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031-238-038
03 �1-218�0 4207-9 P,E,M POTE ST .i, James. 555 Ylibd.. ve e 0 o 0* new sin le f mil. p OTE 23 S8 T t 9 ' Jame s. Yu b. I j F555 a ven e new sin f m, qv ', Zle 0 1 a3l 238 To C -038 94--0083B P,E,M dN-I , T CK, 'DAV E; CONT:; P ONT: JIM, POTLES,TIQ-, -. 555'TUBA -.- AVE- 0RQVILLE'./O/�. D ; " NEW SINGLE FAMILY' 031 238 038 03 7074,' 'N Zj HENRY' S5'�5.YUB Vt'OkbVIL LE,' CONT ADPOOL . SPOOLS I'S I Tl 507-97 031-239-038- 03,10128 SANCHEZ, HENRY �55�5IYUBA AVE, OROyILLE NA LE .CONT: ADONIS POOLS fi � �/. \. ' R r ��� � ` � v � � 1 �,� r v � � � � � � ;� f :�� ., . �._ , _ .. y ,'��, _ i� -- ----�, County of Butte Oroville, California GENERAL CLAIM CLAIMANT: Adonis Pools ADDRESS: 12 Pheasant Run Ct. IMPORTANT: CITY & STATE: Chico, CA 95973 SEE INSTRUCTIONS ON REVERSE SIDE DATE OF CLAIM: 6/2/2003 0110ne►r f%► A 111 Tn napePTMFAIT RFCF1V11Vr. MOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Reason for the Cancelled project ' Refund: Ellag Permit App No.: 03=0794 AP No ........ ........ .... ._... Receipt No.:375762 ,., ,...,, Receipt Date: Bldg Permit Fees: ._ Owner's Name: I-lenly Sanchez ;, y TOTAL FEES PAID: $335.00 TOTAL FEES RETAINED (Breakdown Below): $108.00 Building Permit Filing Fees: :,2 Plan Checking Fee: Plumbing Permit Filing Fees: $20 O0 Energy Plan Checking Fee: Electrical Permit Filing Fees: ZO OQ' Refund Processing Fee: $25 0:0 E.. Mechanical Permit Filing Fees: Inspection Fee: SRA Fee: -: ..•, --$227.00 I, the undersigned, declare under penalty of perjury that the services or articles clai h been performed c - e and ec s stated Dated this .day of ®rdelivered;'ancoofftis 2003, at lif. Signature of Claimant 1• the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have?eeVperformed or deliv ed d th there is a Budget Appropriation or Specifi Boa oval o e) for the same. Dated this day of �"" , 2003, at _Oroville Calif. Departme t Head or Authorized Deputy Dept. Code 440-001 Exp. Code 4210500 PAYABLE FROM Constructi n Permits FUND Dept. Code Exp. Code PAYABLE FROM FUND . . Dept. Code Exp. Code PAYABLE FROM FUND DO.NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT & SUB. PROJ. SUB. OBJ CLAIM NO. INV. NO. INV. DATE ENCUMB GROSS AMT. } eV o�UTrFo o Butte. County Department'of Development Services r "Building Division I , REFUND CLAIM APPLICATION REQUEST FOR REFUND ` Refunds can only be made upon written request by the person who paid the fee(s). 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 check fees for work plan checked are not refundable. Fees paid to other County Departments are not covered by this claim. [Butte County Code section 341(t)] CLAIMANT'S NAME: • s 1.U,�p-Y�•,�� MAILING ADDRESS: C) r� A\j r ,Cl aya=L 5q.7? ASSESSOR'S PARCEL #: 3 — �'3 R C) 33 .a 3 v r?� BUILDING PERMIT #: RECEIPT NUMBER(S): S �U A request for refund of fees paid on the above receipt number(s) is for the following reasons: OA All 0 -011-e n X e Please refund any applicable fees in the following categories: (Check those fees which you wish to have refunded.) O Building Permit Fees ( ) Sheriff Fees ( ) 'SRA Fees (CDF Fire Planning) ( ) Other (specify): Disposition of Plans: ( ) Plans returned to me at counter ( ) Please mail plans to me at above address i ( ) Please dispose of plans Signature Date A COUNTY OF BUTTE GENERAL CLAIM FORM WILL BE MAILED TO YOU. FOR SIGNATURE AFTER REVIEW BY BUILDING'OFFICIAL.. J:\IvIy Documents\REFUND CLAIM APPLICATION:doc 12/17/02 FOR BUILDING DIVISION USE ONLY: Receipt Information: Number: 3 Date: 3-,--)-/-3 Issued To: Amount: 9�3 35 Fees Retained: BP# 03 'd 9 /Pg rocessin Fee: / $ b s/Bldg Filing Fee: $ a�0 W1bg Filing Fee: $ r3 0 vflec Filing Fee: $ Mech. Filing Fee: $ Energy P/C Fee: $ An Check Fee: $ Inspection Fee: $ SRA P/C Fee: $ y Other: $ Total Amount Retained: $ TOTAL REFUND DUE:$ Amount from 440-001 Amount from BP# Processing Fee: $ Bldg Filing Fee: $ Plbg Filing Fee: $ Elec Filing Fee: $ Mech Filing Fee: $ Energy P/C Fee: $ Plan Check Fee: $ Inspection Fee: $ SRA P/C Fee: $ Other: $ Amount from Amount from J:WIy Documents\REFUND CLAIM APPLICATION.doc 12/17/02 z .J. r .. i �. -. a �S � [ l ' 1 n �� ' i , I COUNTY OF BUTTE - DEPARTMENT OF -DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 0.3 —D?rf q ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER SAND TifLEPHONE SO. FT. OCC. BUILDING VALUATION CONT 20,000, .OWNER'S MAIADDRESS 555 YUBA AVE. OROVILLE CA 95965 CONTRACTOR'S NAME ADONIS POOLS TELEPHONE 891-1197 CONTRACTORS MAILING ADDRESS 12 PHEASANT RUN COURT CHCIO CA 95973 CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 207-00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 21-00 BUILDING ADDRESS 555 YUBA EX AVENUE, 0E0VTTJE Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SWIMMING POM SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 15.00 Each as water heater or vent 15.00 TYPE OF WORK NewNR Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: MASTER PLAN #507-97 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W 920.00 PERMIT FEE S ELECTRICAL PERMIT I Fling Feel 20.00 Main Service ..A o RR 1 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. �/�yii+j� %® License Class Lic. NO. t��i'�--C 'IIJC/ / 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 Main Service 200A TO I000A 46.00 NEW CONST. DWE IJNG OCOUP. so OR ADDNS. ( a ACC. BLDS. 3.5¢FT, NEW SID. MULTI.OUTLET @7.50 POWER APPARATUS 8 BINDLE OIfTLEf CIR. OUTLET OR FIXTURES 20 @ ''� Ex. OCCU BAL @ .50 Ex. Occup. DUTIETS R,D LNS°� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wifina 23.00 POOL ELEMIC 0.00 PERMIT FEE $ 50.00 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. workers' c�.2 ryj�syrance rner and-policynumber are: Carrier ,,-� CC�� MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $_ Policy Number ,F s? r— ' (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 Calffg an gree that if I should become subject to the wor rs' cc n.,o signs section 3700 of the Labor Code, I shall fo with mply those rovi ' ns. Date ( Si t pplicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures o r 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 335.00 HAZ HA D FEES IMP 7_ CDF PARC HLj� t/ Ssu 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 D e 32 PERMIT EXPIRES ON V 7 If(0, te Receipt No. WHITE-D.D.S.-B.D. CA Y -ASSESSOR I PLINK-INSPEC OR GOLDENROD -APPLICANT db ♦ i Y Z p 7� COUNTY OF BUTTE-DEPARTMENTF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA` 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER �� ASSESSOR PARCEL NUMBER p -o a r f E Proposed Building`Use: Pod � Counter Technician: Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1.. Plot plans, 3 or 4 sets, signedty the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannotproceed. The.permit will be indexed and returned to the plan review line-up when required items are received.. Date Received By ❑ 8. Flood Elevation Certificate, wet-st roped and s gned,"in duplicate.` ............ .!... ....... ❑ 9. Plot plan and business license approval from the City of Biggs .......................:,:............ ❑ 10. Letter of intent for non-residential buildings..................... ................ ❑ 11. Detached Accessory Building Form; filled out by the owner................:..:..............e. ❑ 12. Hazardous Material Form .................................: ❑ 13. Other / Remaining items needed to issue the permit. (May „require additional plan review upon receipt of the following items.) ❑ 14. Fees as shown on the attached Schedule of Fees Due �Sheet .........::`............................... tatement of Intent for Non -heated and A/C Buildin s.......... p �.!.........:............... Q04;C ritation and lot lan ap roval from the Environmeial�Healt�h Department in P p PPi of ChicoPlumbin ermit............ �:..P... :....:s...;....,..ifi..` ..............................: ❑ 18. California Department of Forestry plan approval O paid. Sent. by ...................... ❑ 19. Planning approval for (A) Use: (B)Parkitig: F -(C) Parcel Check:�2 ❑ 20. Contact Land Development about ❑ Improvements,Y ❑ Drainage .............................. -'—"� ❑ 21. Encroachment Permit for driveway from the Public -Works Dept. (construction approval prior to occupancy). ❑ 22. Pre -Inspection for required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ..............:.............................. ❑ 25. Owner -Builder -Verification (❑ Given to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization.................................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance............................................................... ❑ 29. Existing violations and/or expired permits......................................................... ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone ''//9' _`' and hold for pickup. I have been informed of the above items and rea it m!ents for �� App cant: 66� e. .3 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required If Contractor, designer, owner, was advised cfthe above data by ❑ phone, D mail, ❑ counter, by Date: _ Contractor, designer, owner, was advised of the a � ove to by ❑ phone, 0 mail, ❑ counter, by Date: Plans reviewed�y: % Date:yy b3 Plans approved by: --- Date. Structural reviewed�by: a e: Structural approved by: Date: Note transfer by: Date: VrllnwRuilriino.•rliuicinn - .. . ... _ OUTTF 00Butte County Department of Development Services COUNTY,, ° -_�: ° Building Division APR,2 8 1003 coU Nty F DEVELOPMENT SERVICES REFUND CLAIM APPLICATION REQUEST FOR REFUND Refunds .can only be made upon written request by the person who paid, the fee(s). 