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HomeMy WebLinkAbout027-020-0251 • { 27-0,2-25 CHARLES SMITH �G ¢� �g/ E 3309 Grubbs Rd, Orovi a U�;' Permit#1512-84B,E(addition/SF) " 027=020-025 #98-2703 SMITH, ANNA'°"""" 3309 RABBIT ROAD, PR OWNER Ic1US6 f GAS LINE & INSERT z r. ri f r a ti r. ri f __ � �' �n �,� � ,' ®�� �n ��� � �s �ir.aass +.+.TRvS••r�r ���.� . �••-.mom...-m.+'nr�:*!'�sZVV,i�'4i.'+i.-"�':►7NwWv"�t.�.:�vr-..._9yif.xr:Y:.c.t+Ml��'�D3i�I�A+'�7!!;!',�6:•1 �• s .ems., ,� ,.; - .. . , �.�r.�r. �,�, _ . • a F -020-025 #98-2703 ITH, ANNA 9 RABBIT ROAD, ORO NER GAS LINE & INSERT • i i OFFICE COPY p ddress S t } GAS ti j Meter BY pate G E�ECTR��, Meter 51 o If F\ C COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION I 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 -PERMIT _ _ 1,--,a, .PERMIT NO. "► (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING ARMR 5 BUILDING PERMIT OWNER SMI111 ANNA TELEPHONE 533-•4x178 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS ; 33019 RARIT ROAD (_)ROVTLLF 95c)(30 CONTRACTOR'S NAME IN �f1,� TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation Is ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ BUILDING ADDRESS 3309 RARRIT ROAD, OR(? Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP _ PLUMBING PERMIT ; Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF Of Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: CAS LTNP & FIREPLACE TW.RFPT Gas piping system 1 - 5 outlets 15.00 15. Building sewer 15.00 Mobile Home I S I G I W I.. @20.00 PERMIT FEE S 35.00 ELECTRICAL PERMIT Filing Fee 20.00 Main Service 200AORLESs 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under 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 effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: . ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. t , as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 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 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 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ,op --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 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. X %� /�✓" - .�r w _ Date �% �� %��� Signature of Applicant - b Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A To 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. 8 ACC. BLDS. 3.50Fr. NONAN ROESID MULTI -OUTLET @7,50 PSOWERINGLE APPARATUS 8 OUTLET CIR. 20 @ 1.00 Ex. Occup. OUTLET OR FIXTURES BAL @ .50 Ex. Occup. OFlxuT,EE°TSA_JR � OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Filing Fee 20.00 Heating 115,00 Cooling Hood 6.50 Ventilation PERMIT FEE $ 35.00 Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE 70 (1(1 TOTAL FEE $ HAZ. I D. FEES IMP I FLOOD CDF PARCEL PD HD I ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By !1 A ,/ w Date PERMIT EXPIRES ON ////Jr n i Dafe Receipt No. 2 �� �,1_ WHITE -D. -B. D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT y , / COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION • 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 RERMIT NO. ZU- (Rev.12/96)- APPLICATION AND PERMIT Q g � ASSESSOR PARCEL NUMBER 027-020-025 ZONING 0, f -r 5 BUILDING PERMIT OWNER SPITE ANNA TELEPHONE 533-4078 SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS 3309 RA3IT ROAD. OROVILLF 95966 CONTRACTOR'S NAME Or.,ir?ER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. , Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 3309 Ti38I . ROAD. . ORO ...A'T �.0�� Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF C� Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: GAS LIr!E F:.FIREPL ACE I1TSERT Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE S 35.00 ELECTRICAL PERMIT Fling Feel 20.00 Main Service 200AORLESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under 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 effect.P License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will o the work, and the structure is not intended or offered for sale. as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DW EwNG OCCUP. OR ADDNS. a ACC. BLDs. SO 3.5¢FT: NEW ONST. R SID MULTI -OUTLET @7,50 OWER APPARATUCIR.S 6 SINGLE OUTLET Ex. Occup. OUTLET OR FocruREs 20 @' 00 BAL @ .50 Ex. Occup. ouTLEETs P=.OFRA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE S WORKERS' COMPENSATION DECLARATION 1 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 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 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) J�ertify 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 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 pr visions. X � �„/� t.o' Date � / �� 1 �G' %� Signature of Applicant - 0 Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating -. 