000 34 32 30 22 30 30 26 18 28 26 24 16
3.500 I 32 32 30 20 30 "i 30 . 2618
4,030 I 32 32 30 20
4,507
5.003
A) 1. 3'i Concrete Slab: HC•8.93; R-.29; Factor -1.3
2. 3 3/4` Thick Common Brick: IIC-7.125; R-.13; Factor -7.3
• B) 1. SV Concrete Slab: HC -14.106; i•.45B; Factor -7.1
C 1. 8.1 So11d Filled Block: HC -20.60; R-1.90; Fac[or-6.1
2. 8` Sol1d F111ed Block With Both Sides Exposed To Conditioned Air.
ROTE: Use all square footage directly exposed to condttioned air
for Thermal Mass Area: IIC-10.164; R-.96�; Factor -6.1
D) 1' Thick Concrete/Ti.le: MC -2.55; R-.083; Factor�-3.7
Table 3-19. Zonally Controlled
Electric Resistance
Space Heating Points '
rPoints for this measure v!11^I Table 3-20. Solar Water Heating With Cas Backup Points
be completed after the CEC I
I `fag approved an Alternative 1
Component Package for Resistance 'I
I neat. 1
Table 3-15. Active Solar Space
Heating with Gas Points
I
Net Solar Fraction I Points 1
I (VSF), Z I I
I I I
I o-6 I 0 l
I 7-14 I +2 I
I 15 - 23 j +4 I
i 24 - 30 I +6 I
I 31 - 39 I +8 I
I 40 - 47 I : +LO I
I 48 - 55 I +12 I
I 56 - 63 I +14 I
I 64 - 71 j +18 i
I 72 up I +20 1
I: I
4,000 I 4,500 _5_,000 I
8 C 0 1 A 6
0
0
0
0 0
C
0
Ci
0
0
0
D 1
2
2
0
0 2
2
0
0.
0.
0
0
0 1
2
2
2
0 2?
2
01
2
2
z
0
2
2
2
2 2
2
2
22
+3
+7
2
+14
2
2
2
2 2
2
2
2I
2
-
2
2
2
2
2
2 2
2
2
2'
2.
2
2
2
4
4
2
2 4
4
2
7
2
2
7
2
4
4
4
2 I 4
4
2
2
I 3
4
2
2
6
S
4
2 G
<
4
2
4
4
4
-
6
6
6
4 I 6
5
e
2
I 6
6
4
'�2 '
8
6.
6
4 6
6
6
41
6
6
5
7. ! i
+1;
6
6
4 8
6
6
4
6
6
v
3,000 -1,.d tin
s
8
18
4 8
8
6
4
B
B
6
r i
10
f0
8
6 8
8
0
41
.",
8
6
4 i
10
10
10
6 1 1:1
10
•8
E!
!J
B
f
;
•12
12
10
6 110
10
�8
6
11
10
8
6 i
12
12
10
6 112
.0
10
C 110
; 0
f,
u
14
14
12
8' 12
12
;G
6;
10
13
17
` 1
14
14
12
p 117
12
10
61
;2
12
I-
o !
18
18
16
10 , 16
16
i 4
L
14
14
12
S i
22
22
13
.2 20
20
I8
!: !
is
.3
16
a
24
24
22
14 22
22
20
14
26
2814
16 26
24
21
141
'4
;4
20
14 ;
30
30
16
10 79
:b
24
If � ?5
2-i
2:
if �
32
32
28
2U 30
30
26
1E j i6
..
2=
;E
32
32
2i
20 j 1J
� 6
1:.
wood stove #33 points'(no back up)
casablanca fan + l point
Multifamil (per unitpoints)
1
Table 3-21. Other Water
Heating Pts.
I System Type I
Floor Area
I I
1
Net Solar Fraction (NSF)- Z
0 1
perunit,
I
0
I
I Solar vith Electric I
1
i
I Re+lstonce Backup I
I
I Meeting the Require-(
I
ft2.