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 check fees for work plan checked are not refundable. Fees paid to oth County Departmenti °are' t covered by this cl im. [Butte County Code Section 3-41(t)) CLAIMANT'S NAME: )MAILING ADDRESS. ASSESSOR'S PARCEL #: BUILDING PERMIT # .: RECEIPT NUMBER(S): , . (-.F . 7, ` 7 Ge A request for refund of fees paid on the above receipt number(s) is for the following:reasons: 74n)/ C ' Please refund any applicable fees in the following categories: (Check those fees which you wish to have refunded.) Building Permit Fees ( ) Sheriff Fees ( SRA: CDF Fire Plannin Y ).- ( g) ( ) Other (specify); Disposition of Plans: ( ) Plans returned to me at counter Please mail plans to me at above address ( ) Please dispose of plans , ` Signa e L , rDate42 Y7_ A COUNTY OF BUTTE GENERAL CLAIM FORM WILL BE MAILED TO. YOU FOR 4 SIGNATURE AFTER REVIEW BY BUILDING OFFICIAL-. , J:\MyDocuments\REFUND CLAIM APPLICATION.doc 12/17/02 ' FOR BUILDING DIVISION USE ONLY: Receipt Information: Number: Date: Issued To: Amount: Fees Retained: BP# BP# Processing Fee: $ Processing Fee: $ Bldg Filing Fee: $ Bldg Filing Fee: $ Plbg Filing Fee: $ Plbg Filing Fee: $ Elec Filing Fee: $ Elec Filing Fee: $ Mech Filing Fee: $ Mech Filing Fee: $ Energy P/C Fee: $ Energy P/C Fee: $ Plan Check Fee: $ Plan Check Fee: $ Inspection Fee: $ Inspection Fee: $ SRA P/C Fee: $ SRA P/C Fee: $ Other: $ Other: $ Total Amount Retained: $ $ TOTAL REFUND DUE:$ `` $ Amount from 440-001 $ Amount from $ Amount from $ Amount from $ J:WIy Documents\REFUND CLAIM APPLICATION.doc 12/17/02 1 .) PI�(�I • i��fiE COUNTY OF BUTTE " 1�•.' 4,'"' . O r- FFICIAL R Ill ke; , ,� :Y OFFICE O DE A TMENT ISS ING Al ceived'from ( RECEIPT a 2(1; { ayG Mie Sum of sFory >r�:,,; t' ld ��— $ > jai - �(� y „ �r� �:� .. _•^q[� � Y.: .. LV1,'YtLi I kt�, }-t>i i P_• 5! Recet G 3- O % �} �% + - .. ,^�=; .` ;=��1�,��"t ;PIP Y" Received By CASH TitleEll r By .,' DAVCO BUSINESS FORMS (BIB) 7�3-8511 I ; " 1 '' ,t foundation plans, all in duplicate. di i 1 f F �„• ., 7.: Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views initnplic l (D) Floor plans in triplicate. All of these must '�l•, I� � �� -be stamped and wet -signed by the en ineer. Kt Items required for initial plan review. If checked items have not been received, srindexed,and s .YYt 7•� ' tri) KAY (I6;4 plan review cannot proceed.' returned till plan review line-up when required items are received. The peril, l .. } t r ❑ 8 F10od Elevation Certificate wet -stamped and signed, in duplicate. ;`❑`9. � r " Plot plan and business license approval from the City of Biggs. Oa 10 Letter of intent for non-residential buildings. ,r 11 'Detached Accessory Building Form filled out by the owner. ' ;Hazardous Material Form. •�,' ��. 13`�Other '- – Remaining items needed to issue the permit. (May I ,l require additional pl review upon receipt of the following items) sP4 0 ;14. ,Fees as shown on the attached Schedule Fees'Due of Sheet. i• <t b",�15: Statement of Intent for Non -heated and A/C Buildings. ;!.0`.;0. ;€ 16 'Sanitation and plot plan approval from the Environmental , ; i alth Department in ��,❑ 17City of Chico Plumbing o permit. ( _0148.'California Department of Forestry approval .; ` plan ❑ pat ??`t" 0?:� �:•- '19.' Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ! `' ' • �•� O120.. Contact Land Development about ❑ Improvement , ❑Drainage. •21 `Encroachment ;; •w F ❑ Permit for driveway from the Pub ' Works Dept. (construction approval prior to occupancy). p t22 - Pre-Inspection for ( f required. r$ ,4!,-;0'-23` Contractor's license information. (Number, N me Style, Classification). =gi0.,24 j i }: , •, ` w3 rWorker's Compensation Carrier and Policy umber. `ek❑"�25'-Owner-Builder Verification ( ❑ Given to wrier, ❑ Mailed 'to *owner). 126.', t:."10 Letter' of Signature authorization. '0:27 .r'Recorded copy of Agricultural Ackno edgment Statement. t (7 38 ;Manufactured home utility clearanc ,' ;❑'29' :'Existing violations and/or expired ermits. s" r ❑ 30 ; ❑Grant Deed, ❑ M.H. Title/Sta ment of Facts, ❑ Letter from Legal Owner, p Check to H.C.D. $ >r� ❑�31 Other: I jWhen`issued Telephone hold and for pickup. � ,I have been informed of the nh p ct.— ---a r' NOTES RESIDENTIAL 031-238-0383-1028' SANCHEZ, HENRY PERMIT NO 555,YUBA-AVE,OROVILLE_. CONT. ADONIS POOLS POOL MASTER#97-50 F s 1 r x SPECIAL CONDITIONS CHECKED - BY SRA' FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. # SPECIAL INSPECTION ITEMS i VERIFY t, p USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER F t i a JOB FINALED (D e t Signature '\ J=OK 0 = Not OK = No Reaa,ledy• MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch - .3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test-Wrap;-/ /" L 'ft. / /'Nat. or/ P' L "ft./ P LPG - 7. Well Clearance A Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card 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 -Connector 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 Card 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 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 3. Decks, Girders. and/or Joists- Decking -Braci ng -Stairs- Rails 4. Wood Awn.; Posts- Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. 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 Card B-1 Date Card B-1 Date -Card B-1 Date POOL (Plans) OK except #'s Setbacks -Easements oils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining lec.; Receptacles and Lighting, Distance-GFI Vic.; Pool Lighting; 15 Volts-GFI , 6. E Enclosures; Conduit Entries -Terminals; Listed . Elec..; Bonding; Metal w/5' -Circulating Equip. -Heater $_ZIrs.; 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 t Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = Not Applicable . =Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 1. Zoning -Setbacks -Easements -Flood -Slope Garage Fire Protection Framing -RC Channel 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth Property Line Firewall & Openings 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 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 Shear Walls; Nailing -Bolts 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test Brace Interior/Exterior Wall Panels 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test Date 12. Electric Underground Card B-1 Date Card B-1 13. Plenums & Ducts; Clearance -Material -Support -Ins. Card B-1 Date Card B-1 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 65. 16. Insulation 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 70. 17. Water Htr.; Vent -Access -Combustion Air Baffle 71. 18. Water Pipe; Test & Anchor -Nail Protection 72. 19, D.W.V.; Test Fittings & Anchor -Nail Protection 73. 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 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection Date Plb.; Elec. & Mech. Equip. Listed for Location Card B-1 Date Card B-1 Date Elec. Receptacles in Garage (F.F.I.)-Romex Protection 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 83. 27. Romex Installed Close to Edge of Studs & C.J. 84. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 85. 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al Water Well, Disconnect, Electrical, Plumbing 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes 0 No Exterior Elec. Trim, G.F.I. Receptacle -Underground 32. Service -Riser Conductors & Ground Main Disconnect 89. 33. Equip. Clearances Panels-Motors-Mech. Equip. 90. 34. Clothes Closet Light -Shower Light -Spa Light 91. 35. Smoke Detector 92. Gas Test -Meters Tagged, Gas -Electric Date Water & Sewer Connected -C/O to Grade -HD Approval Card B-1 Date Card B-1 Date Energy Compliance Certificate -Other Certificates Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support Date 37. Vent Fan, Exhaust above insulation Date 38. Condensate Drain & Overflow, Size & Grade Date 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet Comments at Final: 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 A Flue -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 3' -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 -Bolts 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. Duct in Garage -Damper 77. Wtr. Htr.; 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 0 Yes 83. Following Instld./Drive 0 Yes O No/Walks 0 Yes 0 No/Planters 0 Yes 0 No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-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: 4 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - B LDING DIVISION 7 County Center Drive • Oroville,'California 95965 • Telephone ( 0) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT � �a -OP ASSESSOR PARCEL NUMBER -/1M8- ZONING BUILDING PERMIT OWNEgZ ,TELEPHONE 523-3100 SO. FT. OCC. BUILDING VALUATION CFar _f) 000.00 DWNESSs53IUNC3La ADDRESSNI' Aveve Oroville CA 95966 °DAt �rB"PWIS _ 391-1197 CDffC o SMAIUNQ _ADDRI7[TN COURT CHTCO CA 95973 CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ 20,000.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 207.W ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 23.00 BUILDINGADDRESS 555 Yuba Avenue Oroville CA 95%6 Energy Plan Checking Fee $ $ PERMIT FEE $ 2_50,00 LAT NO. SUBDNIs10NS NAME' PARCEL MAP � PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF,O Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 ,51.