00 Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 70.00 HA2. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under in the Butte County Code and/or indicated above for which fees have By PERMIT E PIRES ON the applicable provisions Resolutionsito do work been aid. Date Date ReceiptNo.�S I�1 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMLiER62? 02 >0 ^ v 2-5 z0,',"3/,_ys- BUILDING PERMIT OWNER / TELEPHONE SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS _1_33D!2 CG CONTRACTOR'S NAME Q TELEPHONE CONTRACTORS MAJING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation b ARCHITECT OR ENGINEER LICENSE NO. Flin Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGWEERS MAILING ADDRESS Checkin Fee $ A /� DPlan sURDINGADDREss V I` Energy Plan Checking Fee $ _ a PERMIT FEE S LAT NO. SUBDNISIONs NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SFiRKDuplex ❑ Mobilehome ❑ Other sPECON Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ UtilitiesA Installation E3Other E3 Describe Work: 6j2 Q L,,,r'S— Qf or Y11— /O �e�— I -L ( Gas piping system 1 - 5 outlets 15.00 5:5t Building sewer 15.00 Mobile Home I S I G I W 020.00 PERMIT FEE ELECTRICAL PERMIT Fling Fee 20.00 Main Service p.OR LLSg 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under 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 effect License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 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 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 of the Labor Code, for the performance of work for which this permitis issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed If the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 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. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 50' deep and demolition or construction of structures over 3 stories in height Main Service PRA TO 1000A 46.00 NEW CONST. DWELLING OCCUR so OR ADONS. a Ate. BLDS. 3.5¢FT, NEW CONST. MULTI -OUTLET T @7.50 BRAWN CIRCUITS POWER APPARATUS & SINGLE Ounce cm Ex. Occup. OUTLET OR FIXTURES 2001.00 sAL w Ex. Occup.XES A (RD, � 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating � Cooling Hood 6.50 Ventilation PERMIT FEL: $ !L Mobile Home Installation Fee $ Energy Inspection Fee L Occ CONST. TYPE TOTAL FEE $ ®,► --- , D FEES IMP I FLOOD I COF PARCEL PD HD ISSUE This permit is hereby Issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By Date PERMIT EXPIRES ON provisions to do work paid. ro ReceiptNo. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PE"IT APPLICATION DATA SHEET OWNER: Id_ S �, k— ASSESSOR PARCEL NUMBER: d y 7O ZO Proposed Buil ' g Use: -_9jzLc- Building Inspector: s(3 Date: At time of permit application, I was advised the following data must be submitted prior to perm' processing and/or issuance: 111. All items have been submitted. 112. Plot plans, 3/4 sets, signed by the preparer of plans. ❑ 3. Complete plans, 3/4 sets, signed by the preparer of plans. 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. 115. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! 06. Energy Design Compliance and supporting documentation. ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ❑ 8. Hazardous Material Form. 09. M ufactured Home data and installation instructions including Tie Down Specifications. . Fees of $ 7 D ❑ 11. Impact fees as shown on the attached schedule. ❑ 12. California Department of Forestry plan approyal/fees. ❑ 13. Flood elevation certificate. ❑ 14. Sanitation and plot plan approval Health Department. ❑ 15. City of Chico plumbing permit. ❑ 16. Plot plan and business license approval from the City of Biggs. ❑ 17. Planning approval for (A) Use: (B) Parking: ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. 