0 i
I
I Electric Resistance I
I
I Only
400 I
0.9
10-19
20-29
30-39
40-49
50-59
60-69
70-79 ,
600-799
0
+3
+7
+10
+14
+17
+21
+24
800-999
0
+3
+5
+8
+11
+14
+16
+19
1,000-1,499
0
+2
+4
+6
+8
+10
+12
+14
1,500-1,999
0
+1
+3
+4
+6
+7
+8
+10
2 1.00 and up 1
0 1
+1
+2
+4
4-
+6
+7
+9
All others (pe
bu_ilainF
points)
r
800-8.99
900-999
0
0
+5
+4
+10
+9
+14
+13
+19
+17
+24
+29 +34
+26 +30
1,000 1,199
0
+4
+7
+11
+15
+-19
+22 +26
1,20(,1,499
0
+3
+6
+9
+12
+15
+18 +21
1,500-1,999
0
+2
+5
+7
+9
+1;
+14 +Ii:
2,000-_','199
+2
+3
+5
+7
+8-
+10 +Il
3,000 -1,.d tin
-0
0
+t
+3
+4
+5
4.7
+S +10
1
Table 3-21. Other Water
Heating Pts.
I System Type I
Points I
I I
1
CBS Only 1
0 1
( Beat Pomp I
I
I
0
I
I Solar vith Electric I
1
i
I Re+lstonce Backup I
I
I Meeting the Require-(
I
I menti i:% Part 2 I
I I
0 i
I
I Electric Resistance I
I
I Only
400 I
RESIDENTIAL PLAN CHECKING GUIDE 7/85
(S.F.,-DUPLEX & MISC. ONLY)
Bldg. Permit /706 ` 1�
OWNER kOUlS T/olejv4Z A:P. # 2( 04f, /f
GENERAL
oning requirements: (sideyards and number of permitted living units).
•2'. Valuation.
/ePlans signed by designer'.
nergy Design and Compliance.
�! Existing violations on property.
PLOT PLAN
F
Complete parcel size and dimensions.
Z," -Setbacks, sideyards, easements, etc.
9 -.'—Other buildings or structures. •
4< ----Grading, fills, -drainage.
5flood hazard.
6/ Special conditions on creation map or compliance document.
FLOOR PLAN
1<�_ Complete to scale plan with dimensions.
Required windows for light and ventilation (Sec. 1205).
3!Required windows for second -exit (Sec. 1204).
.--4-.--Skylights (Chapter 34 & Sec. 5207) .
Human impact glass (Sec. 5406).
6Required room sizes, ceiling heights (Sec. 1207).
a/ G.F.C.I.'s in baths, garage and exterior outlets (Article 210-8).
Light fixtures, switches, receptacles, and exterior receptacles for maintenance of
mechanical equipment.
Locations of water heater, heating and cooling equipment, other electrical or gas
1,,,,, -equipment, and plumbing fixtures.
Garage firewall, door size, and closer (Sec. 503(d)(3)).
1�1�1 - 3'0" exterior exit door (Sec. 3304(e)).
1 Fireplace and wood std location.
13-.' Smae detectors (Sec. 1210).
STRUCTURAL DETAILS
Foundation plan complete ehough:to construct building.
a -*'Floor construction details complete enough --.to construct building.
elevations and wall construction details complete enough to construct building.
4-' Roof construction details complete enough to construct building.
Fireplace construction details and calcs if necessary.
Sufficient data and details to satisfy energy requirements (State Law) (Form 1).
MISCELLANEOUS ITEMS TO LOOK OUT FOR
fexposure I plywood on expose& locations and overhangs.
g/�irway details landings, rise and run, head clearance, handrails (Sec. 3306).
II' 3 - ardrail details (Sec. 1711 & 3306(j))_
k. �! Brick or stone veneer (Chapter 30).
Exterior plaster - weep screeds (Sec. 4706).
roper roof, pitch for roof covering (Chapter 32)..
17---lRafter ties or bearing ridge beam.
RESIDENTIAL -PIAN CHECKING GUIDE (CONT'D) 7/85
MISCELLANEOUS.ITEMS TO LOOK OUT FOR (CONT'D)
arage door or porch header sizes.
9! Adequate bracing.