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Unities ❑ Installation ❑ Other E3 . Describe Work: NEROM MASTER # 95do /i'.i� / Gas piping sy2tem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ 35.00 ELECTRICAL PERMIT Fling Fee 20.00 OOVOR LESS Main Service 2o0A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 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 �_ �" ��iti Lic. No. [im"G37 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❑ 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 permit is issued. My workers' compensation insurance carrier and policy number are: Carrier 15 �/ ;P - c ';GV Main Service 200A To 1000A 46.00 NEW CONST. DWEL CNG OCCUP. ;UAUC-OUTLS. 3 SQSO. FT. NEW CONST. NON-RESID.BRANCH CIRCUITS @7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FD(TURES 20 @ 1.00 BAL Q .50 Ex. Occup. GFlx�e R=°REA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 POOL ELECTRIC 1 30.00 30.00 PERMIT FEE $ 50.00. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number <PW 7 — ::5_�—C;) (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 lav��vs'f California, and agree that if I should become subject to the worker� c�p€nsation provisions of section 3700 of the Labor Code, I shall Ifo with com I wRh'th provisions. P y P J� X Date �( 0 _ bignatLire—of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee Is occ CONST. TYPE TOTAL FEE $ 335.00 HAZ. ,mss I D. FEES IMP FLOOD CDF PARCEL ........- PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or incicatedlabove,for which fees have y PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. / Date / r i 4//I/ 0 4/ Date Receipt No. 5' -3 WHITE-D.D.S.-B.D. CANARY,ASSE SOR' PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT'OF DEVELOPMENT SERVICES ' .. V _ 411 Main Street • Chico, CA • (530) 891-2751 - 7 County Center Drive • Oroville, CA • (530),538-7541 w) CORRECTION NOTICE TA OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the / above address and should be corrected. Please notice this office when correction of work Is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. 1 n z2i1i11 Date - Inspect r REV 10/92 C �Y COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT �0aL0 ASSESSOR PARCEL NUMBER 031-2-19-0-19 ZONING BUILDING PERMIT OWNER Sanchez FENTRY TELEPHONE 533-3100 SO. FT, OCC. BUILDING VALUATION CO ST ""N i i `720,000.00 . OWNERS MAILING ADDRESS 555 Yuba Ave Oroville CA 95966 CONTRACTOR'S NAME ADONIS POOLS TELEPHONE 891-1197 OD OPHOANTRUN COURT CHICO CA 95973 CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ 20 000.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 907.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 23.00 BUILDING ADDRESS 555 Yuba Avenue Oroville CA 95966 Energy Plan Checking Fee $ $ PERMIT FEE $ 0 LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF b Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 - Solar or heat um water heater 23.00 Water piping 15.00 5.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other EX Describe Work: ;\: P00 L9a,5='ER 9 9 s� Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W Ca20.00 PERMIT FEE $ 35.00 v ELECTRICAL PERMIT Fling Fee 20.00 Main Service eo.OR LESS 2o0A OR LESS 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.POWER 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 Main Service 200A TO 1000A 46,00 NEW CONST. DWELLIG OCCUP. N OR ADONS. ( a ACC. BLOB. SO 3.5¢x. NON-REESID. MULTI-OBRANCH UTLETFtcu 97.50 APPARATUS 8 SINGLE OUTLET CIR. EX. OCCU OUTLET OR FDrrURES 20 0 "00 BAL @ .so LNS Ex. Occu . OFlxun�rs Aes oR.f 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 POOL ELECTRIC 1130.00 V 30,00 PERMIT FEE S 50.00. 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'-rgmpensation insurance carrier and policy number are: Carrier 5z�� �J,' '0 MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ 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 la f California, and agree that f I should become subject to the workers' o nsation p�'ofsection 3700 of the Labor Code, I shall mply w' s _ Date 5 at of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONS�TYPE EE $ 335.00 HAZ. CDF pgRCEL pp HD ISSUE This permit is hereb issued under the applicable of thtte Couin Code and/or Resolutions ind' ated r which fees have been D PERMIT EXPIRES ON provisions to do work paid. to ate Receipt No. WHITE-D.D.S.-B.D. CANARY- SSE O PINK -INSPECTOR GOLDENROD -APPLICANT National Pollutant Discharge Elimination System (NPDES) Phase II & SWPPP Non -Certification for Project # for Butte County Storm Water Permit Compliance By signing below, I, the project architect/engineer of record, indicate that I am aware that a construction project that disturbs more than 1 acre of land requires a Construction Storm Water Permit from the State Water Resources Control Board. I, additionally, understand that it is the project owner's/owner's agent's resppnsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP) and a fee of $700.00 to the State Water Resources Control Board to obtain such a permit. I, further, certify that this project will not disturb more than 1 acre of land. I have also reviewed the Best Management Practices Handbooks, California Storm Water Quality Task Force, Sacramento, CA. I certify that appropriate BMPs will be implemented to effectively minimize the negative impacts of this project's construction activities on storm water quality. I acknowledge that it is my obligation to make the project owner and contractor aware that the selected BMPs must be installed, monitored, and maintained to ensure their effectiveness. If, at any time, site conditions and/or observations by a County official warrant reevaluation and revisions of the chosen BNIPs, the appropriate changes will be made without unnecessary delay. I am aware that failure to properly implement and maintain the BNIPs necessary to prevent the discharge of pollutants from this project during construction could result in significant penalties and/or delays. Signed: Title: Date: By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs more than 1 acre of land requires a Construction Storm Water Permit from the State Water Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP) and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit, if my project disturbs more than 1 acre of land. I, further, certify that this project will not disturb more than f acre of land. This document and all attachments were prepared under.my direction or supervision in'accordance with a system designed to assure that qualified individuals properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons directly responsible for gathering the information, I certify, to the best of my knowledge and belief, that the information submitte�.is trueaccu-Fates-and_omplete. Signed: Title: Date: NPDES & SWPPP Non -Compliance Certification Draft Butte County Stonnwater Plan COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 QPERMIT APPLICATION DATA SHEET OWNER: _ C ASSESSOR PARCEL NUMBER 1000�.JU Proposed Building Use: Counter Technician: ate: I Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.;; Plot plans, 3 or 4 sets, signed,�y the preparer of the plans. 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information; ,(C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ..................... ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings........................................................... ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... _ ❑ 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 14. Fees as shown on the attached Schedule of Fees Due Sheet .................................... e - 15. Statement of Intent for Non -heated and A/C Buildings ................................... .. _ 16. Sanitation and plot plan approval from the Environmental Health Department in ❑ 17. City of Chico Plumbing permit........................................................................ _ ❑ 18. California Department of Forestry plan approval ❑ paid. Sent by: ...................... _ 0 19. Planning approval for (A) Use: (B)Parking: . (C) Parcel Check: _ ❑ 20. Contact Land Development about ❑ Improvements, 0 Drainage ............................... _ ❑ 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 22. Pre -Inspection for required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ..............:............................... ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ....::.........,.... r- ❑ 26. Letter of Signature authorization.......................................`.............. ............. ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance ......... ...........:.......................................... ❑ 29. Existing violations and/or expired permits........................................................... ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑Check to H.C.D. $ tV ❑ 31. Other: When issued Telephone and hold for pickup - I have been informed of alb/o,v .items a -' r q ire ents for obtaining a building permit. Applica Date: 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised cf the above data by ❑ phone, ❑ mail, ❑ counter, by Date: _ Contractor, designer, owner, was advised of the abo dto by 11phone, ❑ mail, ❑ coun r y Date: A'' Plans reviewed by: 91 Date: Plans approved by: Date: AD G Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow Ruildinv Divicinn C� V=OK ' O =-Not OK - = Not Applicable ' MOBILE HOMES`` r ; i. MISCELLANEOUS = Not Ready 'Date/Initials 'MOBILE HOME UTILITIES (Plans) OK except #'a Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'a - 1.'Zoning Requirements-Setbacks-Easements _ .,r 1. Zoning Requirements-Setbacks-Easements . 