1:119. Encroachment Permit for driveway (construction approval prior to occupancy). 020. Pre -inspection for required. ❑21. Contractor's license information. (Number, Name Style, Classification). 022. Workers' Compensation carrier and policy number. ❑23. O er-Builder Verification (Given to owner ❑, Mailed to owner 11).. Letter of signature authorization. 1125. Recorded copy of Agricultural Acknowledgment Statement. 026. Letter of intent on building use. 027. Manufactured Home utility clearance. ❑28. Existing violations and/or expired permits. 029. 0433 A, []Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ 1130. Other: When you issue the permit, process as follows ❑ Mail to owner, ❑Mail to contractor. []Telephone and hold for pickup at office. ❑ Deliver with inspector. Applicant: Date: EXPIRATION OF APPLICATION Applications for which a permit has not been issued, will expire by limitation one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan checking fees for work plan checked and other department costs are not refundable. Original - Applicant y � j+ j,_::� .�sr"`P"- sjq•��tiM'N`���+1�IK",�'�9i'R�V�°Rt�ii�•' �".,'t' k��'��. 1 COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 5r 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PE"ITAPPLICATIONDATA SHEET OWNER:- �S vL �- ASSESSOR PARCEL NUMBER: O 2— 7 © Z O Proposed Bnildmg Use: 9P;- Building Inspcetor: �� Date: At time of permit application, I was advised the following data must be submitted prior to pe ' processing and/or issuance: Date Received By ❑ 1. All iiems have been submitted. ❑ 2. Plot plans, 3/4 sets, signed by the preparer of plans. ------ '❑3. Complete plans, 3/4 sets, signed by the preparer of plans. 114. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! --------- ❑ 5': `Energy Design Compliance and supporting documentation. ------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ---- 118. --- ❑8. Hazardous Material Form.-------------------------------------------------------------------------==--------------- ❑ 9. Manufactured Home data and installation instructions including Tie Down Specifications .------------------ Feesof $ D!'4� --- ------------------------------------------------------------------------------------- ❑ 11 /'Impact fees as shown on the attached schedule. ----------------------====--------------------------------------- f . ❑ 1/2. California Department of Forestry plan approval/fees. --------------------------------------------------------- r ❑'13. Flood elevation certificate.---------------------------------------------------------------------------------------- ❑ 14. Sanitation and plotjplan approval Health Department. ------------------------------------------- ❑ 15. City of Chico'plumbing permit------------------------------------------------------------------------------------ ❑ 16. Plot plan and business license approval from the City of Biggs. ❑ 17. Planning approval for (A) Use: (B) Parking: -• ❑ 18. Contact Land'Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ❑ 1.9. Encroachment Permit for driveway (construction approval prior to occupancy). --------------------- ❑20. Pre -inspection for required. Request to Building Inspector, on 112 1. Contractor's license information. (Number, Name Style, Classification). ❑ 22. Workers' Compensation carrier and policy number. ----------------------- ❑23.9a er-Builder Verification (Given to owner ❑, Mailed to owner ❑). -• 4 Letter of signature authorization.-------------------------------------------- E125. ------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. ------------- ❑ 26. Letter of intent on building use. ---------------------------------------------- ❑ 2:7. Manufactured Home utility clearance. -------------------------- ------------- ❑28. Existing violations and/or expired permits. --------------------------------- 1129. 