JZ—.Living area over garage - complete 1 -hour separation required on garage side
including supporting walls and posts, etc.
-Two exits on three-story dwellings (Sec. 3303 & see Mezannines.1716).
12"� Attic access and ventilation (Sec. 3205). e
1 -3 --Underfloor acess and ventilation (Sec. 2516).
Akood st000., clearances, alcoves & 1 -hour shafts.
ombustion air for fuel burning appliances.
16: --Noise requirements on duplexes.
14.— Adobe soils - special foundation design.
1.8•,—Retaining walls requiring design.
-119-.— Unusual shape, size or split level house requiring lateral design.
Return to DPW AGRICULTURAL STATEMENT.OF.ACKNOWLEbGEMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8.1 of the Butte County Code requires this acknowledgement
be recorded prior to issuance of a building permit. T20552
REOORDED IN OFFICIAL RECORDS
OF BUTTE COUNTY, CALIFORNIA
AT TNF REOLIEST O.
1686
JAN 30 AN 9. 20
The property described herein is adjacent to land or included ELEANOR K BECKER �
within an area zoned for agricultural purposes, and residents of thigURK-RECORDER EEE
property may be subject to inconveniences or discomfort arising from N,
the use of agricultural chemicals, including, but not limited to herbicides, pesticides,
and fertilizers; and from the pursuit of agricultural operations including, but not limited.,
to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust ;`off
smoke, noise, and odor. Butte County has established agricultural 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:
All that certain real property situate in the County of Butte, State of California,
described as follows:
The South 4.04 acres of Lot 4 in Block 87 of Subdivision No. 1 of the Palermo
Citrus..TYact, according to the Official Map thereof, filed as of record in the.
office of the County Recorder of the County of Butte, State of California,
September 17, 1888.
EXCEPTING THEREF'ROM the east 2 acres thereof.
(AP No. 026-04_0-019-0)
Date: PROP Y OWNERS:
IT
State of 0. J On this the abt�- day of , 19_IL, before
SS. me, the undersigned Notary Pu ic, personally appeared
County of ) _
LOlit. S �
Men
e z ,,,.SIL Ye s' S vr� rte
Ll Personally known to me. Proved to me on the basis
of satisfactory evidence.
_,m,.�.�= to be the persons) whose iiame(s)r� subscribed to
OFFICIAL SEAL the within instrument and acknowledged that
So-IE�LEY SClf=LI I executed the same for the purposes therein contai ed.
NOTARY PUBLIC -CALIFORNIA P P
Principal Office in BUTTE County IN WITNESS WHEREOF, I hereunto set my hand and official seal.
MY Commission Expires Sept. 30. 1988
f
✓ /�Present A.P. No.
J
r
4
IHx-'YHIN-1 r 1 K-LHKUN
1.
NAIL SYSTEMS 7525 N.U. 37TH AVE. MIAMI. FLORIDA ?
bl'AN
TOP CN.
dol.
CHORD
I AX OVH
CAMS. PURL.
BRG.
JOINT I
M OE3T.r .rD M r
n.ws artf..rr .....
a•.r.r u...,..,. _..
JOINT 2
JL.
.r
JOINT 7
TCH SPL.
BCH
SPL.
FT -IN
SIZE
GRI;9E
SIZE
GRADEFT-IN
(IN.)
SPACE
1N -SX
HL01
INTI
PK 12
IN02
2- 7
SPIO
SP10
IFT.I
YID
LEN
V
YID
LEN
YID
LEN
WID
LEN
X
YID
LEN
RIO
LEN
31- 7
2X
4 N0.2
2X 4
N0.2
3- 9
0-3/8
PSH
3- 8
3.OX
7.9
.25
2.0X
2.3
4.OX
4.5
3.OX
3.9
1.50
3.-0)(4.