2. Soils; Special MH Support Sketch "V �� 2. Footings; Soils-Size-Depth-Spacing-Connectors-Steel 3. Sewer;, Location-Teat-Fall-C/O Concrete 3. Decks; Griders and/or Joists-Decking-Bracing-Stairs-Rails - 4. Water; Location-Teat-Easement Needed (Sketch) -.l 4. Wood Awn.; Posts-Beams-Rftrs.=Connectors 5. Electricity;•Location-Clearences-Grnd-/ /Amp-Concrete; Shthg.-Rfg.-Bracing, 6. Gas; Location-Teat-Wrap: / ./"L"11. r 5. Alum. Awn.; Columns-Connections-Splice-Decal-Enclosures - / /"Net. or/ /'L"ft./ /"LPG 6. Carports; Windows-Doors 7. Well Clearance & Disconnect 7. Electric 8. Utility Clearance S. Frmg; Sils-Anchors-Studs-Rftrs-Trusses - 9. Siding; Nall ing-Veneer-Stucco-Mesh 10.,Roof; Shthg-Roofing 11. Ext.; Steps-Doors-Landings Date/Initials MOBILE HOME INSTALLATION (Plana) OK except #'a,. 1. Zoning Requirements-Setbacks Easements -2. Footings; Size-Spacing-Marrlage Line -•. _, .<; '` .3.. Gas; MH Test-Demand-Valve-Connector, 4ti - Date/Initials POOLS (Plans) OK except #'a 4.. Electricity; MH Test-Crossovers-Breakers-Clearancea'`ra ` 1. Setbacks-Easements S. Drain; MH Test-Fell-Flex Connector 2. Soils;-Compaction-Structure Stability 6. Water; MH Test-Regulator-Connector 3. Pool Structure; Steel-Connections-Thickness , 7. Water and Sewer Connected-C/O to Grade-HD Approval Dead Men -Lining " 8. Gas and Electricity Tagged 4. Elec.; Receptacles and Lighting, Distances-GH 9. Exits; Insp.-Sketch - 5. Elec.; Pool Lighting; 15 volts-GFI 10.-Cert. of Occupancy 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 ` '• a .' J. . r , r J V=OK O = Not,OK - = Not Applicable = Not Ready RESIDENTIAL, (Single & Duplex) Date/Initials UND FLOOR Plana OK except #'s boning -Setbacks -Easements- od-Slope C6 F g., Main; Soils-Elec.d.-/0-/-Etg. Depth l . fjg., Garage; Soils-Steel-Elec. Grnd.-j4,.,Z�Ftg. Depth - . Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth AKKS mwalls, Main; Steel-Blockouts-Wrapped cRlStamwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 7 Cf .V.; Fell -Fitting -Test -2 Way C/O -Sewer Test TT `' 10. UF. Gas Pipe; Size -Anchors -yard gas piping: size -teat rL Z7 ater Pipe; Test -Anchor -Regulator -Service Test 12. E ctric; Underground P' nums & Ducts; Clearance -Material -Support -Ina. Girders- 'IIs -Anchor Bolts -Joists -Vents -Cripples 15. Ac ass ent� ation 16.. Insulation Date/Initials PLUMBING Permit OK except #'s 1@_ -Water Htr.; Vent -Access -Combustion Air -Baffle 7. We , Fest & Anchor -Nail Protection D.W:V.; Test -Fittings & Anchor -Nati Protection 19 Shower Pan; Test, First Floor -Tub Access 0. Tast- ' Shower, Second Floor -Tub Access 1.Gas Pipe; Size & Anchors Date/initials ELECTRICAL (Permit) OK except #'a 22. Fixture & Transformer Clearance -Ins. Protection 3. Elgc. Receptacles Spacing -Lights & Switches at Doors Sip—Boxes & No. of Conductors -Stapled ex Installed Close to Edge of Studs & C.J. 26. E ip. Ground made up w/Mach. Fastners-Bond Gas & Water 2 Apple-CGcuts in Kitchen & Conductor Size/GFI ,___28.-'5_bfeed Wi Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu ange Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insul d -Neutral ❑ Yes ❑ No ervice- ise Conductors & Ground -Mein Disconnect learances Panels -Motors -Mach. Equip. es Closet Light -Shower Light -Spa Light 3. Smoke Detector Date/Initials MEC AL Permit OK except #'s 4. A.0 Ducts Insulation & Support Vent .an; Exhaust above insulation 36 idensate Drain & Overflow; Size & Grade 37. F e -Vent; Access -Comb. Air -Return Air Vent -115 outlet 8. Attic Access & Platform if Furnance in Attic Date/Initials FRAMI lana OK except #'a Si pier Material & Anchors Walls ds -Nailing, Spacing & Bracing -Plates -Sound Barin s over Girders & Floor Nailing ra Stop in Walls (rat proof) Fire Sto s: Furred Ceilings -Stairs -Chases -Tub seders & Beam -Size & Bearing Date/Initials / FRAMING (Continued) L/4�He -Post Caps -Anchors -Connectors Cing. Joist-Rftr. ties-Purlin=root Brac-Truss-Shthng.-Rfng. Nies or Type A Flue -Fireplace Throat clearance 48. Attic ize & Romex Protection -Draft Stop -Ins. Baffles t-149.76cirm. Window .or Exiting Doors -Sill Hgt. & Dimensions erage Fire Protection Framing 51. Line Firewall & Openings Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits e Wit -Headroom-Rise-Run-Landing-Fire Protection p ywood on Roof Overhang -Attic Vents -Rafter Outriggers Siding-Nalling Veneer esh-Drip Screed -Fd. Vents-Underflr. Access 7 Gla ' rea-Glass Protection -Skylights -Plastic ear Wells; Nailing -Bolts . Ins ' n -Wells -Ceilings Infiltration -Walls- indows Date/Initials FINAL Plane OK except #'a xt. Steps -Door & Sidelight Protection -Landings moke Detector 63.,,"ace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor.-Ducts-Mech. Protection 64.,Eedroom Exiting Qtbr6'F.I. & Bath Fixtures & Tub Access -Spa A&tlec. Trim & Subpanel; Breaker Sizes & Labels -6Z-8tatrs & Rails or Stove; Clearances -Hearth 69—Etch Outlets at Wood Panel; Int. & Ext. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 7,3. E ac. Outlets & Receptacles at Kit. Counter Garage Fire Door, Swing -Landing -Closer Z - —C. Duct in Garage -Damper i4.Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor -Mach. Protection . Plb., Elec. & Mach. Equip. Listed for Location 74-Elec. Receptacles In Garage; (G.F.I.)-Romex Protection Insulation -Foam -Looked in Attic ❑ Yes .7d—Guard Rails & Deck Construction -Post Caps Z0,-Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive Yes ❑ No; Walks ea ❑ No; Planters ❑ Yes ZI'No .�8k-Slncco;'Brown-Finish _ ,83,-frC. Unit; Disconnect, Electrical, Plumbing ta—Virnts Above Roof; Pibg.-Appliance-Fireplace: Clearance to Openings _44—Water Well; Disconnect, Electrical, Plumbing &�xterior Elec. Trim; G.F.I. Receptacle -Underground 26. ntilation Throughout House ass Protection rre it vious Inspections Gas tera Tagged; Gas-Electric72,3 g ater & Sewer Connected -C/O to Grade -HD Approval ner Compliance Certificate -Other Certificates Comnwnts at Final: 4 �� , ,�, j' Y r 7 � 'y w a .. ;r Insulation Certificate 07 ��S7-'11� Numbv and Succt Ctry . County Subdivision Loi Numtiber Description of Installation ROOF Material Brand Name Thickness (inches) Thermal Resist=e (R -Value) . CEILING Bator BlankctType FIBERGLASS Name CERTAINTEED Thickness (inches) Thermal Resistance (R -Value) Loose Fill Type INSULSAFE III Brand Name CERTAINTEED Conu=tor's minimum installed waght/ft lb Nunimum twckn=/ t kxhes Manufacturer's installed weight per square foot to acheive'Ihermal Resistance (R- Value) EXTERIOR WALL Material. FIBER ,T.ASS Bi=dName CERTATNTF.F.N Thickness (inches) Thermal Resistance (R-Valtre) RAISED FLOOR 'Matecil FIBERGLASS Brand Name CERTAINTEED Thickness (inches) 6 / Thermal Resistance (R -Value) SLAB FLOOR Material Brand Name Thickness (inches) 'Thermal Resistance (R -Value) Width (inches) - FOUNDATION WALL Material FIBERGLASS BrandNamc CERTAINTEED Thickness (inches) Thermal Resistarice (R -Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained inTitle 24 of the California Administrative.Code. f r Genual Conuaetoe (Builder) Lice=Numbcr ee y Sitnaturc and Tide Dau ` SHASTA INSULATION. 272941 uSCo r ( uion 4utaller) tieenuNumb= 1 , S= .2-5V ,= ai i' S►Pd Tidc � Dau � i )COUNTY OF BUTTE BUILDING DIVISION ' R• DEPARTMENT OF DEVELOPMENT SERVICES" 1469 Humboldt Road, Chico, CA - (916) 891 ,2751, ' 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 .r { CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. ou have any questions pertaining to this matter, or need additional explanation, please co ct this office immediately. 1 Date /'-Z Inspector REV 10 2 1/ COUNTY OF BUTTE - DEPARTMENT OF,DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 25965 - Telephone (916) 538-754 PERMIT NO. APPLICATION AND PERMIT 0-0o W :2' ASSESSOR PARCEL NUMBER 031-238-038 ZON JF- BUILDING PERMIT OWN bA.VE�7�.Tn*ONICK TELEPHONE 589-0155 SQ. FT. OCC. BUILDING VALUATION i6dfrp �� '(-`/'j v /'+ OWNEJTAIV foRa RR I CRF �,{ 40U 1'1 p O T V �-FO . CONTRQCtTP�'Sf��dESI�IO J�A TELEPHONE ES 894-5579 32 C 416 . -- coNT O1'1r�VdTd AtMELL LN., DURHAM, CA 95938 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ -2-q'? Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ M- --- , ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 555 YUBA AVE., OROVILLE PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 63.00 Solar or heat pump water heater 23.00 Water piping 15.00 15.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 15.00 USE OF STRUCTURE SF $jY Duplex O Mobilehome O Other SPECIFY Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 0 Mobile Home S G W @20.00 TYPE OF WORK New MX Addition O Remodel O Utilities ❑ Installation ❑ Other O Describe Work: PERMIT FEE $ 143.00 Contractor ELECTRICAL PERMIT Filing Fee 20.00 4 BEDROOMS 100V OR L1 Main Service ( 200AORLESS ) 23.00 23,00 Main Service ( 200A TO I000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( & ACC. BLDS. ) 3.50 FTSO., CONTRACTORS LICENSE LAW I de lare under penalty of perjury (check one) I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code a d my icense is in full forceAnd effect. License No. L%�-E% Classification 1.2 O I, as the owner, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET -NON-RESID. ( BRANCH CIRCUITS ) �q+� @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) B20 @ 1.00 Ex. Occup.FIXED (RESID) E ( OUTLETS IRESID.1 EA. ) 5.00 Temporary Service ry 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): O This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating DUAL PAK 15.00 Cooling UNDERFLOOR DUCT 1 5.00 Hood 6.50 6.50 Ventilation PERMIT FEE $ 56.50 Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California 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 allA liabilities, judgments, costs, and expenses which may in any way accrue against said in coenc the granting of this permit. Date / < of Applicant ❑Owner Contractor ❑Agent ?OSre HA permit is required for ' cavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ n LQUJT.PE TOTAL FEE $ i � ° Igo 42-7 717 HAZ. I D. FEES IMP I Flo,jP#QoJ COFPARCEL PD HD 1 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. DIRECTOR OF PUBLIC WORKS Q �/ BY PERMIT EXPIRES ON (Date/ ReceiptNo. 