HomeMy WebLinkAbout031-282-04031-282-40
CHARLES WAUGH
645 Thermalito Ave, Oroville
Contr : Theveos Const Fi'rnal $j�BI �`�
Permit#640-84B,P,E,M(new single family)
32-282-40
Contr: Theveos Const
Permit#13373-85BBB,E(new private detached
rage) F7na k 9/gp%/Fs
t
I
r
s
I
31-282-40
CHARLES WAUGH
645 Thermalito Ave, Oroville
Contr : Theveos Const Fi'rnal $j�BI �`�
Permit#640-84B,P,E,M(new single family)
32-282-40
Contr: Theveos Const
Permit#13373-85BBB,E(new private detached
rage) F7na k 9/gp%/Fs
I
I
31-282-40
CHARLES WAUGH
645 Thermalito Ave, Oroville
Contr : Theveos Const Fi'rnal $j�BI �`�
Permit#640-84B,P,E,M(new single family)
32-282-40
Contr: Theveos Const
Permit#13373-85BBB,E(new private detached
rage) F7na k 9/gp%/Fs
v
010
PERMIT NO. 640-841i,P.E,M
PERMIT EXPIRES --'4'
OWNER CHARLES WAUGH
CONTR. Theveos Const
ASSESSOR PARCEL 31282-40
LOCATION OThermalito Ave, Oroville
=00
000"
JOB FINALED (Date)—e 47,
Sig, ure
3%
a Ir
IS
Temp. Power Pole—
Called PG&E
Temp. Elec. Service_
Called PG&E_
Temp. Gas Service
Cal led PG&E —
000"
JOB FINALED (Date)—e 47,
Sig, ure
3%
a Ir
IS
C�.
J = OK ,
0 = Not OK
- = Not Applicable MOBILEHOMES MISCELLANEOUS -
* = Not Ready
Date
MOBILEHOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/O -Concrete
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; Location -Test -Easement Needed (Sketch)
4, Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfo.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Gas; LocatiorrTest-Wrap:/ /"L"ft./ /"Nat. or/ L"ft./ /"LPG
6. Carports: Windows -Doors _ •,
7. Utility Clearance
7. Elec.
Card -BI
Date Card -BI Date
Card -BI
'Date Card -BI Date Y
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
Card -BI
Date
Date Card -BI - Date _
POOLS (Plans) OK except #'s
1. Setbacks -Easements '.
2. Footings; Size -Spacing -Marriage Line
2. Soils; Compaction -Structure Stability
3. Gas; MH Test -Demand -Valve -Connector
3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining
4. Electricity; MH Test -Crossovers -Breakers -Clearances
_
4, Elec.; Receptacles and Lighting; Distances-GFI
5. Drain; MH Test -Fall -Flex Connector
5. Elec.; Pool Lighting; 15 volts-GFI
6. Water; MH Test -Regulator -Connector
6. Elec.; Enclosures; Conduit Entries -Terminals -listed
7. Water and Sewer Connected -C/O to Grade -HD Approval
7, Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater
8. Gas and Electricity Tagged
8. Elec.: Grounding; Equip. w/5' -Circulating Equip. -Pool Lgh[g.
Boxes- Enc losures- Pane lboards-Ins. to Main in Conduit
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test -Water Supply Test
Card B -I
Date Card -BI Date
Card -Bl.
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
.c
J Olt
0 = Not OK
Not Applicable
= Not Ready
RESIDENTIAL (Single and Duplex)
Date UNDER OOR PI OK except#'s
Date FR
(Continued)
oning requirements -Setbacks- asements
IT'_Vco'perty
Line Firewall & Openings
tg., Main; Soils -Steel -E _ / /" Ftg. Depth
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
Ftg., Garage; Soils-Steel.Z/ /" Ftg. Depth
50.
irs; Width -Headroom -Rise -Run -Landing -Fire Protection
4,NFtg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
�./,i.
Plywood on Root Overhang -Attic Vents -Rafter Outriggers
Ae!temwalls, Main; Steel-Blockouts-Wrapped-Slab
52.
Siding -Nailing -Veneer
6. temwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7. Piers -Fireplace Ftg.-Steel
54.
Glazing Area -Glass Protection -Skylights -Plastic
_ : F -Fitti s -.T t-2 way C/O -Sewer Test
55.
Shear Walls; Nailing -Bolts
9 Gas Pipe; Size -Anchors
1 ater Pipe; T t -Anchors -Regulator -Service Test
11c,-Ele ric; Underground
1 enums & Ducts; Clear e -Material -Support -Ins.
141
&A
irders-Sills n Joists -Vents
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Capd=81 Date d -BI Date
Date FINA (wars) OK except #'s
Card -BI Date F� and -BI Date
Date ING (Permit) OK except #'s
.
E ps-Door & Sidelight Protection -Landings
oke Detector
_ 14. ter Ht.; Vent -Access -Combustion Air
Furnace; Vents -Clearance omb. Ai Connector -
In Garage; Above Floor -Ducts -Meth. Protection
Water Pipe' Test & Anchors at Pro
16. D.W.V.; Test-Fttngs & Anchorsroo
xiting
_
17. Shower Pan; Test, First Floor -Tub Access
60.
G.F . & Bath tures & Tub Access
_
18. Tub & Shower, 2nd Floor -Tub Access
61
ec. Tri Subpanel; Breaker Sizes La el
_
1 . Gas Pipe; Size & Anchors
ai Rails t '
- - -treplac
r St e; Cleark tt<es-H th
Card -BI Date �%�Zc Card -BI Date
66lElec. Outlets at Wood Panel; Int. & Ext.
6 Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI Date Card -BI Date
Elec. Outlets & Receptacles at Kit. Counter
Date ELECTRAL Permit OK except #'s
67.
Garage Fire Door; Swing -Landing -Closer
68.
A.C. Duct in Garage -Damper
20.&f1-x.wre & Transformer Clearance -Ins. Protection
6t iWCF. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
_ 21. leL Receptacles Spacing -Lights &Switches at Doors
7
•, Elec. & Mech. Equip. Listed for Location
_ 22. i
22.4 -.p -Boxes & No. of Conductors -Stapled
71,
Elec. Receptacles in Garage; (G. F.I.)-Romex Protec.