5
3.OX
4.5
32- 7
2X
4 NO.2
2X 4
N020
3- 9
0-3/8
PSH
3- 8
3.Ox
7.9
.25
2.0X
2.3
4.OX
4.5
3.Ox
3.9
1.50
3.OX
4.5
3.OX
4.5
34- 6
2X
4 NO2D
2X 4
ND20
3- 9
0-3/8
PSH
3- 8
3.OX
7.9
.25
2.OX
2.3
4.0X
4.5
3.OX
3.9
1.50
3.OX
5.1
3.0%
5.1
34-11
2%
4 NO.1
2X 4
W020
3-10
0-3/8
PSH
3- 8
3.OX
7.9
.2S
2.OX
2.3
4.OX
4.S
3.OX
4.5
1.75
3.OX
5.1
3.Ox
5.1
35- 4
2%
4 N0.1
2X 4
N0.1
3-10
0-3/8
PSH
3- 8
3.OX
7.9
.25
2.OX
2.3
4.OX
4.5
3.0X
4.5
1.75
3.OX
5.1
3.OX
5.1
35- 8
2X
4 SS.
2X 4
NO.1
3-10
0-4/8
PSH
3- 8
3.Ox
7.9
.25
2.0X
2.3
4.0X
4.S
3.OX
4.5
1.75
3.OX
5.1
3.OX
5.1
36- 8
2X
4 SS.
2X 4
NOID
3-10
0-4/8
PSH
3- 8
3.OX
9.0
.25
2.0X.2.3
4.0X
5.6
3.OX
4.5
1.75
3.0X
S.1
3.OX
5.1
37- 1
2X
4 NOID
2X A
NOID
3-11
0-4/8
PSH
3- 8
3.OX
9.0
.25
2.0X
2.3
4.0%
5.6
3.0%
4.5
1.75
3.OX
5.1
3.0%
5.1
38- 3
2X
4 O.SS
2X 4
NO10
3-11
0-4/8
PSN
3- 8
3.OX
9.0
.25
2.OX
2.3
4.0X
5.6
3.0X
4.5
1.75
3.OX
5.6
3.OX
5.1
39- 0
2X
6 NO.2
2X 4
NOID
5-11
0-4/8
3.7
3- 8
3.0X
9.0
.25
2.0X
2.8
S.OX
4.5
3.OX
4.5
1.75
4.OX
4.5
3.0X
S.1
39- 2
2X
6 NO.2
2X 4
SS.
5-11
0-4/8
3.6
3- 8
3.0X
9.0
•25
2.OX
2.8
S.Ox
4.5
3.OX
4.5
1.75
4.0X
4.5
39- 2
2%
6 NO.2
2X 4
O.SS
5-11
0-4/8
3.6
3- 6
3.OX
9.0
.25
2.OX
2.8
5.0%
4.5
3.OX
4.5
3.0X
5.1
1
1
1.75
4.OX
4.5
3.OX
5.1
ALL WEBS 2X4 STO DEFLECTION
SPAN LIVE
FT -IN LOAD
39- 2 L/480
NOTE - PSH INDICATES PLVWOOD SHEATHING.
SYSTEMS PLUS LMBR. CO.
1800 S. Barney Street
ANDERSON, CALIFORNIA 96007
FORCE COEFFICIENTS(LBS/FTI
REAC. 1- 2 2- 3 6- 7 7- 1 2- 7 3- 7
36 -78 -69 51 74 -12 21
FORCEILBS] - FORCE COEFFICIENT X SPAN(FT)
r o
A
�� 12
BUTTE coo ` (/ ° 4.01
BUILDING DFP/%RTMSNI
36 PSF 'UBC 15 PC /,� P � � ®V
CODES- UBC NAIL VALUES(PSI) /�
SPACING =24 IN TOP CH. LL= 16 PSF GN CHORDS WEBS
LAR INCR.=25 PC OL- 10 PSF )163 1MIN42 163 1MIN
42 � ��
NAIL 1NC.= 0 PC BOT CH. LL= 0 PSF 20 163 142 163 142 "�` EOUAL PANELS
TCH. LS. =15 PC DL= 10 PSF Q
BCH. LS. r 0 PC TOTAL LOAD 36 PSF
SPANS SLOPE ON 12 HEEL -4/16 O
OVN SPAN SPLICE WITHIN 9 IN. OF 1/4 PANEL
31- 7 TO 39- 2 4.00 _. _. _ _
Nanaling t Erection Miscellaneous Infornmuon
lC-.:aa r...wwo v mro�c+rn wwi ru tE w...mD nn D.+. a.<n .w r.a .Tar+rn..auow. r M ..o.wi. v D..o-+•a
tsaur•i YD rawre.T � ra rrDED..D nnrow+! tln[•4. K_ •rD { OT tp •[ ODr.[D w a«d4 a w r+wT. Ol IYD rD.