154094/509.901 ! WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GO DENROD-APPLICANT `FY`T,�•wr��"-Y�"S=..����L'/�•ty.��.y.{I/9.Y/7,(+�.-�,•R1q�••ayi �[.1'.'.�—Y,y�r}L,�y:}j._ -_l' ��.y. �ri.,.}...rr^CT. COUNTYOFBUTTE - DEPARTMENTOFD VEWPMENTSERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CAL'IFCJRNIA 95965 -TELEPHONE (916) 538-7541 / PERMIT APPLICATION DATA SHEET OWNER l ,X A. Proposed Building Use Building Inspector Dated , At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3, Complete plans, 3/4 sets, signed by preparer of plans . ...................... .4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Forma ........................................... . 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . /9 Mobilehome data an ,manufacturer's installation instructions, 2 sets. ........ . d. Feesof$ 9/f.•.?.? ................................... ` 11: Impact fees as shown on attached schedule. ............................ . 12. California Department of Forestry plan approval/fees. ....:.................. 1.3. Flood elevation letter (100 year flood) by California Engineer . ............... . �l 14. Sanitation and plot plan appfoval' i' 'f Health Department. 15. City of Chico plumbing permit. .. ............................ 16. Plot plan and business'license approval.from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ......... 18. Contact Land Development.about (A) Improvements (B) Drainage. ........... . 9. Driveway permit (construction' approval required prior to occupancy). .. o'. _ .. 20. Pre -inspection for P�4nssppeclon n:que required. .. to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... Owner -Builder Verification (Given to owner Mail to owner ) ............ 4. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ....................... 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. 'Letter of intent on building use . .......................................... 28. Mobilehome utility clearance. ............ 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ................ 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. 34. When you issue the p�r,(nit pros ss as follows: Mail o Goner. Mail to contractor. Telephone ll T "�7And hold for pickup at / Gffice. Deliver with inspector. Other Parcel Creation Acreage Applicant Date �b Copy of Haz-Mat form sent Health Dept. Fire Dept. 41 Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prio o it 's nce: rcl e i not checked above). 1. Index permit for above items No. 2. Additional items required: o tract designer, owner, was advised of above required data by _ phone _ mail Counter by _ ate Contractor, designer, owner, was advised of above required data by _ phone _ mail y Date ��,� Plans checked by Date Plans approved by,,,-' Date— Sets of plans on hold in File cabinet AP folder ° �� ���-• Copy - Department of Public Works TO: Building Department FROM: Encroachment 'Permit Section RE:, Driveway Clearance 3s/ 3 </ AP # owner location Driveway permit �4162 o has been issued for the above property. si/ature date COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER O S/ V ZONING BUILDING PERMIT OWNER 0,1 L,5- �A f vv SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAMETELEPHONE /.6p, fro 75 75 i7 42 CONTRACTOR'S MAILING ADDRESS G di,5_0 fi S,z%_ G.v 1�V2N Cid /5 30 Fireplace CONSTRUCTION LENDER y , O J� UNKNOWN Total Valuation $ 3 �� LENDERS MAILING ADDRESS A.! Filing Fee $ 20.00 Permit Fee $ ,Q ARCHITECT OR ENGINEERLICENSE NO. Plan Checking Fee $ , Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS `f, �r PERMIT FEE $ 1 -J ' �r •�� SCD PLUMBING PERMIT Filing Fee 20.00 Each Trap 11 7.00 06 - Solar or heat pump water heater 23.00 Water piping 15.00 ,Q a LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 14,06 USE OF STRUCTURE SFDuplex ❑ Mobilehome ❑ Other SPECIFY Gas piping system 1 - 5 outlets 15.00 / ,00 Building sewer 15.00 Q Mobile Home S G I W '@20.00 TYPE OF WORK New C)Addition ❑ Remodel Utilities O Installation O Other ❑ Describe Work: Aa=Z:41-61 YV/ PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 6001 OR LESS ) 200A OR LESS 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( & ACC. OLDS. ) 3.50 FTgp., CONTRACTORS LICENSE LAW I(d EC)are under penalty of perjury (check one) �rrR�I I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and m license is in full force a effect. LicenseNo. %1j Classification ❑ I, as the owner, or my employees with wages as their sole compensation, 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 contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST, MULTI -OUTLET -NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 3 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) BA20 P 1.000 Ex. Occup. ( FIXED APPINS. OR ) O UTLETS IRESID.) EA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a X;Certiticateof Consent to Self -insure. shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating OVA- L__ 10 /1,—,- S Q� Cooling Hood 6.50 S Ventilation J 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 Butte County Ordinances and California 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. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabi • ies, judgments, c st nd expense which may in any way accrue against said Cou in nsegquuen a of a gran g this permit. X "" Date — / Sig t e of Applicant - 1:1 Owner Contractor ❑ Agent A HA permit is required for excavations over 5"0" dnd demolition or deep construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ 1746 occ CONST. TYPE TOTAL FEES OHDI HAZ. D. FEES IMP FLOOD COF PARCEL 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. DIRECTOR OF PUBLIC WORKS BY Date PERMIT EXPIRES ON (Oe rel C � Receipt No. J / 1 0 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK-INSPE T GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELDPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVIL'LE CA'95965 —TELEPHONE (916) 538-7541 OWNER A . P . # PROPOSED BUILDING USE �`-� �/�g g/ DATE , Aa S`7- REC. # DATE REC 1 ---SCHOOL DISTRICT FEES a O G(paid at District Office)...... ................. 0 / llq h� 2. SHERIFF FEES (paid at Building D partment) Residential...... x _$ unit amt. ommercial (sqft) x _$ sq.ft. -amt. &14 3. AN AREA FEES (paid at Building Department) Residential (per unit) x _$ # units amt. Commercial (per sq.ft) x _$ sq.ft. amt. 2L � 4. RECREATION DISTRICT FEES (paid at District Office) ......................... 5. DRAINAGE DISTRICT FEES (Contact Land Development Division) .............. 6. SRA FIRE INSPECTION AND PLAN CHECK = $89.00...... (paid at Building Department) 7. OTHER 8. OTHER At time of permit application, I was advised the,above fees are required to be paid prior to issuance of the permit. APPLICANT DATE '-.•er.+.,r-.-�,-„,.Y» . ^^%.i's^'rR+yt9��.,n'SS.r rw r.Q"Y[?X'w.r--•r'aw.r-irw-vr'*ir ,-•ks,.,F. �� --1�`i�^.� ma-c•--�"'+y BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM _ (One Form Per Building) School District Ro 01 /-/ S Building Department No. A.P.Number0,7/'Z3,�:-f �O Jurisdiction City County Property Owner DA VJ5 -T7DN / Property Location/Address V Subdivison Lot No. Residential Development E/:1 0 Sq. Footage _ , 4 95/ No. of Living MHI Addition (Group R) Units Commercial/Industrial 0 Sq. Footage New Addition (Including Exterior G Building DepartmenpAepresentative;:- (Floor Plans reviewed by School District Personnel) X40.096 - i L, 'IIL V” H,, y�1 iil w►1� School District certifies that (Applicant) a f Roofed Areas) - / 11-:7 /�F Date (Street Address) 1 (CRY) has complied with the requirements of Resolution No.' - �y + d:; representing( � S7� 1 square,feet. ' School (Phone Number) A (Zip Code) by payment of $ -415 - 6l .. B Date Paid by Check Number5�° Remarks: Bank Number _ 11-%D-7 Paid by Cash If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school distiict) :ti. feeform.wkl (4/92) , AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT ivision FOR RESIDENTIAL DEVELOPMENT fir.= 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 ,1r2 X994 within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort arising from . 