11433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ 030. Other: When you issue the permit, process as follows ❑ Mail to owner, []Mail to contractor. ❑ Telephone and hold for pickup at office. ❑ Deliver with inspector. Applicant: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: Date: By: Date: By:. (Date) .r 1. Index periit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone; ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: , 1 Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: r % Plans reviewed by: Date: Plans approved by: ' Date: t F i Sets of plans 6r' hold in ❑ Plan Cabinet, ❑ A.P. folder.. Note transfer by: Yellow Copy - Department of Development Services, Building Division. % OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing'your'signaput, Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan, to provide the major labor and materials for construction of the proposed property improvement : YES NO C3 2. I HAVW HAVE NOT 0 signed an application for a building permit for the proposed woo& 3. I have contracted with the following person (firm) to provide the proposed construction: " t NA►��_ ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to cuordinate; supervise, and provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to p 9 ide the work indicated. NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: SOCIAL SECURITY NUMBER: DATE: NOTE: This Owner Builder Verification is required by Section 19831 and 19832 of the• California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER _ 7s✓— - a y f _i F, r • 1 I • i t 1, PERMIT NO. 1512-84B , E PERMIT EXPIRES i 4, .r: OWNER _ CHARLES SMTTN ' CONTR.. owner ASSESSOR PARCEL 27-02-25 I LOCATION 3309 Grubbs Rd,, Oroville 1' t r r- S9 i ti Temp. Power Pole Called PG&E Temp. Elec. Service " 1 Called PG&E Temp. Gas Service Called PG&E ) JOB FINALED (Date) , Signature Owner: Peniit No. ENERGY C E R T,I F ICAT ION ATION DESCRIPTION OF INSULATION ROOF Material Thickness(inches) EXTERIOR WALT. Material Fiberglass Thickness(inches) 3_ CEILING Batt or Blanket Type_ Fiberglass Thickness ( inches)fj Loose Fill Type_ Fiberglass Minimum Thicknn (Inches) Area covered(ft.)' FLOOR, ELEVATED Material Fiberglass Thickness(inches) FLOOR, SLAB Material Thickness(inches) W idth(inches) FOUNDATION WALL Material Thickness(inches) 9z'7 - 0 -:z - A. P. No. Brand Name Thermal Resistance (R Value) Brand Name Certainteed Thermal Resistance(R Value) Brand Name Certainteed Thermal Resistance(R Value)_ Brand Name Certainteed Number of Bags. Wt. per bag _ lb. Thermal Resistance(R Value) Brand Name Certainteed Thermal Resistance(R Value) r Brand Namer Thermal Resistance(R Value) Brand Name °ihenmal Resistance(R Value) r - I hereby certify that the above insulation was installed.in the above building in conformance with the State of California Energy Requirements. Hawkins Insulation Co., Inc. FIR4 NAME/OWNER SIGNATURE OF INSTALLATION APPLICATOR A 378407 STATE CONTRACTOR'S LICENSE NO. '%/; � -, 01�-- V 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. C;yADP�Ct�`S �..r i 7" ff FIRM NAME/OWNER (Pleas print) STATE CONTRACTOR'S LICENSE NO. GNATURE OF (QE.NERAL CONTRACTOR/OWNER 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 = OK = Not OK = Not Applicable MOBILEHOMES - MISCELLANEOUS = Not Ready Date ' MOBILEHOME UTILITIES (Plans) OK except H's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except H'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 Card -BI Date Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Card -BI Card -BI Date Date 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 4. Electricity; MH Test -Crossovers -Breakers -Clearances 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 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 Lghig. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Health Department Approval 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 10. Plumb; Cir. Test -Water Supply Test Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date V = OK 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) Date UND LO0 Plans OK except #'s Date FRUI nt hued 1. o%pifrequirements-Setbacks-Easements 4t#:, fro ine Firewall &Openings 2. g., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. xt. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth - room -Rise -Run -Landing -Fire Protection 4. Ftg orches & Decks; Soils -Steel- / /" Ftg. Depth 51 ywood on Roof Overhang -Attic Vents -Rafter Outriggers 5.4 Sfmw , Main; Steel-Blockouts-Wrapped-Slab 52, Ing -Nailing -Veneer 6. S -walls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access iers-Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test-Anchors-Regulator-Seryice Test 11. Ele tric; Underground ^AY 12 Kenums & Ducts; Clearance -Material -Support -Ins. / - Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -B Date rd BI Date Card -81 Date and -BI Date Card -BI Date Card -BI Date Card-BIA 4X Dat Card -BI Date Date FIN Plafis) OK except #'s Card -BI t Card -BI Date Date PLUM NG ( rmit) OK except #'s Ext. Steps -Door & Sidelight Protection -Landings 57. 1 Smoke Detector 14. WaW HtV Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector, In Garage; 9 e; Above Floor-Ducts-Mech. Protection 15. Wat P e; Test &Anchors -Nail Protection 16. D.W. est-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Sh a Pan; Test, First Floor -Tub Access 60 G.F.I: & Bath Fixtures & Tub Access 18. T st T bl& Shower, 2nd Floor -Tub Access ec. Trim & Subpanel; Breaker Sizes -Labels 19. as PipN' Size & Anchors to rs & Rails 63.1 Fireplace or Stove; Clearances -Hearth 6A.1 Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65.1 Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 661 Elec. Outlets & Receptacles at Kit. Counter Date ELEC CAL Permit OK except #'s 67 Garage Fire Door; Swing -Landing -Closer 6 A.C. Duct in Garage -Damper 20. Fi re & Transformer Clearance -Ins, Protection 6 Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. le eceptacles Spacing -Lights &Switches at Doors 22!27%,_1%$., s & No. of Conductors -Stapled Elec. & Mech. Equip. Listed for Location 2 o -rnstalled Close to Edge of Studs & C.J. 71, Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 2 quip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic es in Kitchen &Conductor Size ire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 73.E fuel Rails &Deck Construction -Post Caps 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ,0 -Y -es 7. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI, nsulated Neutral ❑Yes El No 75. Following instld.: Drive es ❑ No; Walks El Yes E) No; Planters ❑Yes ❑No 28. 29. Ser -Riser Conductors & Ground -Main Disconnect Equip. Clears Panels-Motors-Mech. Equip. 76. Stucco; Brown -Finish 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78, Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 8 terior Elec. Trim; G.F.I. Receptacle -Underground Card B -I 0& Date Card -BI N Date V ntilation throughout House Card B -IF Date Card -BI Date 82. IGlass Protection Date MECHANI AL (Permit) OK except #'s 83.1 Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. ucjgj Insulation & Support 45. 1 Wgaer & Sewer Connected -C/0 to Grade -HD Approval 32. Vent W;/Exhaust above Insulationoge-"Energy Compliance Certificate -Other Certificates 33. Conde a e Drain & Overflow; Size & Grade 34. Furn c Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Atti Access & Platform if Furnace in Attic C -BI Date Card -BI Date Card -BI Date Card -81 Date Card -BI Date Card -BI Date Card -BI Date F A Date Card -BI Date G ans OK except #'s Card -BI Date Card -BI Date Comments at Final: 3 . S' oper Material & Anchors 37, Valfs;_$kuds7Nailing, Spacing & Bracing -Plates -Sound 3ring alts over Girders & Floor Nailing 39.Dr t in Walls (rat proof) 40 Sto s; Furred Ceilings -Stairs -Chases -Tub 41 Header & Beam -Size & Bearing - os Caps -Anchors -Connectors 43. qoi"Fir!2!��ies . Jois=Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnq_.-Rfn_q_._ or Type A Flue -Fireplace Throat 4 Access; Size & Romex Protection -Draft Stop -Ins. Baffles 4 drm. Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Framing (NOTE: An entry must be made each time youvisit jobsite) J 1! COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND"PERMIT PERMIT NO ASSESSOR PARCEL NUMBER . _ '— ZONING BUILDING PERMIT OWI11Ee s � TELEPHONE SQ. FT. OCC. BUILDING VALU OWN 'S MAILING AD ESS .. S CONTRACTO SNAME LO V� TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace' t' CONSTRUCTION LENDER UNKNOWN Total Valuation $ $' Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ .S00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ gs ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDR PLUMBING PERMIT Filing Fee- 10.00 Each Trap 2.00 Solar Water Heater 20.00 rp Water piping 5.