.U�.rprPRwtrag4ilAYrOQ3•.r•LLROIMDrED•r0 YrYIDd\t!D[lrlOrt•rOMV Mr1Br300ROi(Or6Iw.Tw•rr Or@awe
"-D w Dr.l.w O SOrD.S •rl r0 R •r•a!D To
MATOOPNJOMrrw+w rtrTOeY1•rt�prrt•Tl•rt+K•tirl Ttl11l0l. .Ww0p1 ftwmarwOn1CHr1 4rTO•Tr•rlLrlrD6tltwV•ra 03O1 rrAIw •lDaTOl•rarw••SDEldr®n•
TO Cow-
-TOnrOMa\ltSKfOruTlt1l/tYDrv[ aIMnupQtlDtDLDIwMa1pa0wagD•0nrw[lDmCYYOwwaOrq3va [•1ruwDl rOaVQl3[rtdx. ••0rr•[1b•Dr•r[OFTnaO•MllOt0nf••gDOO6wOOwpDDI./vfCiD4Mpp6[OrYhg4/Vr/M�nE-
Olen rEw[Qw •r0 Dir r• Elco. •iM3i••{1 •OC nD rrvii OC rCr vsE rw3 Dfaif
MMi•a. tTtilaq K OlrPwS r. W+•.D. •.. Mr .-.. 1a
Ol9D.6tllllra MrM.t 'ter. ...n .. w_ �.� •w�•G� Wr �•rC !EY [D G✓rG+•l naT[b.K DM•OrrC
_ v... u -ea -.a•-,..-. ... r+. o. i•r roan v D•+....
war.F�no-.o- ODrrornr•s wo[Dl.
sraeing information
uraw �•oo ar�lvw a rw
w.o.n agwar! rB 184+6 ro
YTSwflY1®
l6WtiOr•OrEilaO wirf•raO3rF•pri[ll:.f•[rDq•rLRrawDoR l•rwDi•sOeiYllwfwl!llE!iOsOrr. wT/o0�rs0[1r. [ir045wal<..
•Tl�.rr d un+K tiCwD •.O
•Oo10•Y lr•6.4r ra M QT•Nl
anrS'rW r! .O 1[ w•OwO[DT l..E DE.
s.o.!•o- •r c wnt nwiciw
Connector Hardware
oo-.tc*o. runs ue r.w•cns�n.
•Dm.o�rDl .m. Tn
rV.n3rVrrl •4i•LL[DatTrrKt3
tv1rMl•M•rOHTaiaa wirOr1�y4M6tir wr['otrrertv nOrMnwrww•2a-E5ihar•Uer DtaE vr•Dq
Mn lOCltO4 r'DLiO• ra.ift S+
rn.Y !. .NVr Orlt u�EES O+NI
we.3c a ..c 5.+_w
Lu"dper
lu.reE. rvsi Dua • o+•DE
r•lt r•Or • •RY FD
rdECi�OY MMUY-oOvEi
3
nta�lEl
DruEAK•[ lSr�sTEOrECpRa�rRSTerDsEE
06 Moll SW*m., Inc.
urw..+q HEST
r1T3 urv. dl b, M E • ►O Do• SMM• SrDr, ww.7p. Mw
wa[I cm, Y}.r00•rYb.0 w•TS;,.q •iFI/M
. /aGD/!
+E
c-.Tfn .BE7R5
'
�
OSo-nal.
94iT
OD w fir] f/7 r
_ . F i ^ �.. 2 1
esignlOs
Design
M OE3T.r .rD M r
n.ws artf..rr .....
a•.r.r u...,..,. _..
it
0
'PRMIT NO 3835-80B,P,,E.
k -
PERMIT EXPIRES
OWNER Lila M. Bolin
iCONTR Pryor Conti , Oroville
C 26-04-19
LOCATION (A.P.