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, 94-002054 pruning, and harvesting which occasionally generate dust,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 discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: PARCEL I-. "w Lot 7, of Block 26, as shown on that certain map entitled, "Map of Thermalito, Butte County, Cala"; which map' was recorded in the office of the recorder of the County of Butte., State of California-, on June 8, 1887. j PARCEL II: All that certain abandoned portion of Yuba Avenue, 20 feet in width lying contiguous to the Northerly line of Parcel I, herein described, as set forth in Resolution of Abandonment recorded March 1, 1951, in Book 1 of Road Deeds, Page 207, Butte County Records. PARCEL III: All that certain abandoned portion of the alley way 7 1/2 feet in width lying contiguous to the Southerly line of.Parcel I, herein described 'as set forth in Resolution of Abandonment recorded rTr,vcmhar Iq. 1979, in Book 2464, Page 366, Official Records. . Date: State of California County of On\\\ before me PROPERTY OWNERS: Div iatil6,/t_ personally appeared Q IYS personally known to me (or proved to me on,the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, thee (® : r the oentity ® upon •sbehalf � onbehal eof which the a person(s) acted, executed the instrument. oFFICat sE m WITNESS my hand and official seal. 9 tOTARY ANGELA DBM� ELOWOPULIa LIFOANIA Prtrr4el Office In SUM. C.oun1y a My CO -18W11 EWIM SEPT. 10994 a A.P. 11 THERMALITO:IRRIGATION DISTRICT 410 G.RAND•AVENUE OROVILLE. CALIFORNIA 95965 TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: 555 Yuba Ave. Owner's Name:-.J-a4>e-ir-P-4Dt-e-&t-i-0- Dave Tonick Date: 12/6/90 Address:37 TNT Drive Berry Creek, CA. 95916 Acct. No: LOT 7 A.P. No.: 31-2380--3-5038 Phone: S 8 9 1-7-8,4- 589-0155 No. Units: 1 Applicant/Agent: James Potestio Agents Proof; Address: 9050 Lasell Lane Durham, CA. 95938 Fees: Phone: Application $ 30 00 Arrearage Preliminary Review By- Date: CSA 26 sso On Remarks: Sewer connection fees will be those I;: SC -OR 9'00 00 i applicable at time of connection to the sewer 1st mo. S.C. collector system, and must be paid prior to Other connection to sewer collector system. Cleanout up o grade req d at ,p2erty line. Total Fees 1480 00 • / v Collected B Y:. Date: 4 Field Review By: Date: Remarks: MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON: ❑ Date of TID approval of completed building sewer (early connection). ❑ 30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("existing construction", prior to Mar. 5, 1974). ❑ 180 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("new construction", after Mar. 5, 1974). DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID ;j "d -RESIDENTIAL PLAN CHECKING GUIDE 8/91 (S.F., DUPLEX & MISC. ONLY) Bldg. Permit # 9�' �d sa OWNER IONIC V_- A.P. # Plan Checker GENERAL e%�oning requirements: (sideyards and number of permitted living units).' �. Valuation.����'�i� s signed by designer. ' Proper description of work on application. `sting violations on property. Items on data sheet. (W.C., fees, Health, Developer Fees, License law, etc). -Z---Recorded notice of violation. PLOT PLAN *---Complete.parcel size and dimensions. 4.�Setbacks, sideyards, easements, etc. ,4 -.--Other buildings or structures. i1jGrading, fills, drainage. l.Flood hazard. Special conditions on creation map, ustible, and foundations). �-FAU & FAS road setback. (noise, CDF, fire sprinklers, non-comb- -8----Fuilding or utilities across lot lines (Record form). ` FLOOR PLAN omplete to -,-.scale- plan :•with°:dimensions. Required windows `f or light and ventilation (Sec. 1205). Required windows,,for second exit (Sec. 1204). kyligtits `(Chap.ter 34 & 5. Sec..5207)'k. c.4Human impact glass (Se506) t equired room sizes, ceiling heights (Sec. 1207).`' CIs in baths, garage, kitchen, and exterior outlets (Arti:cle';210-8) °_• "% Light fixtures, switches, receptacles, and exterior receptacles for main - fiance of mechanical equipment. Locations of water heater, heating and cooling equipment, other electrical /or gas equipment. 16�arage firewall, door size, and closer (Seca 503(d)(3)). 1�. 1 - 3'0" exterior" exit •door-'(.sec.,3304 (f). lb�ace and wood stove location; alcoves, and clearance. detectors (Sec. 1210). 1 Plumbing fixtures, water closet clearances and shower size. STRUCTURAL DETAILS I. Standard bracing or engineered design (Table 25V) usual shape, size; or split level house requiring lateral design. �estory requiring balloon framing and/or engineering. ree story building requiring engineered calculations and plans. undation' plan complete enough to construct building. Floor or construction details complete enough to construct building. 7./ Elevations and wall construction details complete enough to construct building �f Ro f construction details complete enough to construct building. ireplace construction details and calcs,if necessary. 1 after ties or bearing ridge beam. l�arage door or porch header sizes. 1 -Stud heights. 1f. Adobe soils— special foundation design. 4. Retaining walls requiring design. Special.Inspection required. -Fomn.<' C 1 8/91 RESIDENTIAL PLAN CHECKING GUIDE MISCELLANEOUS ITEMS TO LOOK OUT FOR Stairwadetails: landings, rise and run, head clearance, handrails ' 3306). Guardrail details (Sec. 1711 & 3306(j). rick or stone veneer (Chapter 30). error plaster - weep screeds (Sec. 4706). 5. P�reper roof pitch for roof convering (Chapter 32). Roof covering type - (fire hazard). ation - protection. -&---6"—halls and stairways. 4--tawi-ng-area over garage - complete 1 -hour separation required on garage side including supporting walls and posts, etc. three-story dwellings (sec. 3303 & see Mezannines - 1716). 1 jAtde=acc7essand ventilation (Sec. 3205). 1 rfloor access and ventilation (Sec. 2516). . Combustion air for fuel burning appliances - L.P.G. requirements. olse requirements on duplexes. nergy design. 1�Fresponsible t all exterior openings. 1 area requirements. j- Is _q L/ 1? v4T,4 /_/ % -� 4-- a No _ THERMALITO IRRIGATION DISTRICT 410 GRAND AVENUE OROVILLE. CALIFORNIA 95965 TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: Owner's Name: Date: Address: Acct. No: C rf-nn• . _: ;+ern. w�.c- `� C, 'L- .., ' A.P. No.: . t .3 Phone: _j -"� = M -*-----s No. Units: Applicant/Agent: Agents Proof. Address: �K' Fees: Phone: Application $ Arrearage Preliminary Review By: Date: CSA 26 Remarks: 1 Y SC -0 R r 0. -(1 C', Ar, -4. i Y.: ,.... 1 st mo. S.C. r, 1 - }., . ::, c -�. r •, _ Other Total Fees Collected By:,� �- Date: Field Review By: Date: Remarks: *U'A n�re4men� v:i*n I.U.Q. On d/eJ/-'•1 fees C. L'I Lr ^v:Y Y E. J C..Y . Pl r l i W 7 1 t.: 4 '�: i i \: 1.1 Y Y r J � i Y! J Y. d l 1 1h1 i; - L L ` : I S,I " 1 �f .J : • ) ..! -: L( _- � MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON: ❑ Date of TID approval of completed building sewer (early connection). ❑ 30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("existing construction", prior to Mar. 5, 1974). ❑ 180 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("new construction", after Mar. 5, 1974). Uig I HIULITION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID cIN r7a, Modr�� . OROVILLE, CALIFORNIA GENERAL CLAIM CLAIMANT: ADDRESS: 1716 Bald Rock Rd. CITY & STATE: Berry Creek, CA 95916 IMPORTANT: DATE OF CLAIM: January 4, 1991 SEE INSTRUCTIONS ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Owner has decided not to do work. Permit #4205,4206,&4207-90B,P,E,M AP#31-238-35(port), Receipt #84593, dated 12/6/90. Total Permit Fees Paid for BP 4205- --------------- Retain Building Permit Filing Fee ------------ $10.00 Retain Plumbing Permit Filing Fee ------------ Retain Electrical Permit Filing Fee---------- 10.00 Retain Mechanical Permit Filing Fee---------- 10.00 Total Permit Fees Retained-------------------------- .40.00 TOTAL REFUND DUE------------------------------------ $170.00 Total Permit Fees Paid for BP#4206-90--------------- $ 70.00 Retain Plumbing Permit Filing Fee------------ 10.00 Retain Mechanical Permit Filing Fee---------- 10.00 Fees Retained - --------- TOTAL REFUND DUE ------------------------------- _____$ 30.00 Total Permit Fees Paid for BP#4207-90---------------- $ 70.00 . Retain Plumbing Permit Filing Fee------------ 10.00 EleGtpieal Perfflit Filing Fee -Total 10.80 Retain Mechanical Permit Filing Fee---------- 10.00 2 r -mit: Feaea-s Retained 49. 99 TOTAL REFUND DUE ------------------------------------ $ 30.00 TOTAL I, the undersigned, declare under penalty of perjury that the services or articles claimed have en performed o deli ere and et this claim is true and correct as stated. AA� /nfiQn, '{� Dated this ........{�................. day of i�4.. 19 et..J...'!`Y..�!.irC�- Calif. ...... .L.... ........... ......• ........ 1 / ...... .. S eture of Claim— t B ..... .. ill... I, the undersigned, hereby certify that. to the best of my knowledge• the services or articles s e fied above have been performed or de- livered and that there is a Budget Appropriation ❑ or Specific BoardApproval a (Check one) for e Dated this 4th ....................... day of T x1!l:�xy........ 19..f .1. at ..Q ixille..... . call(. ......... . .. ..... .............. ... ................... D ertment Head or Authorized eputy Dept- 440-002 Exp. 4210500 Const. ermits Code ............................................ Code ................................................PAYABLE FROM ........................................................................................... FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. COUNTY OF BUTTE, - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovill6, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 31-238-35 ortion ZONING AR BUILDING PERMIT OWNER James Potestiol�_ TELEPHONE 589-1784 SQ.FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1716 Bald Rock Rd. BerryCreek, CA 95916' ' CONTRACTOR'S NAME Same TELEPHONE 30 GeV Q 0 CONTRACTOR'S MAILING ADDRESS Fireplace I"A" 1,000. CONSTRUCTION LENDER Sacramento Savings UNKNOWN Total Valuation $ ' LENDER'S MAILING ADDRESS Chico Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER None LICENSE NO. Plan Checking Fee $ 1 Ener Plan Checking Fee Energy g 0/� $ 15.\.�0 ARCHITECT OR EN'GINEER'S MAILING ADDRESS Penalty $ Bil DING ADDRESS S-55Yuba Avenue Oroville Permit fee $ 350:00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 91 2.00 18.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEARCEL l 7 PMAP Water piping 5.00 5.00- Each qas water heater or vent 5.00 5.00 USE OF STRUCTURE SF[M Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5.00 Building sewer 5.00 5.00 Mobile Home S I G W 10.00e TYPE OF WORK New �a Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: 3 BR Master# Permit Fee $ 48.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP ORSLESS 10.00 10.00 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): INZ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions jCode _and my license is in full force and effect. License No. y'i �S �A Classification t-7 ElFIXED 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- ontract- ors. ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DNS. DWELLING cuP.a OR AD ( ACC. BLD S 21/4sgft 4 5 NEw CON5TRMULTI-OUTLET NON•RESID BRANCH CIRC ITS 2.50 ea (POWER APPARATUS a� SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES .20050 APLN Ex. Occup. OUTLETS IPRESID.IREA.) 2.00 Temporary service 10.00 10-00 Mobile Home Facilities 15.00 Misc. Wiring 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. 1 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 6,00 as ak Cooling 6,00 Hood 3,00 3,00 Ventilation - permit Fee $ 25.00 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 County of 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 agast said County in sequence of Ahe granting of this permit. X ' Date -^T �� Signat re of Applicant - Owner ❑ Contractor Agent ❑ An�_0/5HA 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 occ CONST TYPE TOTAL FEE $ 526.35 HAZ I CUA PARK I SCHL I FLD PAR 'P HD ISSUE Th;s permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. 84593-70.00// (p/c only) WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE DEPART " 5 PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 918/538-7641 PERMIT APPL--I`t-ATI.ON DATA SHEET �of jPermit No. O - OWNER S"b f I O A. P. No. Proposed Building Use Building Inspector Date 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 ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation ,oO instructions... * ;\��--...................................... 10. Fees of $56 ........................ 11. Chico Urban Area fees paid ....................................... 12. Park f s paid 3. rot © Sch of Is 'ct fees paid .............. 4. Sanitation approval from I� Health Department 15. 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: ...... 018. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 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 .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 7z25. Lette f signature authoriz ion V 2 fi AR �Stin c 5Se-S S .P),l (9-.V1 . 27. v W1 6i y— Whe you issue the perm't, ro as follows: Mail o owner. Mail to contractor. Telephone �� and hold for pickup at �rO office. Deliver w. /inspector. Other Applicant Date 12- Copy 2 Copy of Haz-Mat form sent Health Dept. fire Dept. Air Pollution Date Copy of plans sent Health Dept. _Fire Dept. Other Date By. The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone---nail—counter by date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Sets of plans on hold in Copy—DPW Date Plans approved by File cabinet AP folder Date Mandatory Measures Checklist: Residential MF -1 R NOTE: Lownse residential buildings subject to the Standards must contain these measures regardless of the c6mpliance approach used. Items marked with an asterisk (') may be supersedet7 by rtr?re stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only.- . DESCRIPTION I DESIGNER I ENFORCEMENT Building Envelope Measures • §150(a): Minimum R-19 ceiling insulation. it 50(b): Loose fill insulation manufacturer's labeled R -Value. • §150(c): Minimum R-13 wall insulation in framed walls (does not apply to exterior mass walls). ' §150(d): Minimum R•13 raised floor insulation in framed floors; minimum R-8 in concrete raised floors. §150(1): Slab edge insulation - water absorption rate no greater than 0.3%, water vapor transmission rate no greater than 20 pemvinrh. §118: Insulation specified or installed meets California Energy Commission quality standards. Indicate type and form. §116.17: Fenestration Products, Exterior Doors and InfiltratioNExfiltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Manufactured fenestration products have label with certified U -value, and infiltration certification. c. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. §150(g): Vapor barriers mandatory in Climate Zones 14 and 16 only. §150(0: Special infiltration barrier installed to comply with §151 meets Commission quality standards. §150(e): Installation of Fireplaces. Decorative Gas Appliances and Gas Logs 1. Masonry and factory -built fireplaces have: a. Closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2 No continuous burning gas pilots allowed. Space Conditioning, Water Heating and Plumbing System Measures §110.13: HVAC equipment water heaters, showerheads and faucets certified by the Commission. §I50(i): Setback thermostat on all applicable heating systems. §150(j): Pipe and Tank Insulation 1. Indirect hot water tanks (e.g., unfired storage tanks or backup solar hot water tanks) have insulation blanket (R-12 or greater) or combined intenouextenor insulation (R-16 or greater). 2 First 5 feet of pipes closest to water heater tank non -recirculating systems. insulated (R-4 or greater). 3. All buried or exposed .piping insulated in recirculating sections of hot water system. 4. Cooling system piping below 55°F insulated. S. Piping insulated between heating source and indirect hot water tank. §I50(m): Ducts and Fans 1. Ducts constructed• installed and seated to comply with UMC Sections 1002 and 1004: duan insulated to a minimum installed value of R-4.2 or ducts enclosed entirely within conditioned space. 2 Exhaust fan systems nave backdrah or automatic dampers 3. Gravity ventilating systems serving conditioned space have either automatic or readily accessible. manuatly operated dampers.. §114: Pool and Spa Heating Systems and Equipment 1. System is cerdfiec with 78% thermal efficiency, on-off switch, weatherproof operating instructions. no eiectric resistance nearing and no pilot light. 2 System is installed with: a. At least 36' cipe oetween filter and heater for future solar heating. b. Cover for outdodr.pools or outdoor spa. 3. Pool system nas etrecoonai inlets ano a circulation .pumo time switch. §115: Gas -'fired centra furnace, pool heater• spa neater or household coouino appliance have no continuously bunno phot tight. (Exception: Non -electrical cooking appliance with pilot < 150 8twhr.) Lighting Measures §150(k): 40 lumenswar, or greater for general lighting in kitchens and rooms with water dosets: and recessed ceiling fixtures kC linsuiation coven approved. COMPLIANCE STATEMENT This certificate of compliance lists the building features and perfortrimm spedfitxdons needed to cotnpiy'vAth Title 24, Pans f and 6, of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by ft individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple onentabons, any shadaV feature that is varied is indicated in tete Special Features/Remarks stiction. Designerror'Owner (psi v"ni" a Profeisien, cod.) Name: TitIe/Fvm: Address: Telephone: Uc. s: (signature) (data) Enforcement Agency Name: Title: Agency: Telephone: (signarurerstamp) (nate) Documentation Author Name: Title(Fmm: Adtress: Te one: (51g re _ (dam) Certificate of Compliance: Residential Climate Zone 11 8 v My ProjectTiLle 4-0© � NOUS f ., it4y IE Building Pemtit III PrejectAddrw Checked By / Date noeurnentation Author Telephone Enforoanerlt Agency Use Only Component Insulation LocatiiorXomments Type R -Value (attic, to garage. Dap ECL eta) Roof ............. Roof............. Wall .............. - 3 Wall.......... Floor.............. Floor ............. Slab Edge ....: FENESTRATION Sing Devices .-Eenestration Area Type Interior Exterior Overhang Framing Type Orientation (if) (single. double) (roller blind, etc.) (shKt==en. eta) (yes/tto) (mewlhxood) North North ( ) East ( ) -';'(v East ( ) South ( ) Sou th ( ) West ( ) JG---z- West ( ) Skylight....... O — - TIiERMAL IViASS j!t! ''CE COUN Type/Covering Area Thickness (slab/exvosed. tile, etc.) (SO (inches) Location/Descriotifga6 a�� TMEN1 � In►nnn�� t� r IiVAC SYSTEMS tiiinimum Duct Type (furnace, air Efficiency Fenestration BUILDING DATA (auia, eta.) 17 it Area % Conditioned Floor Area Number of stories North East SCP 3. Slab/Raised Floor Number of _Units South 30 Single Family Detached (SFD) [ ] Addition Alone West ( Single Family Attached (SFA) [ ] Existing Building Skylight O • 90 [ ] Multi -Family (MF) [ ] Existing-Plus-Addidon Total / &S B UII.DING SHELL INSULATION Component Insulation LocatiiorXomments Type R -Value (attic, to garage. Dap ECL eta) Roof ............. Roof............. Wall .............. - 3 Wall.......... Floor.............. Floor ............. Slab Edge ....: FENESTRATION Sing Devices .-Eenestration Area Type Interior Exterior Overhang Framing Type Orientation (if) (single. double) (roller blind, etc.) (shKt==en. eta) (yes/tto) (mewlhxood) North North ( ) East ( ) -';'(v East ( ) South ( ) Sou th ( ) West ( ) JG---z- West ( ) Skylight....... O — - TIiERMAL IViASS j!t! ''CE COUN Type/Covering Area Thickness (slab/exvosed. tile, etc.) (SO (inches) Location/Descriotifga6 a�� TMEN1 � In►nnn�� t� r IiVAC SYSTEMS tiiinimum Duct Type (furnace, air Efficiency Location conditioner, heni outnn) CAF UE, SEER.HSPF) (auia, eta.) 17 it A7 -r I Cor Duct Heat Pump R. -Value Thermostat Type Tyne (sR ; or kgl Z ,iE C71i31AtUtL k IIOT WATER SYSTEMS .rte R Value Svstem Type (storage gas. etc.) Capacity Number Ene +Factor Ext. Tank Ins _ ih ct r; t„xr; .,., S.G, 5_ O M0.— I r__A —.611, ,3 ..... -17, _ ISI -M SPECIAL FEATURES/REMARKS Point System Summary: Climate Zone 11 1. Ceiling Insulation 3 2. Wall Insulation 3. Raised Floor Insulation or U -value [0.028] or u -value [0.065] or U -value 10.0371 Point Scores V 4. Slab Edge Insulation or R -value 101 F2 factor 10.751 5. Infiltration Any Ducts in Unconditioned Space? ( Y / N) (Y] 6. Fenestration Heat Loss j� 11-:7 Type U -value ( .651 Total % Fenes. [161 Sum 1.6 7. Fenestration Heat Gain t S x _ % Fenestration SCShads open Elf. % Fenes. North 02P 15- x +% % _1,93 - East x = r South X = r West_ x -27 SEER (10.01 Skylight�x _ Effective SEER R-5 6 4 Overhangs? ( Y / N 0.81: 2+ story: 0.871 0"1 t 8: Interior Thermal Mass or 0 0 % Exp. Slab (201 Int. MaWCFA 9. Exterior Wall Mass Ext. Wag Mass Shade Elf. Ratti T ,.� 7-- 4D 10. Heating System t S x _ 1. Ceiling Insulation R-0 AFUE or HSPF Duct Effie. 11 story: Effective AFUE - (78% or 6.81 0.83: 2+ story: 0.881 or HSPF 11. Cooling System R-vilue One Two x = -48 -27 SEER (10.01 Duct Effie. (1 story: Effective SEER R-5 6 4 R-30 -1 0.81: 2+ story: 0.871 0"1 t 12. Water Heating R-38 0 0 0 System 1 C7erq�D (Z- (2- 501/. He(SGSOJ� En Fa=r Ext. In .Z -value Auxiliary Input .55 (0 1 [ 1 (None[ Zonal Control Adjustment (0) Zorlalconttol Adjustment 101 Dis (STD1 System 2 Heater Type (None( Energy Factor Ext Ins. R -value Auxiliary Input Distribution Point Total: Sum -9 0 S. Infiltration (Duct Air Leakage) 2 Ducts in Unconditioned Space 0 2 No Ducts in Unconaaioned Space 3 single• ire. t -Ywue Family Family hftllCl- Totai 1.31 1.21 1.11 1.01 .91 .81 .76 .71 .66 .61 .56 .51 .46 .41 .36 .35 R -Value t S Attacnea 1. Ceiling Insulation R-0 -72 4. Slab Edge Insulation Numoer of stones , - Numoer at Stones R -value Oni - Two f Tli.., i R-vilue One Two R-0 •74 -48 -27 R-0 0 0 R-19 -5 + -41- r l -2 v, R-5 6 4 R-30 -1 =1 -,: 0"1 t t R-7 7 4 R-38 0 0 0 6. Fenestration Heat Loss 2. Wall; Insulation less 501/. -100 Point Total: Sum -9 0 S. Infiltration (Duct Air Leakage) 2 Ducts in Unconditioned Space 0 2 No Ducts in Unconaaioned Space 3 single• ire. t -Ywue Family Family hftllCl- Totai 1.31 1.21 1.11 1.01 .91 .81 .76 .71 .66 .61 .56 .51 .46 .41 .36 .35 R -Value Detached Attacnea Fami R-0 -72 -57 -43 R-11 -7 -6 .4 R-13 -5 -4 -3 R-15 -4 -3 -2 R•19 0 0 0 R-21 1 1 1 3. Raised Floor Insulation Percent Iawiatlon ba Floor to Number of stones R•vajue One Two Thre R-0 •14 -9 -5 R-11 -3 •2 -1 R•19 0 0 0 R•30 2 Percent or to to to to to to to to to to 10 to to to or Fenestration more 130-1.20 1.10 1.00 .90 .80 .75 70 65 60 55 .50 45 -- 40 less 501/. -100 -76 -69 -62 .55 48 -41 .38 .34 .31 •27 •24 •20 •17 -13 -10 401/. -77 -58 -52 -47 -41 -36 -30 .27 .25 - -19 -16 -13 -11 -8 -5 35% -66 -119 -44 -39 -34 -29 -25 -22 -20 .1 -15 -12 -10 -7 .5 -3 30% -54 -40 -36 -31 -27 -23 .19 .17 .15 .13 -11 -8 -6 -4 .2 0 28T. .50 -36 -32 -28 -25 -21 -17 -15 -13 -11 -9 -7 -5 .3 -1 1 26% -45 -33 -29 -25 .22 -18 -14 •13 .11 .9 .7 .5 .4 -2 0 2 24% -t1 -29 -26 -22 -19 -16 -12 .11 .9 .7 .6 -i -2 -1 1 3 22T. -36 -25 -22 -19 -16 .13 .10 .8 .7 .5 -4 •2 -1 1 2 4 20% -31 -22 -19 -16 -13 -11 -8 .6 .5 -4 -2 •1 1 2 3 5 18% -27 -18 -16 -13 -11 -8 -6 -t -3 -2 -1 1 2 3 4 6 16% -22 -14 -12 •-10 .8 .6 .3 .2 -1 0 1 2 3 4 6 7 14% -18 -11 -9 .7 .5 -3 -1 0 1 2 3 s 5 6 7 8 12% -13 -7 -6 -t -2 -1 1 2 3 0.73 4 5 6 7 8 9 10% -8 -t .2 •1 1 2 3 4 5 5' 6 7 8 8 9 10 81/. -t 0 1 2 3 4 6 6 7 7 8 8 9 9 10 11 7. Fenestration Heat Gain (based on Shaoe Effectiveness Ratio) Eff I North East South •rWest Skylight - % 1 .87 .67 .52 .51 1 .87 .67 .52 .51 1 .87 .67 .52 .51 1 .67 .67 .52 .51 1 .67 .66 Fen- or to to . or or to to or or to to or or to to or or or 9511111-Imore .86 .66 less Imore .86 .66 less Imore .86 .66 less Imore .86 .66 less [more less non I I I I I 181/. •5 -4 ' .3 -2 -21 -20 •15 •12 .26 .23 .16 .12 •36 .32 •23 .16 .75 .50 16% -4 -4 .2 -1 -18 •16 •13 •10 .21 .19 .13 •9 •31 -27 .19 •14 .65 -44 14X -4 .3 .2 1 •14 •13 •11 •8 -16 -14 •10 -7 -26 -23 -16 -11 •55 •38 12% •3 •2 •1 1 -11 -10 -8 -6 .12 •10 .7 -4 •21 •18 -13 -8 46 •31 11% -2 •2 .1 0 -10 -9 .7 •6 .10 -8 •5 .3 •19 .16 •11 -7 .41 •28 101/. •2 •2 -1 0 -8 -8 -6 .5 .8 •7 -4 •2 •16 -14 •9 -6 -37 -25 9% '-2 •1 -1 0 -7 -7 •5 -d .6 •5 •3 •1 •14 --12 -8 -5 -32 -22 8% -1 •1 -1 0 •6 •5 -4 -4 -4 .4 .2 0 -11 •10 -6 -4 •28 •19 7% -1 -1 0 0 •5 4 -4 •3 -3 -3 -1 0 •10 -8 •5 .3 •24 •17 6% -1 •1 0 0 -4 •d •3 •2 -2 -2 -1 0 -8 -7 -4 •2 •20 •14 5% -1 0 0 0 -3 •3 -2 -2 .2 •1 0 0 -6 -5 •3 -1 -16 •12 4% 0 0 0 0 •2 -2 -1 .1 •1 -1 0 1 -4 4 •2 0 •12 •10 3% 0 0 0 0 •1 -1 0 0 0 0 1 •2 -- 0 1 •9 •7 2% 0 0 1 0 0 0 0 0 0 1 1 0 0 1 2 -6 -5 1% 1 1 1 1 1 1 1 1 0 0 0 0 1 1 2 2 3 2 0% 1 1 1 1 1 1 1 1 0 0 0 0 3 3 3 3 0 0 8. Interior Thermal Mass Houses With Ducts (R4.2) Exterior Method A (SlWo-on-grade Construction Only) Poem One Family Two Three Exo med Son Aimcned Stones Stories 0 0 •3 0.20 •2 3 .1 10 7 -2 4 .1 9 •1 20 0.80 0 10 0 1.00 0 30 9 1 17 1 10 1 . 40 14 3 1.60 2 17 1 50 23 4 14 3 24 2 60 2 5 15.0 3 16 2 70 2 6 12 d Effective SEER 2 80 19% 8 (SEER: duct 5 to 3 90 Three Story House 9 Sum of 7.9 6 3 100 -25 or 10 -14 to -4 to 6 16 or 4 AC less Method B .15 more Int -25 Slab Floor Raised Floor Mass 5.0 Stories -29 -23 Stones .4 1CFA One Two Three One Two Three 0.0 -11 -8 •6 -1 -1 0 0.1 -10 .7 -6 0 0 0 0.3 -9 -6 -5 1 1 1 0.5 -8 -5 -4 2 2 2. 1.0 •6 -3 .1 4 4 5 1.5 -4 .1 1 6 6 6 20 -2 2 4 8 8 8 25 1 3 5 9 9 9 3.0 3 1 • 5 11 10 10 4.0 4 6 7 13 13 13 5.0 4 6 8 14 14 14 6.0 5 7 9 15 15 15 7.0 7 8 10 16 16 16 8.0 8 9 11 18 17 17 9. Exterior Wall Thermal Mass Houses With Ducts (R4.2) Exterior Single- Single- Mufi Wall Family Family Family Mass Detached Aimcned -25 or 0.00 0 0 0 0.20 3 3 2 0.40 7 5 4 0.60 9 8 6 0.80 12 10 7 1.00 14 12 9 1.20 17 13 10 1.40 18 14 11 1.60 21 17 13 1.80 23 18 14 200 24 19 14 11. Cooling System House Stra Adjustment Hose Sae (ft ) Subtotal Houses With Ducts (R4.2) 1000 Water Heating SEER to Poen Score 1000 Sum of 7.9 30 17 Spirt Pckg -25 or •24 to -14 to .4 to +6 to 16 or AC AC less -15 -5 +5 .15 more 10.0 9.7 0 0 0 0 0 0 11.0 10.7 4 3 2 2 1 0 120 11.6 8 6 5 3 1 0 13.0 1Z6 11 9 6 4 2 0 14.0 13.6 13 11 8 5 2 0 15.0 14.6 16 12 9 6 2 0 12 8 Effective SEER 0 PC" Score 19% more (SEER: duct efficiency) to or Elf SEER Three Story House Sum of 7.9 Split Pckg -25 or -24 to -14 to -4 to +6 to 16 or AC AC less -15 •5 +5 .15 more One Story House -25 0 2 78'1. 5.0 4.9 -29 -23 •17 -11 .4 0 6.0 5.8 •16 -13 -9 -6 -2 0 7.0 6.8 -7 -6 -4 -3 -1 0 8.0 7.8 -1 0 0 0 0 0 8.1 7.9 0 0 0 0 0 0 9.0 8.7 5 4 3 2 1 0 10.0 9.7 9 7 5 3 1 0. House Stra Adjustment Hose Sae (ft ) Subtotal lets 1000 Water Heating assn to Poen Score 1000 1499 30 17 .5 .25 -14 .4 -20 -11 .3 -15 A -3 .10 -6 •2 •5 3 .1 0 0 0 5 3 1 10 6 2 1S 9 3 20 11 3 25 14 4 House Stze Adjustment 10. Heating -System Pkg -25 11.0 10.7 12 10 7 4 2 0 3 0 House Sae (it) Houses With Ducts (R4.2) 120 11.6 15 12 9 6 2 0 13.0 126 18 14 10 6 3 0 Subtotal 15M mm Sum at 1.6 14.0 13.6 20 16 11 7 3 0 Water Hating to or Gas Split Pkg -25 -24 -14 .4 +6 16 15.0 14.6 22 17 12 8 3 0 PC" Score 19% more AFUE HP HP 1111 to to to to or Two or Three Story House -30 0 3 - NSPF HSPF less -15 -5 +5 +15 more 5.0 4.9 •35 •27 •20 •13 •5 0 -25 0 2 78'1. 6.8 6.6 • 0 0 _ 0 0 0 0 6.0 5.8 -21 -17 •12 -8 .3 0 -20 0 2 80Y. 7.0 6.8 1 1 1 1. 0 0 7.0 6.8 -11 A -7 -4 .2 0 -15 0 t 85% 7.4 7.2. 5 4 3 2 2 1 8.0 7.8 -4 •3 -2 •1 •t 0 -10 0 1 90% 7.8 7.6 8 7 5 4 3 1 8.7 8.4 0 0 0 0 0 0 .5 0 0 95% 8.3 8.0 11 9 7 5 4 2 9.0 8.7 2 1 1 1 0 0 0 0 0 10001. 8.7 8.5 13 11 9 7 4 2 10.0 9.7 6 5 4 2 1 0 5 0 0 Zones Effective AFUE or HSPF Pou Inmd 11.0 10.7 10 8 6 4 1 0 10 0 0 .1 t (AFUE or HSPF z duct efficiency) Alt 120 11.6 13 10 7 5 2 0 15 0 •2 Effective Sum 011 6 13.0 126 16 12 A 9 10 6 6 2 3 0 0 � 25 0 2 Gas Split Pkg -25 •24 -14 -4 +6 16 14.0 13.6 18 15.0 14.6 20' 1 16 11 7 3 0 AFUE HP HP or to to to to or NSPF NSP* less -15 •5 +5 +15 mora Zonal Control Adjusunmt One Story House 33% 29 2 •62- -53 -d4 •34 •25 -16 All 6 5 4 _ 2 1 08 4(W. 3.5 3.4 -40 •34 -28 -22 -16 -10 12. Water Heating 50% 4.4 4.2 -19 -16 •13 -10 -7 -5 60% 5.2 5.1 •4 -4 -3 -2 •2 -1 One Water Hater - No AsusWary Crd$s 64% 5.6 5.4 0 0 0 0 0 0 0Wnbtaton Syzem2 70% 6.1 5.9 6 5 4 '11 2 1 Rome Systems 80% 7.0 6.8 13 11 9 7 5 3 Wast Ci+na<a Energy SM HWR Pip No Timet, Oemd 90% 7.8 7.6 19 16 13 11 8 5 Hewer Tvoel Zones Favor Pou Inmd On 100% 8.7 8.5 24 20 17 13 10 6 SG50 Alt am 0 3 1 -0 .5 0 Two or Three Story House 0.63 5 8 6 .4 0 5 33% Z9 Z8 a -58 -48 -37 -26 -15 0.73 8 11 9 0 4 8 401/. 3.5 3.4 -46 •39 •32 -24 •17 •10 SG75 N 0.48 -2 1 -1 -12 -7 -2 500/6 4.4 4.2 -24 -20 -16 -13 •9 -5 0.58 3 6 5 -5 -1 4 60% 5.2 5.1 -9 -8 -6 •5 -3 -2 ase 7 10 8 -1 3 7 69% 6.0 5.8 0 0 0 0 0 0 SE Al 0.87 -20 -12 -17 -41 32 -19 70% 6.1 5.9 -1 1 1 1 0 0 0.83 -17 -0 -13 38 -28 -16 80% 7.0 6.8 9 8 6 -...5 . 3..-- 2.-. All ..am 2 -5--3 - 90Y. 7.8 7.6 15 13"' 10 8 6 ' 3 IE Al 023 -21 -12 1007. 8.7 8.5 20 17 14 11 8 d HP 6.11,13.15 1.ti0 4 7 5 -5 -1 4 Zonal Control Adjustment Two Nater Haters - No AuzMar7 Csedlb System Type SG50 Al am -7 -4 -6 -17 .12 -7 Resistance 6 4 3 2 1 0 0.63 1 5 3 -0 -4 1 Omer 3 3 2 1 1 0 O.M 6 10 8 -2 2 7 SG75 Al 0.48 •12 -e -11 -22 -17 •12 Adjusanent for No Tani Inzalatim am •1 3 0 -11 -6 -1 Nu miter of Wats Men= 0.68 6 9 7 •4 1 6 water Heater Tvoe One TWO SE Al 0.87 •22 -14 -19 -46 -35 -22 SG50 -2 .5 0.93 .16 .7 -12 -39 •28 -15 SG75 .3 a ;G Al 0.80 .4 •1 •3 SE -5 -9 1 Al 0.93 -21 •12 HP '2 -4 HP 6.11.13.15 1.80 •1 3 1 .10 -6 0 Deep end raid ' 'Retaining Wag r