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer 5.00 Mobile Home S 10.00 e G W TYPE OF WORK New ❑ Addition ,Relnode i tilities ❑ Installation❑ Other EJ Describe work: QJ �J1 ` y- V- VA100 Permit Fee $ ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V DR LESS 10.00 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELL OR ADD. ( ACC. BL G / 2h0SQft 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 NEWCONSTR UL71-OUTLF-T 2,50 ea _NON .RESID BRANCH CIRC ITS NEW CONSTR. /POWER APPARATUS &' NON.RESID. \SINGLE OUTLET CIR. 20050e Ex. Occup(o TS OR FIXTURES SAL®30 FIXXEEDDAPPLNS, OR EX. Occup. OUTLETS (RESID,) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ a (7 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor 1 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 saio Qqunty in coq ce of the granting of this permit. %� Date Signature of Applicant - Owner N 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 F e $ V)t TOTAL PER FE $ occuP. GROUP I TYPE OF CONST. I PARCEL PD I ND IsSUE 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 / Hca 0 Z •/ ` By Date � PERMIT EXPIRES Date_ &: �--��,� Receipt No. p�� —�'a WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT ENERGY -SHEET ;r FOR " ADDITIONS TO RESIDENTIAL BUILDINGS PERMIT No. �PACKAGE "A" (Additions) NAME n JOB ADDRESS TYPE OF WOR FOR M '7 J -f SQUARE FOOTAGE d Existing Residence pp �— New Addition New Total The following information sheet, showing mandatory features and required features of Package "A" must be completed and attached to all plans for additions. to dwellings. Additions to dwellings include room additions, .converting garages and patios to living areas, house moves that add footage and attic conversions, and any space that is ex- isting non -conditioned space that is converted to conditioned space. Remodeling of existinq conditioned space,is not included. ZONE 11 NE 12 ZON 16 .INSTALLED APPLIES TO NEW AREA CEILING R-30 f, R 3 -38 WALL R-11 R- -19 FLOOR R-11 -11 R 19 R-11 R- 7 GLAZING ,65 .65 'SHADING SOUTH - OPTIMUM OVERHANG or .36 S.C. WEST . - .36 S.C. LOOSE FILL INSULATION (Density) INFILTRATION CONTROL (Weatherstrip doors, certified windows, caulking) r DUCTS PER UMC - Ch, 10 LIGHTING KITCHEN & BATH NOT LESS THAN 25 LUMENS/WATT MAXIMUM GLAZING 16% OF AREA PLUS REMOVED GLAZING NEW HVAC AND HOT WATER IN CONJUNCTION WITH AN ADDITION SHALL COMPLY AND FILL OUT DATA ON BACK OF THIS SHEET 7/83 MEELS MINNUM HEATING VENTILATING. AIR CONDITIONING SYSTEM (A) Heating Central Gas Furnace -f .S� (brand and model number) SE Btu/hr (heating capacity) Heat Pump (brand and model number) ACOP Btu/hr (heating capacity at 47°F) Active Solar type (liquid or air) Collector brand and ft2 model number solar fraction collector area collector orientation collector tilt rated y -intercept rated slope Other (describe) (B) Cooling Electric Air Conditioner (brand and model number) (seasonal EER) Btu/hr (cooling capacity at 95°F) Electric Heat Pump Btu/hr (cooling capacity at 95°F) Other x / 's (describe) EER n DOMESTIC WATER SYSTEM ❑ (A) Gas Only `�� L�� Gallons (brand and mode number) (tank size) ❑ Heat Pump w/Electric Backup (brand and model number) Gallons 2 (tank size) C3* Active Solar (collector brand and model number) (rated y -intercept) (rated slope) (solar fraction) ft (backup heater type, brand and model number) (collector area) (collector orientation) (collector tilt) ❑ Location of Solar Panels ❑ Other (Describe) *1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing charts (form #4) or other approved methods, section 2-5352(8), and fill out the following: Heating: Winter design temperature °, elevation ', heating load BTU elevation factor x heating load = maximum outlet capacity gas furnace BTU Cooling: Summer design temperature ', cooling load BTU *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 California %A`ddmministration Code. SIGNATURE OF BUILDI G DESIGNER OR APPLICANT w . ' I L III LIL il! IIIlli l) Illilillll_