2380 Bohemia Ave., Palermo
qAk
th
Temp. P-16wer Pole
Called PG&E
Temp. Elec. Serv_yf:�L ?�w
Called PG&E
Temp, Gas Serv.
Called PG&E
JOB
FINALED
(Date)
(Sig,
-re)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING
t-ootings
Stemwal I
01-�
Mesh
Scratch
Brown
Finish
iances
01-1-- 9. 7-4
Water Piping Sewer Gas Piping
MOBILEHOME INSTALLATION - - - - Support Elec. Continuity
Water Piping Drainage Gas Piping
DATE MARKS OR CORRECTIONS
C•
(NOTE: An entry must be made on this form each time you visit the job site.)
i
RES IDENT IAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFO. E 14ITH CJJRRENT ENERGY CONSERVATION REGULATIONS
AT
22 Sd ac"
(location)
BUILDING PERMIT NO.?k:; S – A. P. NO. ,-o -0
THE FOLLOWING -HAVE BEEN INSTALLED AS PER APPROVED'PLANS:
(Check each item or write N/A if not applicable)
INSULATION:
Slab Edge.
Fdn. Walls
Floors
Walls
Ceiling/Roof
Ducts
Circulating Pipes
APPROVED HEATER
APPROVED WTR.HTR.
GLAZING
Single Glazed
Special (Insulated)
CERT. & LABELED WDS.
& SLIDING DRS.
WEATHERSTRIPPED DRS.
BACK DAMPERED FANS
INTERMITTENT IGNITION DEVICES
CERT. APPLIANCES `
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name,
Signature of
(please print)
Insulation Applicator
State Contractors
ense No.
�a
General Contractor/Owner Nam e`s
j
6 �-�O�
please print)
Signature of
General Contractor/Owne
Date
tate Contra torq
•License No.
THIS CERT IF ICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
I T ✓:. ..
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS ERMIT NO
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION -AND PERMIT
ASSESSOR 26PARCEL UMBJE7 ZONI G BUILDING PERMI
OLE NER TELEPHONE SQ. FT. OCC. B ING VALUATION
&LI A/
OWNER'S MAILING ADDRESS • Q�%
• •• 2�•PR i � % b0 • ®a
CONTRACTOR'S NAME ITcl caunn�c
CO AC TO f�'S MAI% IN A
CONSTRUCTION LE ;W4
LENDER'S MAILING LENDER'S MAILING ADORE
CHITECT OR ENGINEER
EER'S MAILING ADDR
BUI..2INGDDREss ',30N/�1rf1-
T NO. •I SUBDIVISION NAME
AVE-
UNKNO
pryLCI�
PARCEL MAP
�,� USE OF STRUCTURE
SFU Duplex❑ Mobilehome❑ Other
SPECIFY
* TYPE OF WORK
New Additions !Rem�o�d'el❑i Utilities innsst�a%lation❑ Other❑
Describe work:0P AA, �T /i/Cf/+i � fC��Lcz
N1SGo,w,ed; , eE- PLUMB. Nim cca_•1'• Alf
i 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. ,�72- -'/0 Z- 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)
Contractor
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Permit Fee $ ,
Fireplace
Filing Fee
3.00
Total Valuation $
5-00
Permit Fee
$
72 00
Plan Checking Fee
$
`• pp
Penalty
$
Land Development Fee $
Permit fee
$
, co
PLUMBING PERMIT
Filing Fee 3.00
Each Trap
FIXED APLNS
Ex. Occup.(OUT ETS P(RESID,)REA.)
2.00 ,-
Repair drainage or vent piping
Temporary service
2.00
Water piping
Mobile Home Facilities
15.00
Each qas water heater or vent,
Misc. Wiring
2.00
Gas piping system 1 - 5 outlets
Building sewer
Lawn sprinkler system
2.00
Permit Fee
Contractor
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Permit Fee $ ,
ELECTRICAL PERMIT
Filing Fee
3.00
Main service 100 AMP ORV OR LESS5.00
5-00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST ' OR ADDNS. ( ACC DWELLING
BLDGS.0
20 sq ft
�Q
—NON.RESID NEW CONSTR. BRANCH CIRCUITS
2.50 ea
Land Development Fee $
NEW RESID. (SINGLE OUPOWER TLETUCIR.&)
NON.RESID.
oc uP. GRouP
. T`--3
TYPE OF CONST.