23.jg InstalledClose to Edge of Studs & C.J.
_
w/Mech. Fasteners -Bond Gas & Water
72•
Insulation -Foam -Looked in Attic
uard Rails & Deck Construction -Post Caps
iance Circuits in Kitchen &Conductor Size
46. Subfeed Whe l3iee -/ ga. Cu or AI-A.C. Wire Size / / ga. Cu or At
74.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor es
27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral `Yes El No
- 28. §arvice-Riser Conductors & Ground -Main Disconnect
75,
Following tnstld.: Drive es No; Walks
g '�� ❑ [j Yes ❑ No;
Planters Elfas ❑No
76.
Stucco; Brown -Finish
_ 2610'Equip. Clearances; Panels-Motors-Mech. Equip.
7
.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
-----.e 30 IohP,5 Closet Light -Shower Light -
------- -- ---
Card B -I _ Dater/ Card -BI -- Oate
ents Above Roof; Plb9•-Appliance-Fire I•Clearance to O n s.
79.
Water Well; Disconnect, Electrical, Plumbing
xterior Elec. Trim; G.F.I. Receptacle -Underground
9ntilation throughout House
Card B -I Date Card -BI Date
Gss rotection
Date MEC ICAL (Permit) OK except #'s
8
_
C ectionsfrom Previous Inspections
8
-Meters Tagged; Gas -Electric
er & Sewer Connected -C/O to Grade -HD Approval
- -- r A -Ducts; Insulation & Support
_
_32l�Vent Fan_ Exhaust above Insulation
Energy Compliance Certificate -Other Certificates
33. Condensate Drain _& Overilow; Size & Grade
34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35. Attic Access & Platform if Furnace in Attic
- - -- ----------
Card -BI - Date r-,' Gard -BI Date
Card -BI Date Card -BI Date
Date FRA Plans) OK except #'s
Card -BI Date Card -BI Date
Card -BI e . Card -BI Date
Card -BI Date Card -BI Date
Comments at Final:
Sill ; Proper Material & Anchors _
37-VJa Studs -Nailing, Spacing & Bracing -Plates -Sound
aring Walls over Girders & Floor Nailing
39. raftlp in Walls (rat proof)
40. Fps; Furred Ceilings -Stairs -Chases -Tub
41. Beam -Size & Bearing
42.7ry✓aggers-Post Caps -Anchors -Connectors
43. Ing. Joist-Rfir. Ties -Purl' Root Brac. T s-Shthnq.-Rfnp.
44. F' lace Ties or Type F,4replace roat
45f' -j c Access; Size & Romex Protection -Draft Stop -Ins. Baffles _
46. Bdrm. Windows or Exiting Doors -Sill Hg I. & Dimensions
47. ire Protection Framing_ _-
_
-
(NOTE: An entry must be made each time you visit job site)
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS ' ,
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
&P a
i sof i : � �I r Lr • =
t
Inspector Date
` •'�. COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise -- Phone: 872-2961, Ext. 57
....,--,-CORRECTION NOTICE
/Q�t,
,A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when .correction of work is completed. If you have any question pertaining to this
matter', -or need additional explanation, please contact this office immediately.
A "
V
r
Inspector___
Date
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
f CORRECTION NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is
completed. If you have any question pertaining to this
matter„or need additional
explanation, please contact this office immediately.
- Y
Inspector _.
Date
v COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57
CORRECJ1051 NOTICE
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, eed additional explation, please contact this office Immediately.
t4 ka4er-c=X
Inspectel;'� L��.—� Date/ 4— _
Owner,: Z�a r %f'. C•Cl f A' -gl Permit No. G � O - � y
ENERGY C R R T I F ICATION
LOCATION A.P. No.
DESCRIPTION OF INSULATION
ROOF
Material �i �t� y�-r
Thickness(inches)
EXTERIOR WALL
Material
Thickness(inches) d '-
CEILING
Batt or Blanket Type /--),q-77-
Thickness(inches)
--),g-TT
Thickness(inches)
Loose Fill Type
Minimum Thickness(Inches)
Area covered(ft.2)
FLOOR, ELEVATED
Material - F,6e
Thickness(inches) "
FLOOR, SLAB
Material
Thickness(inches)
Width(inches)
FOUNDATION WALL
Material
Thickness(inches)
Brand Name / WA F 7'
Thermal Resistance (R Value)
Brand Name F 2 -
Thermal
Thermal Resistance(R Value) e- /2
Brand Name /f --,i L T
Thermal Resistance(R Value)
Brand Name
Number of Bags Wt. per bag lb.
Thermal Resistance(R Value)
Brand Name /-DP,4 p 7.-
.
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)
I hereby certify that -the above insulation was installed in the above building
in conformance with..the State of California Energy. Requirements.,
I'll �O 7
/FIRM NAME/OWNER STATE'CONTRACTOR'S LICENSE NO.
7/f
SIGNATURE OF INSTALLATION APPLICATOR fi DATE
I hereby certify the above insulation and all required items as shown on the
Building Department approved plans and attachments have been installed as
required by the State of California Energy Requirements.
All equipment, devices and materials are of the quality prescribed or are
specifically approved by the State of California.
FIRM NAME/OWNER (Please print) STATE CONTRACTOR'S LICENSE NO.
SIGNATURE OF GXNERAL RA. R OWNER �� ` D T /
THIS CERTIFICATE MUST BE ON FILE WITH THE.BUILDING DEPARTMENT PRIOR TO FINAL
INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN, THE BUILDING.
January 1984,
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orovifle, California.95965 - Telephone 916/534-4541
APPLICATI6N ANIJ PERMIT
PERMIT NO.
D
�1
J„� 6ER
ASSESSO_Y/ARCEZGU
ZONING
BUILDING PERMIT
OWNER &�nAJYC�L6S p%I� 1AJ�����]'/L/L�
meq_gE770
`y" (,
SO. FT. BUILDING VA
.77 00
O W N V ' S � 1/L'17/ K 4J 9 SS AV E O/�-��/ V//TWC_. C
%.
gOCC.
i_6P � (iC/
-�j/0�
/57 /.C/ - &a
E fV/CSS NAME
CO C_TTOli'S NAME ^ A)�i-�0_770�
Cst/11/
TELEPHONE
/50Ojj
0 0
CONTRACTOR'S MAILING ADDRESS
Fireplace '1%fJ
CONSTRUC ION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ , l9 -Z
ARCHITECT O GINEER
LICENSE NO.
Plan Checking Fee
$
ear,auy GS
.c.
$ .
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADS
Tzle4(,>/AJTU /9vF.
PLUMBING- PERMIT
Filing Fee 10.00
Each Trap
p 2.00 QO, &,J
Solar Water Heater
20.00
Qeoi��L��
Water piping
5.00 55F.0-0
LOT NO.
_
SUBDIVISION NAME PARCEL MAP
Each qas water heater or vent
5,00 J, 04
Gas piping system 1 - 5 outlets
5.00 5 -,Vo
�� USE OF STRUCTURE
SF [E Duplex ❑ Mobi lehome ❑ Other
SPECIFY .
Building sewer
5.00 �, 00
Mobile Home I S1 G W
10.00 e
TYPE OF WORK
New Addition❑ Remodel[] Utilities❑ Installation❑ Other ❑
Describe work:
Permit Fee
$ jQ, 00
Contractor
ELECTRICAL PERMIT
FilingFee 10.00
Main service 600V OR LESS
100 AMP OR LESS
00
10./0. 00
Main service EA. ADD'L 100 AMP
2.50 Zso
NEW CONST. ( DWELLING OC�y &i�
ADDNS. 1 ACC, BLDGS. 4 (/
,z1�ZQSgft , 6-0OR
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check One):
f_1NON-RESID,
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and m license is in full force and effect.
y
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR ULTI.OUTLE 2,50 ea
NON.RESID BRANCH CIRC ITS
NEW CONSTR. /POWER APPARATUS &)
SINGLE OUTLET CIR. /
20050e
Ex. Occup(o XTs OR FIXTURES 6AL®30
FIXEEDDAPPLNS. OR
Ex. Occup. OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $ 100
Contractor
MECHANICAL PERMIT
FilingFee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shal I be deemed revoked.
Heating CFX
4"00
Cooling �3
(0, t'K7
Hood
3.00 ioa
,
Ventilation
permit Fee
$ 'z �o�
Contractor
1 certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyof
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X �� F l/�/ Date a;A14';/
�—�
Signiiature of Applicant — Owner � Contractor ❑ Agent ❑
AnVSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over stories in height.
Mobile Home Installation Fee $
30,C4v
TOTAL PERMIT FEE $ 77
OCCUP, R.GROUP
TYPE OF CONST.
. /
►V
PARC
PD
H
ISS
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
B'/ K�
MIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been aid.
p
WORKS
Date -- /7-- PpLI
Receipt No. �tes
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT
FOR RESIDENTIAL DEVELOPMENT S4— 6348
OFFICIAL RECORDS
Section 26-8.1 of the Butte County Code requires this acknowledgeme�tL–TE COUNTY-CA1.11=
be recorded prior to issuance of a building .permit.
The property described herein is adjacent to land or includedLAR 6 (� 19 AM 198d
within an area zoned for agricultural purposes, and residents of th s
property may be subject to inconveniences or discomfort arising frcft ANw'%x.
the use of agricultural chemicals, including, but not limited to hS`id%Fif-,01'p$ ,
and fertilizers; and from the pursuit of agricultural operations including, but notFEimited
to cultivation, plowing, spraying, 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 disconform from normal,
necessary farm operations.
All that real property situate in the County of Butte, State of California, described
as follows:
Date:
,Cis/mac _*op 3 _ TG .�. ✓ a �' T/jr r /yla�. ��
State of C'�9� /F• )
SS.
County of 4-'77",
PROPERTY OWNERS:
On this the 6th day of March 19 84 , before
me, the undersigned Notary Public, personally appeared
Charles R. Waugh and Rose E. Waugh
W Personally known to me. L/ Proved to me on the basis
of satisfactory evidence.
to be the person(s) whose names) are subscribed to
the within instrument and acknowledged that they
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and.official seal.
Notary Public
Present A.P. No. 3/
i
OFFICIAL iSEAL
. ..ih,
SHERRY L. TUCKER
NOTARY PUBLIC - CALIFORNIA
PRINCIPAL OFFICE IN
BUTTE COUNTY
MY COMMIS!ION EXPIRES JANUARY 19, 19Q8
PROPERTY OWNERS:
On this the 6th day of March 19 84 , before
me, the undersigned Notary Public, personally appeared
Charles R. Waugh and Rose E. Waugh
W Personally known to me. L/ Proved to me on the basis
of satisfactory evidence.
to be the person(s) whose names) are subscribed to
the within instrument and acknowledged that they
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and.official seal.
Notary Public
Present A.P. No. 3/
i
1•
,
THERMALITO IRRIGATION DISTRICT
410 GRAND AVENUE -�
OROVILLE, CALIFORNIA 95965
TELEPHONE 533-0740
CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT
Service Address: G45 Thcr,--nlieo Avonceo
Owner's Name: Chncloc R, 6 Rom ycu0h Date: t'`tirch 5, 10'^4
Address: 1543 Yubc Avon= Acct. No:
Ozovilln . C,n. A.P. No.: 31-282-40
Phone: SX -6770 No. Units: 1
Applicant/Agent: Agents Proof:
Address:
Fees:
Phone: Application $ 20 3L
Arrearage
Preliminary Review By: Date: CSA 26
Remarks: SC -OR poo r'0
r
1st mo. S.C.
i
!6 /,7 r Other
rc�s J-1 Total Fees 17,
Collected By:
-+ Date:
Field Review By:, 1'�,. �.� //�C'<.T�- :=Date:
Remarks:
MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON
El 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, wl-ich ever comes
first ("new construction", after Mar. 5, 1974).
DISTRIBUTION: WHITE - TIC, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TIO
.F t
PERMIT NO. 1373-85B E
PERMIT EXPIRES `
OWNER CHARLES WAUGH
CONTR. Theveos Const
ASSESSOR PARCEL 31-282=40
LOCATION 645 Therinalt6 Ave, Oro
0
7
1.
tr
t
!i
tJ.
{F{'
4
Temp. Power Pole
Called PG&E
1�
r
Temp. Elec. Service
Called PG&E
Temp. Gas Se
Called PI
JOB FINALE
Signature
V=OK
0 = Not OK
= Not Applicable MOBILEHOMES
* = Not Ready
MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except it's `
1. Zoning Requirements -Setbacks -Easements -
2. Soils; Special MH Support -Sketch
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/0 -Concrete
3. Decks; Girders and/or.Joists-Decking-Bracing-Stairs-Rails
4. Water; Location -Test -Easement Needed (Sketch)
4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Gas; Locatiort-Test-Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG
6. Carports; Windows -Doors
7. Utility Clearance
7. Elec.
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except H's
1. Zoning Requirements -Setbacks -Easements
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements - a
2. Footings; Size -Spacing -Marriage Line
2. Soils; Compaction -Structure Stability.
3. Gas; MH Test -Demand -Valve -Connector
3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining
4. Electricity; MH Test -Crossovers -Breakers -Clearances
4. Elec.; Receptacles and Lighting; Distances-GFI
5. Drain; MH Test -Fall -Flex Connector
5. Elec.; Pool Lighting; 15 volts-GFI
6. Water; MH Test -Regulator -Connector
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Water and Sewer Connected -C/0 to Grade -HD Approval
7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater
8. Gas and Electricity Tagged
B. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test -Water Supply Test
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
= OK �.
= Not OK
= Not A�pplkable
Read
= Not Ready RESIDENTIM )Single and Duplex)
D11
DERFLOOR Plans OK except #'s
Date
FRA Continued
1.
ing requirements -Setbacks -Easements
PrDparty Line Firewall & Openings
s-Steel-Elec. Grnd.- / /" Ftg. Depth
419-
Ext. D ors -One 3' -Check Garage -3rd story, 2 exits
tg., G ge;Xeita-6leel.-/f /" Ftg. Depth
5
- eadroom-R ise-Run-Landi ng -F ire Protection
4.
Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
PI od on Roof Overhang -Attic Vents -Rafter Outriggers
Main; Steel-Blockouts-Wrapped-SlabV,.iding-Nailing-Veneer
temwalls, Garage; Steel-Blockouts-Wrapped-Slabesh-Drip
Screed-Fdn. Vents-Underflr. Access
7.
Piers -Fireplace Ftg.-Steel
ss Protection -Skylights -Plastic
8.
D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
55.
alls; Nailing -Bolts
9. Gas Pipe; Size -Anchors
10.
Water Pipe; Test -Anchors -Regulator -Service Test
11.
Electric; Underground
12.
Plenums & Ducts; Clearance -Material -Support -Ins.
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Card -B
Date Card -BI Date
Date1 Card -BI Date
Card -BI
N
Date Card -BI Date
Card -BI
Date„S 2 Card -BI Date
Date
FI
(Plans) OK except q's
Card -BI Date r Card -BI Date
Date
PLUMBING (Permit) OK except q's
eps- oor & Sidelight Protection -Landings
actor
Water Ht.; Vent -Access -Combustion Air
58r
-F inace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
5. Water Pipe; Test & Anchors -Nail Protection
16.
D.W.V.; Test-Fttngs & Anchors -Nail Protection
5
17.
Shower Pan; Test, First Floor -Tub Access
Fixtures & Tub Access
18.
Test Tub & Shower, 2nd Floor -Tub Access
ubpanel; Breaker Sizes -Labels
Gas Pipe; Size & Anchors
W.
Firepfeee-Q Stove; Clearances -Hearth
64,-z:ee_Q
44ets at Wood Panel; Int. & Ext.
Card -BI
Date Card -BI Date
65--Kft.-f1rt-,-"pliance•
Grnd.-Air Gap -Cooking Clearance
Card -BI
Date
Date Card -BI Date
LE TRICAL Permit OK except k's
66.
64eer49t is & Receptacles at Kit. Counter
6�r-6erege-Fire
Door; Swing -Landing -Closer
68.
A.C. Duct in Garage -Damper
20.
Fixture &Transformer Clearance -Ins. Protection
69.
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
21.
22.
Elec. Receptacles Spacing -Lights -& Switches at Doors
Size Boxes & No. of Conductors -Stapled
70.
Plb., Elec. & Mech. Equip. Listed for Location
23.
Romex Installed Close to Edge of Studs & C.J.
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
24.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
72.
73.
Insulation -Foam -Looked in Attic ❑ Yes
Guard Rails & Deck Construction -Post Caps
25. 2 Appliance Circuits in Kitchen & Conductor Size
26.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI
74.
75.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑Yes ❑No
27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral ❑Yes El No
28.
Service -Riser Conductors & Ground -Main Disconnect
76.
Stucco; Brown -Finish
29.
Equip. Clearances; Panels-Motors-Mech. Equip.
77,
A.C. Unit; Disconnect-Cirnces-Brkr. & Cond. Size -115V Outlet
30.
Clothes Closet Light -Shower Light
78.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79.
Water Well; Disconnect, Electrical, Plumbing
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I
Date Card -BI Date
81.
82.
Ventilation throughout House
Glass Protection
Card 8-1
Date
Date Card -BI Date
MECHANICAL (Permit) OK except q's
83.
Corrections from Previous Inspections
84.
Gas Test -Meters Tagged; Gas -Electric
31.
A.C. Ducts; Insulation & Support
85.
Water & Sewer Connected -C/O to Grade -HD Approval
32.
33.
Vent Fan; Exhaust above Insulation
Condensate Drain & Overflow; Size & Grade
86,
Energy Compliance Certificate -Other Certificates
34.
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35. Attic Access & Platform if Furnace in Attic
Card -BI
Dat;R Card -BI Date
Card -BI
Date Card -BI Date
Card -81
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FRA
Plans OK except q's
Comments at Final:
Si Proper Material & Anchors
3
Wall tuds-Nailing, Spacing & Bracing -Plates -Sound
3
earing Walls over Girders & Floor Nailing
39.
proof)
i e ops; Furred Cei ings-Stairs-Chases-Tub
m- ize earing
- ost Caps -Anchors -Connectors
43.
44r�T'
Clrig. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng_.-Rfn_g_._ _
� A Flue -Fireplace Throat
4
mex Protection -Draft Stop -Ins. Baffles
4
47
r xiting Doors -Sill Hgt. & Dimensions
rarer o F moi^ pion Framing
(NOTE:Anentrymust be made each time youvisit jobsite)
COUNTY OF BUTTE
-i DEPARTMENT OF PUBLIC WORKS-
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
OWNER = }, PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
r�\_ ►� ��� AJ
n, �- v
V
Inspector—(\` Date_"
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
.373- ES-
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
Inspector_i�-' i— �(,A� Date 023 AS�
IFICATt OF'
�\1%)TE OF TIM@IT
A C_
2"
W O
QO
LICENSEE
L . Z CONFORMANCE
/HE UNDERSIGNED MA NUFA C TURER HEREB Y CER-TIFIES
that the products identified below and on attached sheets Nos. are marked
with the Collective Mark of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION (AITC)
and were manufactured in conformance with applicable provisions of American National Standard
ANSI/AITC A190.1-1983, Structural Glued Laminated Timber, and. that. -such manufacture has
been at our plant in SPRINGFIELD OREGON , which plant has a quality control system
approved by the Inspection Bureau of the`AMERICAN INSTITUTE OF TIMBER CONSTRUCTION
and inspected periodically by such Bureau.-
The
ureau.
The manufacture of these members complies with the manufacturing and fabricating provisions of
Chapter 25 of the Uniform Building Code.
JOB NAME: SSEQUOIA SUPPLY
JOB LOCATION: FAIRFIELD CA
CUSTOMER'S ORDER NO. 920074 DATES/10/85
MF,GR'S ORDER NO. 2943-C
TITLE QUALITY OON'TROL ADDRESS SO 22ND STREET DATE 6/6/96
AI TC HEREB Y CERTIFIES that the said company at its said plant is licensed by the
AMERICAN INSTITUTE OF TIMBER CONSTRUCTION to use the AITC Collective Mark in respect
of products which comply with applicable provisions of said Standard, that the adequacy of the quality
control system in effect at said plant is periodically inspected and verified by the Inspection Bureau of
the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION, and that, in the judgment of AITC,
said company is capable of complying with applicable manufacturing and testing provisions of said
Standard in respect of products manufactured at said plant. Conformance with the Standard in respect
of any.specific or particular product is the sole responsibility of the manufacturer.; AITC's guarantee
hereunder being that the said company is qualified to. produce a product meeting the said Standard
and that its plant is periodically inspected and verified by the AITC Inspection Bureau.
AITC FORM IBCA
AITC Certificate No. 13964 A
AMERICAN INSTITUTE OF TIMBER CONSTRUCTION.
C 1983 AMERICAN INSTITUTE OF TIMER CONSTRUCTION
The glulam members of the job covered by this certificate are stamped with one of the
following type quality marks. Each qualified plant has an individual qualification
designation. The designation "P-143" shown on the typical quality marks below is not
assigned to any plant and is used only for the purpose of illustration.
M
A TYPICAL CUSTOM,P.ROQUCT QUALITY MARK
t
P-143 ALTO designation of qualified licensed
plant
QUAL�Ti ® ANSI/AITCIiSPE�TE� Al 90,1-1983
Indicates that the designated licensed plant
has met all requirements for qualification
and maintains an acceptable qua!ity control
system which is periodically inspected by
AITC
Indicates conformance to ANSI/AITC
A190.1-1983, Structural Glued Lamin-
ated Timber
A TYPICAL NON -CUSTOM PRODUCT QUALITY MARK
U0Lr
Identification of structural use, desig-
nated by symbols:
B—simple span bending member; C—
compression member; T—tension mem-
ber: CB—continuous or cantilever span
be*nding'.terr.ber
r►nvn
L.-- Designates appearan_e grade. IND—
p-143 —_ Industrial. ARCH—Architectural.
IND—
P-1.43
A116SPECIES AITC designation of yua:ified licensed
bi v J plant and wet -use t.dhesives. When
dry -use adhesives are Wised, the letter
fillI MTV ^o%^ nn rnrr r D is added
CO uuv-VV UV r
i�SP�CT��
ANSI/AITC
A190.1-198"
e .
Indicates that the designated licensed plant Indicates conformance to ANSI/AITC
has met •all requirements for qualifica"ion A190.1-1983, Structural Glued Lamin -
and maintains an acceptable quality control ated Timber
system which is periodically inspected by
AITC
Name of wood species used
Designates applicable Al TC laminating
specificatipn and combination symbol;
for example: "117-82 24F or 117.82 3"
Pi, For custom products, the details covering the product are included in applicable documents.
10 For non-custoni products, essential details are included on the stamp.
CER�I� OF
�\.,taTE OF TIME.
ITCc
o
QUALIFIED®Z CONFORMANCE
/HE UNDERSIGNED MANUFACTURER HEREB Y CERTIFIES
that the products identified below and on attached'sheets Nos. are marked
with the Collective Mark of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION (AITC)
and were manufactured in conformance with applicable provisions of American National Standard
ANSI/AITC A190.1-1983, Structural Glued t6minated Timber, and that such manufacture has
been at our plant in SPRINGFI n ORFC'rxv , which plant has a quality control system
approved by the Inspection Bureau of the'AMEtRICAN INSTITUTE OF TIMBER CONSTRUCTION
and inspected periodically by such Bureau.-
The
ureau.
The manufacture of these members complies with the manufacturing and fabricating provisions of
Chapter 25 of the Uniform Building Code.
JOB NAME: SSEOUOIA SUPPLY
JOB LOCATION: FAIRFIELD. CA
CUSTOMER'S ORDER NO. 920074 DATE S/ lO/8S MFGR'S ORDER NO, 2243-1_
SIGNATURE 9 �N COMPANY. RiiSRM 1 1 MFR cadeart
TITLE Qu►LITY OONTROL ADDRESS SO 22ND STREET DATE 6/6/86
A/TC HEREB Y CERT/F/ES that the said company at its said plant is licensed by the
AMERICAN INSTITUTE OF TIMBER CONSTRUCTION to use the AITC Collective Mark in respect
of products which comply with applicable provisions of said Standard, that the adequacy of the quality
control system in effect at said plant is periodically inspected and verified by the Inspection Bureau of
the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION, and that, in the judgment of AITC,
said company is capable of complying with applicable manufacturing and testing provisions of said
Standard in respect of products manufactured at said plant. Conformance with the Standard in respect
of any specific or particular product is the sole responsibility of the manufacturer; AITC's guarantee
hereunder being that the said company is qualified to produce a product meeting the said .Standard
and that its plant is periodically inspected and verified by the AITC Inspection Bureau.
AITC FORM IBCA
AITC Certificate No. 13964 A
AMERICAN INSTITUTE OF TIMBER CONSTRUCTION
® •1983 AMERICAN INSTITUTE OF TIMUER CONSTRUCTION
The glulam merntiurs of the job covered by this certificate are stamped with one of the
following type quality marks. Each qualified plant has, an indiviclon' qualification
designation. The designation "P-143" shown on the typical quality m<., r,y oelow is not
assigned to any plant and is used only for the purpose of illustration.
A TYPICAL CUSTOM PRODUCT QUALITY MARK
P -14%3f _ AITC designation of qua!C..,; l.'rensed
plant ,
IIUALITY
NSPECTED ® ALS UA I C
A01 90.1 -1983
Indicates that the designated licensed plant
has met all requirements for qualification
and maintains ,%n acceptable que!ity control
system which is periodically inspected by
AITC
Indicates conformance to ANSI/At'.0
A190.1-1983, Structural Glued Lan!in-
aced Timber
A TYPICAL NON -CUSTOM PRODUCT QUALITY MARK
U %3 V.
Identification of structural use, desig-
nated by symbols:
B -simple span bending member; C --
compression member; T -•tension rnem-
ber: CB -continuous or cantilever span
betiding '-heti ber
L.. Desig!iates appearance grade. IND-
�g �y r Industrial. ARCH -Arch itecturai.
P -14 4F j
remrum
d C !�� __ \ AITC: designation of qua:i`ied licensed
H a E W I Iair plant and wet -use adhesives. When
I \ dry -use, adhesives are used, the letter
1UALITY ® 000-0000E----,, D is added
IWS�PECTED Name of wood species used
ANSUAITC
A190.1--19#3 Designates applicable AITC, larninat.na
specificatipn .and combination symbol;
1 for example: "117-82 24F or 117-82 3"
Indicates that the designated licensed plant Indicates conformance to ANSI/AITC
has met all requirements for qualification A190.1-1983, Structural Glued Lamin -
and maintains an acceptable quality control ated Timber
system which is periodically inspew, o oy
AITC
® For custom products, the details covering Vie product are included in applicable, documents.
Foy non custom products, essential details are included on the stamp.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroviile, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO '
ASSESSOR PARCEL NUMBER
ZONI G�7
BUILDING PERMIT
owN
TE EPHON
SO. FT. OC BUILDING VALUATION
_771
1
OWN R'S MAIL NG ADDRESS
V 6
CON ACTOR'S NAME I
a ve- o
TELEPHONE
COJT ACTOR'mS AILING AD ESS
V IfC I/
Fireplace
CON
ON TION LENDER KNOWN
UN�
Total Valuation $
FilingFee
$ 10.00
MAILING ADDRESS
Permit Fee
$
ARC 1 ECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARC I CT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ f
BUILDING ADDRESS L
PLUMBING PERMIT
Fi Iin g Fee 10.00
Each Trap
2.00
Solar Water Heater
20.00
Water piping
5.00
LOT NO.SUBDI VISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTU1fiE
SF ❑ Duplex ❑ Mobi lehome ❑ Other rJ t 69 a v—
SPECIFY
Building sewer
5.00
Mobile Home S I G I W
10.00e
TYPE OF WORK
New TA Addition [:1Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELLING OCC
OR ADDNS. ACC. BLDGS.
2'hQSQft ,
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
® I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR ULTI.OUTLET 2.50 ea
NON•R ESID BRANCH CIRC ITS
NEW CONSTR. ( POWER APPARATUS &
NON-RESID, (SINGLE OUTLET CIR.
Ex. OCcu ZD®S0C
P.OUTLE OR FIXTURES BAL030Q
FIXED A
Ex. OCCUp. OUT ETS (RESID )REA.) 2.00
Temporary service
10.00
Mobile Home Facilities 15.00
Misc. Wiring
15.00
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Not ce to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
FiIingFee 10.00
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
�( ���� �- Qti J!
Date
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $ ILs
OCCUP. GROUP
I TYPE OF CONST.
PARCEL
Po ND SSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIREqfOOF PUBLIC
BY
PE IT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date -� 1 -7 -,?S'_
1-7 —FA,
Receipt No.IN3
WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT
A, r ,
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541
PERMIT APPLICATION DATA SHEET
/�
j r - Permit No.
OWNER Cko 0 I P I,( Q ► r r A. P. No.
Proposed Building Use Piz `/
Permit Fee Based Upon: Complete Contract Price X DPW 4uation
Other (Explaiq) /
Building Inspector__ A10, 1pry-.P Date
At time of permit application, I was advised the Cfiollowing data must be submitted prior to permit processing
andJor issuance: DATE RECEIVED. APPROVED
1. All items have been submitted. . . . . . . . . .
�2. Plot plans in duplicate./triplicate. . �> S�xrj 4y C1,(&f kw�uv► —00,
Complete plans in duplicate./triplicate. .
4. Complete engineered plans and calcs. . . . . . . . .
5. Plans with Energy Design Compliance Statement. . . . . .
6. State Energy Forms No.
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $
9. Letter of signature authorization. . . . . . . . . . .
10. Sanitation approval from Health Dept. . .
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance.
13. Contractor's License Information (no., name style, classif.)
14. Owner -Builder Verification (Given to owner, Mail to owner ❑.)
15. Improvements may be required. . . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . .
•Pre-Inspec. request to
17. Pre -Inspection for Required. Building Inspector (Date)
18. Recorded copy of Agricultural Acknowledgment Statement.
19. Other
When you issue the permit, process as follows: Mail two owner. Mail to contractor.
X Telephone 5.3N-- 40 and hold for pickup at office. Deliver w.
/inspector.
Other
Applicant Date 5%1
Copy of plans sent Health Dept., Fire Dept., Other Date
During the plan checking process, the following data must be submitted prior to permit issuance.
(For required items not checked above at time of application, circle item.)
1. Index permit for above Items No.
2. Additional items required:
(Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other
By Date
Plans checked by.
Plans approved by
Other
Copy—DPW
Date
t::�Date
T;L22 Md�,,
North
Eiis i
Wt 'L
S ky.1 is!,. t S
(B ) S h a 6
Shad ni
'A : . . "
S j Ml, J L: P:- Ib I P Tr in I c -
t
Coef f is ient Description
East
FORM I
RESIDEM ^.I-
P' -AN
OwnerC1
E�tL.CE�
wes�
].!raft' Zo. A-1 Permit No.
.Floor Area
13
S ir v I j g.
Compl iance path: Packar.k-
A 0 C X-PDint S./Stear. 08ud�,,et (7 Other
(C; SOLIth
DESCRIPTIoN
RE;., -'D
'INSTALLED ITEMS (1)
INk';11, ON:
Length
Ruo f n;,
(D) Moveable in,3LI13tJ;)1-, re,-: DescripLion
wall
Slah F1, - Pei
-_AA-T
Rais�:d 1:1.ot.j-
T
(2)
INFILT R. -"I TUIN
(A) P .--aj,or bar:
i r 1, tL-AtIj1:e ctimnte Tones, 1., 14 S 16.
2Arf:.a
(B) Aj-) .:IwrwfacL!ii-,;d
wind.--w.a and sliding Mass doors - shall meet the
mc
at ic, n
Standards and shall be certified and
V pe
yr
(C) t,
doors and i:indows ieadiiq, Vc, iinc,mOitiont-ci art -as
L,)( at ioi
S!,CP he fUli-
i dea!i-i,2is:rJppud.
'BUM cou"
Tight - the abov,
st--.:idard LIS: BUILDING DEPARTM
(D) Clow i.nuous
int a] LI -a,- i.cn ior
IJ
t -al
(E) E�-,:Ll-ic
t-
ou�Lepjar.e
I
(F) A air
e. a,,: :XCha.1gL` APPROVED
(3)
J).)c
----
Area I R=
Ml
T;L22 Md�,,
North
Eiis i
Wt 'L
S ky.1 is!,. t S
(B ) S h a 6
Shad ni
'A : . . "
S j Ml, J L: P:- Ib I P Tr in I c -
t
Coef f is ient Description
East
SolAil
wes�
13
S ir v I j g.
i L G
(C; SOLIth
)verhang
Length
Of i)TQ-ieCti(,)n fc. Description
(D) Moveable in,3LI13tJ;)1-, re,-: DescripLion
.,-t.2
HC=
M -C =
2Arf:.a
IkD F. t -,j NC=
mc
at ic, n
-R=
e
V pe
Area
MC -
L,)( at ioi
C3
ITC=--.- R=—
Fj
Tyn,
A r
t i c)
J).)c
----
Area I R=
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ix) a I jun
. .....
3
r�
- 1
•
-
'
• ' FORM -1
[j (4)
AIAS01-TRY AND '•:10F'f.'it: i.i_ '!-REPIACES bhCia be equippc-d with tight
fitCir, r.ln�r�t)_� =:r i.-11 or g]ass .doo>,s cov rang the ir.r_ire t, pen ing
.
of the tjl",_UJX a con,bL1t, ioo c,ir int.akc- ,- jk; :.aped with a readily
accnssi'ule, clot°nai,.l.c, and t.ig;rt fittin" damper t.o draw air from the
ot+tsi_c of thy: t:ui idirg.; and a t'gl:t fi' L+n, flue daE;,m,er with a
Y.,adi I y zt •- `ssible Ct>ntrC.'• .
*1!
lic:A'1INC; . VEX,"'..:+_TINt.r„H _:uND111.'!
number.) SE
;f r
— (heat ing capac,t
•'
❑
Heat _- — - --- -•-- —
_ . ._._..
(brand 1n•_'• "[Do(i _'----nu.r�--, ..
Al:pp
'Btu. 1"t 1'
Int'atin'_' CEtp::'LJL'✓ at 470F)
— --- --
-•a
.
L:r•e '; ;c or a,r Co.11;.,.tov 'grand and
ft -2
mo6el n-:t�i�t:-' sola-1 ir•ar'. 'on area collector
..on ,,ctor ti 11 t r,�tec •- it:.erc ept
its) !:oo i ing ,
Air ,;n:1c1iL_ul,k�z00-a.-id
and :!;ods 1 number 1 (scasunal EER)
.f .. bt`--!hr
_Q'j'
j L,.._a` F
r.(' ctr:U Heal. Pump
EER
-
c c(lo i in.; rapac i t a _ ;+_r ` E)
•.-
[;
tither ------- ----
A T,4!)-STAC:F: TILE WiOSTA5 , which` L:',• suppii-mentary brat on
its seco.^.ri sh:ji.1 bc-leyt•i ed 1_.,r :,t>.at puwys.
-- _-`
:.;) 1_i1-Ai�:(1i'iT'lt' t' Si,'ia< �`... ] 1( C' --u' t[i2d �.i L, I I thermostats except
rhCSC CW'LU-)1 Litl)t h ;u. Aps.
"
1"J" a?I�I:F'� : IIET*JCI'. .-heli bt j.-:-ovid,-d for all Fa; fired
fan t:n•: c(.:,--ral turnL. us, errs -fired tan L -int- wail furnaces and
tlia5 L..lic . .t;t•1 ..'t:l i:5 . ”
`1
ti'! i,,1.�.1:f.r_A 1F.i'IP�i•: 51,111 L r:ru.icie� for all fan sN'stews exhausting
LJ
((, ;:t°t;; r��hc;'KIICIlO:L & It•�'t ;:.,':ION. All r r.,,:sversc dt,ct plenum, and
-- - .- ----._..._. ..- _.�__..__ , P
fittiuK j( -ants si1iii b,. S,:aled with p1•easure. sensitive tape or
rna t,t to prevent air ins;: anr' sha"_ 0t: ..n ,1 Led t i conform to
the p; ovis iC s c i Srct ic:1 10')'* u - rht. 'ir!r , i97h Edition .
���3
(6) DOMESTIC WATEF SYSTEM
( (B) Gas Only _ _ _ Gallons
(brand and ni,.A .l number) (tank si<:e)
13 heat Pump w/Electric 3a,.1cup_--_—
(brand and model cumber)
Gallons
(tank size)
(] *2 Active SoIar_—
(collector brand and :andel number)
(rated y -intercept) (rated slope) (solar Craction)
_ft
2
(backup heater type, brand and model number) (collector area)
(collCctor or -enation) (collector tiI0
C3 hocat;.,n of. Solar Panels----
13
anels_—__-
other
—.. _— -- -- -- — — (Describe)
(B)
[� (B) TANK INSULATION. Storabe type water heaters and s;:orage and
backup tanks `or solar systems shall. be externally wrapped with
R-12 insulation or greater.
(C) PIPJ: INSU;ArION. The five L, -:et of pipe closest to the water
Neater and outside conditioned space shall be insulated with a
minimum of R-3. Steam and steam coedits ned space shall be
insulated with a miniusam of R--3. Steam and steam condensation
return piping and recirculating hot water piping outside the
building envelope shall be insulated in a;:c,)rdance with
T20 -1408(d).
(D) 'FUN RESTRICT0RS shall be provided for sirowerheads and faucets
as outlined in the new appliance efficiency standards and shall
be certified to the Energy Commission..
(7) LIGHTIVG
[� (A) Lamps used in iuLainarics for general lighting in kitchens and
bathrooms shall have ar , fficijcy of nog less than 25 lumens per
watt ;usually florescen?-).
*1 Submit documentation of sizing `.:eating a -d. cooking equipment by Manual .1, sizing
charts (form #4) or other approved methods, section 2-5352(gi, and fill.*uut the
following:
° �atg BTU'
eating Winter design temporat:,-irr� elNvation
elevation factor �ropx heating 1.va•.i = maximum outlet capacity gas furnace
BTU
Coo!
Cooling: Summer design temperature °, •o:ing lca' 3� 3_9Tv ,
*2 Submit T-.I.?.S.E. chart or other appr,.ved system (form 'k5) to document sizing of
so Lar panels.
® DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of
Title 24, Part 2, Chapter 2-53 of the Californ;a Administration Code.
7/83
_ I
S GNATURF. OF BUILT) SI 9 OR APPLICANT
11
OWNER THERMAL PASS TAKEOFY SHEET
PERMIT v0.
Thermal mass: Materials which have the ability to store heat (typical types are masonry,
brick and ceramic tile).
Thermal crass cannot bit insulated from the interior of the building. (If covere4,bp car
pet, cabinets, or enclosed in closets the mass -is considered insulated),.•C '
J.
Thermal mass floors must have an exposed and textured surface or design so that carpeting wiil".
not occur. (Covering of vinyl or asphalt the and linoleum is permitted).
TYPES THIMESS LOCATION DIMENSIONS 4. AREA
Entry Floor G� _SQ.gr. -
Beth 01 Floor x L:e r � SQ. FTS
Bath - #2 Floor x
Bath f3 Floor x SQ.F'T.
Kitchen Floor x ' SQ.FT.
G Floor -�--�' x SQ.F'T,
-14649 - FFloorJ! �' X SQ. FT.
F:repla,-ejd x SQ.FT.
AS
Fireplaces' x �'
Bath #1 Counters ' x
-- Bath #2 Counters'* ' x
Bath #3 .Counters x � � SQ.FT.
Kitchen Counter's ' x ' a"
SQ.FT.,
cWa11 Shield ' x ' SQ. FT.*
} Wa1I8 x g SQ.IrT.
Walla x SQ FT,•"I'
Walls ' x ` • 3Q. FT.
SQ. C i. ►. T
- • , x
If compliance method proposed'is-other than the point system (where thermal Bess point
charts are available), use calculation methods on reverse of thi'' form to show thermal
mass compliance.
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3_5" North ClazinJl
QUANTITY(SQ.FT.)
.iA
(o)_� x
(c) x
(d) _ x
(e) x ;. 'a
Total Notth Glazing = (SQ.FT.)
(a+b+c+d+e )
TOTAL
TOTAL %
NORTH
TOTAL BLDG
GLAZING
FLOOR AREA
I?;�
x
SQ.FT.
SQ.FT.
CONVERSION TOTAL %
FACTOR NORTH GLAZING.
100 - -4 %
31?
3-7 South Glazing
QUANTITY SIZE SQ.FT.)
(a) G A;�C,5)
(b) I x
(e) 1 x _
Total South Gazing (SQ.FT.)
(a+b+c+d+e )
'TOTAL
TOTAL %
SOUTH
TOTAL BLDG
GLAZING
FLOOR AREA
I?;�
y' !:;:W x
SQ-. FT.
S Q . FT .
CONVERSION
TOTAL %
FACTOR
SOUTH GLAZING
100 0
L
x 3 0
�t
3-9 Skylights
QUANTITY SIZE
(a) x
(b) - x
(c) x
Total Skyli
(a+b+c)/
AREA (S .)
(SQ.FT.)
(a)
(b)
(c)
3-6 East
Glazing
JlSI
x
,
- A�t� L SQ. I -r. . )
= __
QUANTITY
L
x 3 0
a_ b
(d)
-
_36
x ----
SQ.FT.
(e)
— x
Total East Glazing
=r'�- m j -r .)
(d)
(a+b+c+d+e) .
it
TOTAL
3-8 West
EAST
TOTAL BLDG
GLARING
FLOOR AREA
_Orr i-
- i&A (SQ.FT.)
(O
(b)
x
SQ.FT.
SQ.FT.
CONVERSION TOTAL %
FACTOR EAST GLAZING
100 a ( %
TOTAL
3-8 West
Glazing
TOTAL BLDG
(a)
QUANTITY
SI �
x
- i&A (SQ.FT.)
(O
(b)
SQ.FT.
x
(c)
—
x
(d)
.
x
(e)
x
Total West Glazing
(SQ.FT.)
(a+b+c+d+e)
3'Z►
TOTAL
WEST
TOTAL BLDG
GLA& IG
FLOOR AREA
d x
SQ. 11r.
SQ.FT.
TOTAL
SKYLIGHT TO BLDG OON�'ERSION TOTAL %
GLAZING OOR AREA FACTOR SKYLIGHT GLAZING
s x 100 %
EQ.FT. SQ.FT.
CONVERSION TOTAL %
FACTOR WEST GLAZING
100 = ( %
/�3
FD
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