V /Vs
Ex. OCCUp(OUTLETS OR FIXTURES
50@250
BAL@ 10¢
PD
FIXED APLNS
Ex. Occup.(OUT ETS P(RESID,)REA.)
2.00
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or •resolutions to do
work indicatedabove for which fees have been paid.
DI OR OF BLIC WORKS
a -`/
By ate J/i —�
PERMIT EXPIRES Date
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
6.25
. Lj
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Permit Fee $ ,
. Contractor
WORKMEN'S COMPENSATION INSURANCE
1 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.
fill I shall not employ any person in any manner so as to become subject
t4� 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 3.00
Heating
Cooling
Hood 2.00
Ventilation
permit Fee $
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte 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
d o in consequence of the granting of this permit.
agafte
X Date�eyp6
❑
Sign Appli t — Owner❑ Contractor]gpnd
An rmit required for excavations over 5'0" de demolition or construct-
ion of structures over 3 sto ies in height.
Mobile Home Installation Fee $
Land Development Fee $
TOTAL PERMIT FEE $ r/
oc uP. GRouP
. T`--3
TYPE OF CONST.
V /Vs
PARCEL
V
PD
5su�
p�
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or •resolutions to do
work indicatedabove for which fees have been paid.
DI OR OF BLIC WORKS
a -`/
By ate J/i —�
PERMIT EXPIRES Date
Receipt No. 3
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
BUTTE COUNTY DEPARTMFIqT OF PUBLIC WORKS
`.SPECIAL, INSPECTIGN MORT
Owner:
Address: 2_3 e
Tenant:—_
Building Location:
Type of Inspectionrequested:
A. P.
Date of Inspection _7/7_,-/i0
: T.
Inspector C�, -4-
Hou s ing
C/ 2. F inanc ing 3. Change of Occupancy to
4. Other (specify)
Present use c. -f building:
Sanitation ClLct�vligj
j
7. Vater closet:
Lavatory
Batht-ab or shower:
4 Kitchen. sink:-_...
Hot and cold water to fixtures: /V e__j
Heating fe.c4lities:
7: Natural light and V_e-nfil�=_tion:
8. Room and space requirements:
9. Bedroom window or door for second exit,,-
0
Infestation o;: insects, vermin, or rodents:_ _ _
Connection to sewage disposal:
12. Connect-lon to water supply:
13. Rubbish and garbage facilitfes:
14. Coun, ent s_.
B. Structural
1. Pll.ers and footingq:.
2. Floor con
3. Wall construction:
4. - Ceilin- .........
., and roof constructi-oij:
5. PJrcDlaces:
6— Uruments:__
C. El&ctrica.l
A
ervicc. P.nd ground /1, e,.)
rc- e
2. Receptacles:
3. FusJag:__.___
4. Caamnnts.
D. P ljSbink
1. F-�',xt.ut-es; connecte, d and vented:
2. �3as vater heater:
3. Cas :sating -vex-it's'
4. camnent.s.,
E. Other
1. Maintenance and repair:
2. Fire hazards:
3. Safety hazards:
4. Weather protection:
5. Underfloor and attic ventilation:
6. Comments:
F. Commercial Buildings
1. Roof covering:
2. Distance to property lines:
3. Physically handicapped:
4. Restroom floors and walls: _
5. Exits:
6. Improvements:
7. Zoning:_
8. Comments:
G. Field Problems or Violations
1. Problem or •:violation (give complete description): v
2. What action taken (give complete descriptf.oai) :
3.
VV«aL ai: r_ ivu 1: c vnuuenuea :
7-7A. Inforuation only - file.
B. Hold for ten (10) days, then writc. 1ltter.
C. Write letter.
77D. Other: