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Home My WebLink About039-290-01339-29-13 Stanley Graves S/S Dayton West Rdapp.l mi.W.of Ord Ferry Rd., Durham P rmit #6867-78B de olition/SF) 39-29-13 Permit #6 68-78P,E(uti1.,MH) ELEC. `' � BD P GAS ,C P6- �[� SUPPOIft S RUCTURE REQ. IVO COMP_CTION TES @. itha _rfaIM17V-..._ -. 39-29-13 Contr: Clemons. -Davis MH, Chico Permit #7236-78MHI^ Issued 039-29-0-013'. 92-2678B GRAVES, Stanley & Marys 4451 Dayton West Rd, Chico demo sf 039 0- 92 3059B , P., E,, ' GRAVES,Stan & ry, 4451,Dayton West ,_Chico 'mh utilities ELEC ` 29dO GAS 3 '' COMPACTION TEST REQ SUPPORT STRUCT REQ i = 2==3176B X039=29=0=013'_.-..-.` DAVIS, Gigi & De ns' - 4451 Dayton W t Rd, Chico F- contr: Skyc St mhi 0 i n cr-, :.•�—•z-•y..S?r V•T.• 1=rsz�•c ;� ...a 7�'""�Yt s2�01Y `}':`'�;AcR R' )Y (�'f.tki'I " liE!'.' ? •{ ":ti�.:p, �. I �.��t : « ys• -"' or.� �: 1 RY 0-013 �' `;92=2678B GRAVES, Stanley &'k Mary 4451 Dayton West V , Chico 1. demo sf n�( I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538.7541 APPLICATION AND PERMIT A3SZ33Q R PARCRL NUMBER 439-290-013 - ZONIN-0 A --pct; BUILDING PERMIT OWNER Stapley & Mary Graves TELE HONE 342-7633 S0. FT. OCC. BUILDING VALUATION �7 �y� Gst• 1,000. 00 OWNER'S MAILING ADDRESS 4439 Dayton West Rd. Chico 95928 1` ' CONTRACTOR'S NAME Dan Davis TELEPHONE 894-5317 CONTRACTOR'S MAILING ADDRESS 1679 Hooker Oak Ave. Chico 95926 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 1,0W.00 Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ 22.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 37.50 PLUMBING PERMIT Filing Fee 15.00 ' 44 t $ ChiCQ Each Trap 1 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each pas water heater or vent 7.00 USE OF STRUCTURE SF [% Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New Addition ❑ Remodel ❑ Utilities ❑ InstaliationC Other [ Describe work: Demo House _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600VORLESS j$.50 200A OR LESS Main service 200ATO1000AI 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F]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 .Jo. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.(DWELLING OCCUP3.64 sq.ft. OR ADONS. .E� ACC. BLOGS. NEW CONSTIRMULTI-OUTLET 500 NON -REST BRANCH CIRC ITS POWER APPARATUS tr (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 @ 760 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 1 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. 6yirin 15.00 9 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 yof Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 1 15.00 Heating Cooling g LHood 6.50 I 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 liabil' 1 -ds, judgments, costs, and expenses which may in any way accrue against id County in conse ence of the granting of this permi ,- X Date si nature of Applicant - owner Signature pp ❑ Contractor ❑ Agent An OSHA ion of structures toverr 3gstories oinehe ght ions over 5'0" deep and demolition or construct- Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $37.50 HAz DFEES IMP I FLOOD CDF PARCEL I PD HD ISSUE ` Lam. This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do % work indicated above for which fees have been paid. - DIRECTOR OF PUBLIC WORKS By. I - �. , / Date PERMIT EXPIRES Date c" - /— 3 117788 Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, California 95965 - Telephone: 916,'538-7541 APPLICATION AND PERMIT PERMIT NO. An ASSESSOR PARCEL NUMBER 039-290-013 ' ZONING A-40 BUILDING PERMIT OWNER Stanley Graves TELEPHONE 342-1633 SO, FT. OCC. BUILDING VALUATION Est. 11000. 00 OWNER SMAILLING DRESS 4439 Dayton West Rd., Chico 95928 CONTRACTOR'S NAME TELEPHONE Dan Davis 894-5317 CONTRACTOR'S MAILING ADDRESS Fireplace 1679 ;hooker Oak Ave. Chico 95926 CONSTRUCTION LENDER UNKNOWN Total Valuation Is 1,000,00 Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ 22.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 37.50 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 SF [-t Duplex❑ Mobilehome❑ Other Mobile Home Is G W @ 15.00 SPECIFY TYPE OF WORK New LI Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ® Permit Fee $ Describe work: Demo House Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 18.50 200A OR LESS Main service 200A TO 1000A) CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F -1I 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 .Jo. Classification I, as the owner, or my employees with wages as their sole compen- _37.50 NEW CONST. DWELLING OCCUP.g OR ADDNS. ( ACC. BLDGS. 3.6Q sq.ft. NEW CONSTR. ULTI-OUTLET NON -REST BRANCH CIRCITS @ 5.00 POWER APPARATUS e (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 20 76 cl Ex. Occup. OUTLETS IRESID IED APPLNS, RFr. A) 1 3.00 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) Temporary service 15.00 Mobile Home Facilities 15.00 Misc. lyirin g 15.00 ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE Contractor I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 15.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ 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 Cooling g Hood 6.50 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. 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 liabilielAs, judgments, cost and expenses which may in any way accrue against i County in ctonse nce of the granting of this permi Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONSTTYPE TOTAL FEE $ HAz DFEES IMP FLDDD CDF PARCEL PD HD ISSUE X Date This permit is hereby issued under the applicable provi- Signature of Applicant — Owner ❑ Contractor ❑ Agent sions of the Butte Cou ty Code and/or resolutions to do An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. work�cdri�dbORfor which fees have been paid. OF PUBLIC WORKS Receipt No. 117788 BY DateZ R EXPIRES Date WNITE-D.P.W., YE OW-A33E330R, PINK -INSPECTOR. GOLDENROD -APPLICANT t '« COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION. 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 = TELEPHONE (916) 538-7541,(\ � PERMIT APPLICATION DATA SHEET OWNER S -rAAl1 F 7 �,4 I A. B -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 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 Form . ............................................ 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 and manufacturer's installation instructions, 2 sets. ........... 10. Fees of$ .......................................... 11. Impact fees as shown on attached schedule . .............................. 12. Califofnia Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval 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. ........... 19. Driveway permit (construction approval required prior to occupancy). . 20. Pre44Aspectio� request Pre -inspection for required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification). ertificate of Workmans Compensation Insurance. . 23. Owner -Builder Verification (Given to owner , Mail to owner . ......... Isle T-1- T 7 - Jt -24. 2. 255. Recorded copy of Agricultural Acknowledgement Statement . Letter of signature authorization. ................ .� � 2 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 permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other 71 Parcel Creation ) Acreage Applicant Date 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 _ ph o mail Counter _ to Contractor, designer, owner, was advised of above required data by _ pho e _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works - X91 - ) l SINGLE OUTLET CIR. COUNTY OF BUTTE - DEPARTMENT. OF PUBLIC WORKS �EX. OCcup(OUTLETS OR(a)FIXTURES * 7 County Center Drive - Oroville, California 9Q-5,' AND Telephone: 916.'538-7541MIT PERMIT NO. n APPLICATION (Temporary service 1 15.00 ASSES OR PARCEL N' � ZONI /J- 15.00 :Mise. Wiring BUILDING PERMIT TELEPHONE 31- S0. FT.. I OCC. BUILDING VALUATION OWNF-R*rp MAILING ACIORESS 17PI O C CTOR'� NA E E�.EPM ONE Y9S'9 C O RA CR/' S A 1 L I OADDRESS /,�� ) // C. C- k ajL/ /�(le e --ff CONSTRUCTION CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15.00 ARCHITECT OR ENGINEER LICENSE NO. Permit Fee $ Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ BUILDIN`. AODRESS _ Penalty Permit feeS r $ /Cp PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 SF Duplex❑' Mobilehome❑ Other Building sewer 1 15.001 SPECIFY Mnhi Ic HnmP (Z !_ Int rn'1 s c nn t , TYPE OF WORK New Addition C_ Remodel❑ Utilities❑ Install—,n7i Other Descri6 work: -EG /0 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason Permit Fee Contractor ELECTRICAL PERMIT Main service 600V OR LESS 200A OR LESS Main service 200A TO 1000A1 NEW CONST. DWELLING OCCUP.pi OR ADDNS. ( ACC. BLDGS. Fi ling Fee 18.50 37.50 3.66 sq.ft� @ 5.00 15.00 ! (POWER APPARATUS e) l SINGLE OUTLET CIR. �EX. OCcup(OUTLETS OR(a)FIXTURES EX. OCCU FIXED APPLN5. OR p• OUTLETS IRESIO.1 EA.� A2076d I 3.001 (Temporary service 1 15.00 Mobile Home Facilities 15.00 :Mise. Wiring 1 15.00 WORKMEN'S COMPENSATION INSURANCE OL I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject , to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County,ot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte ag inst all liabilities, judgments, costs, and expenses which may in a7y way a crue against said County in consequence of the granting of this perm' .) X 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 iistailes_in Fieiaht. ermit Fee ontractor MECHANICAL PERMIT eati na 'entilation ;,;it Fee S Fi I inq Fee 1 15.00 S 6.50 Mobile Home Installation Fee S energy Inspection Fee $ OCC=TOTAL FEE $ 3 I HAZ 10 FEES I IMP I FLOOD I COF I PARCEL I PD I HD I ISSUE (his permit is hereby issued under the applicable provi- ;ions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS Demolition Permits Asbestos Notification Statement Date AP# Pursuant to section 19827.5 of the California Health and Safety Code, all demolition permit applicants are required to fill out this form. "19827.5. A demolition permit shall not be issued by any city, county, city and county, or state and local agency which is authorized to issue demolition permits*as to any building or structure except upon the receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to that part. The,permit may be issued without the applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project. The permitting agency may require the applicant to make the declaration in writing, or it may incorporate the applicant's response on the demolition permit appli— cation." Attached is a copy of my written asbestos notification to the United States Environmental Protection Agency for the demolition project located at Signature of Applicant sR I hereby declare that a written asbestos notification to the United States Environmental Protection Agency is not applicabl t this demol' 'on project. n, Signature of Applicant 2/19/91 MAIL TO ASBESTOS'NOTIFICATION EPA/NESHAPS Region IX 1235 Mission St. A-3-3 San Francisco, Ca. 94103 DATE: PROJECT JOB (Please see reverse side) AgonCioa AIM Notisimd: ❑ 1--.1 ❑ Cilifomia Air Aoaou==" Board ❑ Cs1 OSEM �T E� ASBESTOS DEMOLITION/RENOVATION NOTIFICATION Please check one: Renovation Demolition requiring 10 day notice Demolition requiring 20 day notice Revision of Original (Form on reverse side) IDE—PLEASE READ BEFORE USING THIS EPA USE ONLY DateRec Pstmrk School Del/ND ADQUTE? Code#: Doc#: FORM 1. OPERATOR: 3. FACILITY NAME: (Contractor) ADDRESS STREET ADDRESS CITY STATE CITY STATE ZIP PHONE( ) COUNTY ZIP 2. OWNER 4. FACILITY DESCRIPTION ADDRESS V AGE __ SIZE CITY STATIC ZIP PHONE( ) PRIOR USE 5. Project Start Date: Completion Date: 6. Estimate of Friable Asbestos: ON PIPE: Linear Feet SURFACE OF OTHER COMPONENTS: Square Feet Nature of Materials: 7. DESCRIBE METHODS OF REMOVAL: 8. PROCEDURES USED TO COMPLY WITH 40 CFR 61.147 & 152: 9. NAME & LOCATION OF DISPOSAL SITE: ANY FURTHER PERTINENT INFO CAN BE INCLUDED BY ATTACHING ADDITIONAL SHEETS QUESTIONS??? FOR FURTHER INFORMATION CALL (415) 556-6415 8am/4pm M -F INSTAUCTIONS FOR IISF OF LERFRTCIS nEM_O TT TO , /T]T1,/' V TTON NOT IF TCAT TON -, RENOVATION: means altering in any way one or more facility components. NOTICE MUST BE POSTMARKED AS EARLY AS POSSIBLEBEFORE PROJECT DEMOLITION: means the wrecking or taking out -of load -supporting structural members of a facility roQeth r with any related handling'operationE 10 Day notice for MORE than 160 sq.ft.or 260 linear ft. asbestos 20 Day notice for LESS than 160 sq.ft.or 260 linear ft. asbestos, includes facilities which contain no asbestos. FACILITY: means any institutional, commercial -or industrial structure, installation, or building. Renovations on single family residences and apartment buildings with 4 units or fewer are exempt from notification to EPA. - PROJECT JOB A: Your OWN IN-HOUSE I D for a specific jobsite. Optional, but expedites communication -concerning notifications. LOCAL AGENCY: Most areas in Region 9.have local NESHAP delegated agencies. In these areas notice must be provided to both EPA and the local agency. 1. OPERATOR/CONTRACTOR: Full information concerning person doing the work. 2. PROPERTY OWNER: Complete in full. 3. FACILITY NAME: Must have complete address OR directions to the jobsite. 4. FACILITY DESCRIPTION: Current use of building. Project location in the facility. Other descriptive information as necessary. 5. START AND COMPLETION DATE: Provide month, day and year. Must be revised if dates change. .(see revision form below) 6. Estimate of amount to be removed (must be in square or linear feet). Revisions(see form below) must be made for additional amounts uncovered. 7. Examples of methods: glovebag, scrape, remove in sections, etc. S. Examples: Adequate wetting prior to and during work, double bag, etc. DRY REMOVAL MUST RECEIVE PRIOR WRITTEN APPROVAL FROM EPA OR THE LOCAL DELEGATED AGENCY IF MORE SPACE IS NEEDED THAN PROVIDED, ADDITIONAL SHEETS SHOULD BE ATTACHED TO REVISE A NOTIFICATION ALREADY ON FILE WITH EPA, USE FORM PROVIDED BELOW PROJECT NAME PROJECT JOB I ORIGINAL NOTIFICATION DATE Revision Notice #1 2 3 4 5 please circle This is to advise that the above referenced notification presently on file has been revised. Please note the revised portion listed. CHANGES FOR THIS REVISION: 1. NEW Location 2. NEW Scope of Work 3. ADDITIONAL Quantity of Asbestos 4. -NEW Start Date 5. NEW Completion Date 6. NEW Disposal Site PROJECT ( ) CANCELLATION August 3, 1992 To Whom It May Concern: COUNTV OF BUTTE BUILDING DEPT AUG 0 4 1992 Gigi (Gisele) M. and Dennis C. Davis have our permission to obtain necessary permits for new construction on our property on the West end of Dayton West Rd., Section 29, Township 21. Signed: Mary E. raves 0 s 1 1C ( ff R ID NT11-.11r, 39-29-0-013 OJT -Sib 92-3059B,P,E GRAVES, St h & Mary 4451 Dayt,;z West Rd, Chico mh utilities OFFICE COPY Address�_Si bA4-rTj Jl�fT GAS Meter By Dater ELECTRIC Meter By i� A_ --Date-6,1 OFFICE COPY Address �. pate- a. S `! E`ECTRIC pace Meter BY JOB FINALED (Date) Signature V=OK O = Not OK Not = Not Readyable MOBILE HOMES se MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except I'sI Date . DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s ,yZoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements Z' Soils; Special MH Support Sketch Sewer; Location -Test -Fall -C/O oncret Oe ater; Location -Test -Easement Needed (Sketch) Electricity; Location-Clearences-Grnd-(6S Amp�oncrete VGas; L §tion -T -Wr p.. / /" L" ft. / /"Nat. or/ /" L"ft./)41"LPG ell Clearance & Disconnect Utility Clearance Date 7�a`�1� Card B-1 Grp Date Card B-1 Date Card B-1 Date Card B-1 Date MOBM HOME INSTALLATION (Plans) OK except #'s Z ing Requirements -Setbacks Easements . Footings; Size -Spacing -Marriage Line Gas; MH Test-Demand-Valve—Connector lectricity; MH Test -Crossovers -Breakers -Clearances rain; MH Test -Fall -Flex Connector rf"Water; MH Test -Regulator -Connector .'Water and Sewer Connected -C/O to Grade -HD Approval Gas and Electricity Tagged Exits; Insp.-Sketch Cert. of Occupancy Date i[ \gAECard B-1 CBCT Date Card B-1 Date Card B-1 Date Card B-1 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beam s-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6: Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. _ Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK O = Not OK -.V N9Readyable RESIDENTIAL (; Date UNDERFLOOR (Plans) OK except tt's 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg.,, Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/- /" Ftg. Depth 4.,Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel- Blockouts-Wrapped 6a. Hold Downs and Special Anchors,. 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -fitting -Test -2 Way -C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit).OK except ff's 16. Water Hir.: Vent -Access -Combustion Air -Baffle --------------- --------------------------- 17. Water Pipe: Test & Anchor -Nail Protection 18. D.W.V.: Test -Fittings & Anchor -Nail Protection ------------ --- - ---------------- 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower. Second Floor -Tub Access ------- ------------------ ----------------- -- - -- 21. Gas Pipe: Size & Anchors Date Card B-1 Date Card B-1 ----------------- -------------------- --------------------- Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except ft's 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors ------------------------- ----------------------------------------- 24. Size Boxes & No. of Conductors -Stapled ------------------------------------------------------------- 25. Romex Installed Close to Edge of Studs & C.J. ---- - - - ------------------------ -- 26. Equip_Ground made up w/Meth. Fasiners-Bond Gas & Water ------------------ ------------------------------- _ 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI --------------------------------------- -------------------------- 28. Subfeed Wire Size / ga. Cu or AI-A.C. Wire Size / ! ga. Cu or Al ------- --- - -------------------------- ---• - ----- 29. Range Circ. ! ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No -------------------------------------------------- - - ------ - --------------------- ------------- 30. -- -------------------------------------------- 30. Service_Riser Conductors & Ground -Main Disconnect - - - - ------------------------------------- 31. Equip_ Clearances Panels-Motors-Mech. Equip. ------------------------------------------------ 32. Clothes Closet Light -Shower Light -Spa Light ----------- - - ------------------------------------ - ----------- - ---------- 33. Smoke Detector ---------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 --------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except ft's 34. A.C. Ducts Insulation & Support ---------- ----- ----------------------------------- ------------------------------- 35. Vent Fan: Exhaust above insulation ------------------------------- 36. -----------------------36. Condensate Drain & Overflow: Size & Grade -------------------------------------------------------------------------- - 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet ------------------------------------------------------------------ 38. Attic Access & Platform if Furnance in Attic ------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 .------------------------------------- --------------------------- ----------------- Date --------------- Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except ft's 39. Sils. Proper Material & Anchors ------- ------------------------------------------------------------------------ 40. Walls Studs -Nailing. Spacing -& Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing ------------ - ---- ------------------ 42. Draft Stop in Walls (rat proof) ---------------------------- ------------ 43.- Fire --Stops Furred Ceilings -Stairs -Chases -Tub ----------------- ------------------------------------ 44. Headers & Beam -Size & Bearing NO = >ingle & Duplex) Date FRAMING (Continued) Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Ring. r 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Rom ex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions ,. 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings ------------ 52. Ext. Doors -One 3=Check Garage -3rd Story, 2 Exits _ 53. _Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection -_ 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access ------------- 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls: Nailing -Bolts 59. Insulation -Walls -Ceilings -------------- ____ - 60. Infiltration -Walls -Windows --------------------- -- Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except ti's 61. Ext. Steps -Door & Sidelight Protection -Landings ------------------------ -- 62. Smoke Detector r -------------- 52., 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage: Above Floor -Ducts -Meth. Protection --------------- - ---- 64. Bedroom Exiting ----------------------- __ 65. ------------ - 65. G F.I. & Bath Fixtures & Tub Access -Spa ----------- - ----------------- 66. Elec. Trim & Su_b_panel: Breaker Sizes & Labels _ 67. Stairs & Rails --------------------------------- - 68. Fireplace or Stove: Clearances -Hearth 69. Elec. Outlets at Wood Panel: Int. & Ext. ---------------------- 70. --------------------70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door: Swing -Landing -Closer ------------- -------------------------------------- 73.-A.C.-Duct in Garage -Damper. ---------------------- ---- 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection - 75. Plb.. Elec. & Mech. Equip. Listed for Location • 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection ---------------- 7;. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck -Construction -Post Caps 79. Fdn Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.: Drive ❑ Yes ❑ No: Walks ❑ Yes ❑ No; Planters -_0 Yes - ❑ No -------------- - 81. Stucco: Brown -Finish ------------ -_----- 82. A.C. Unit: Disconnect. Electrical, Plumbing 83. Vents Above Roof; Plbg -Appliance-Fireplace.-Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing -------------- ------------------- -- 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House - ---------- -- ----------------- --------- 87. Glass Protection 88. Corrections from Previous Inspections ------------ - -------- 89. Gas Test -Meters Tagged; Gas -Electric ------------------------------- ___________ 90. water & Sewer Connected -C/O to Grade -HD Approval_ 91. Energy Compliance Certificate -Other Certificates - ---------------------------- ---------- ----- -- - 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: MOBILEHOME INSTALLATION ACCEPTANCE n COUNTY OF BUTTE DEPARTMENT -OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 PERMIT N0. Address or location of mobilehome Owner's name (_1 2.PV G S Owner"s address � Li S 1 � �� t � r! W � SC -,rN `� u -i 02 Insigriia or hud number �it_� ��I'�7Z1 Z t A \ Manufacturer's name E) V– L I N Serial number of V.I.N. Year of manufacture �— (Official Approving Installation) (Date)y IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION Ar,CEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE M_OBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 5138 White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE- DEPARTMENT OF PUBLIC WORKS 7 CountyCenter Drive - Oroville, California 95,65 - Teiephone: 916/538-7541 APPLICATION AND PERMIT ERMIT NO. ZZ� ASSESSOR PARCEL NUMBER , 039-290-013 ZONING A-40 BUILDING PERMIT OWNER Dennis & Gi TELEPHONE 342-1633 SO. FT. OCC. BUILDING VAL A ION OWNER'S MAILING ADDRESS 1669 Hooker Oak Ave.Chico 95926 CONTRACTOR'S NAME TELEPHONE 2 —26 4CTOR'S CONTR MAILING ADDRESS 13468 Hwy 99, Chico 95926Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 15,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 20.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit tee $ 35.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO.SUBDI VISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome[ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G W @ 15.00 TYPE OF WORK New Addition❑ Remodel❑ Utilities❑ InstallationgJ Other ❑ Describe work: MHI (3 Bedroom) _ low- .F'S rj Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 r�^� Main service 600VOR LESS 18.50 Main service 200ATO1000A1 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check One): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. 2 QS 1-i License No. Classification C % ❑ 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 DWELLING OCCUP.&\ NEW CONST.OR ACDNS. ( / ACC. BLDGS. // 3.6Q sq.ft. NEW NON-RESID CONSTR ULTI.OUTLBRANCH CIRCET ITS @ 5 00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 76 Ex. Occup. OUTLETS PIRESID IREA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring '15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling 9 Hood 6.50 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 a ov mentioned property for inspection purposes. I also agree to save, in m ify and keep harmless the County of Butte against all liabilities ' dgme osts, and expenses which may in any way accrue again ounty i e of the granting of this permit. X �% Z Date signature of Applic t - 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 S 70.00 Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 105.00 HAz 1 0FEES IMP I FLOOD I COF I PARCEL PD 0 ISSUE This permit is hereby issued under the sions of the Butte County Code and/or Work Indic d p4 for which fees R OF PUBLIC By PER IT EXPIRES Date —/g applicable provi- � resolutions to do � have been paid. WORKS Date q7? Receipt No. 122761 WHITE-D.P.W.. YELLOW-ASSCSSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT II COUNTY OF BUTTE - DEPARTMENT OF-PT1'4L�WORKS - BUILDING DIVISITON, 7 COUNTY CENTER DRIVE - Ot OVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541/ PERMIT APPLICATION DATA SHEET ��• (D- OWNER !/(//S l! � � � o. 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 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 Form . ............................................ 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.A466bilehome data and manufacturer's installation instructions, 2 sets. . ff' Fees of $ 1 . Impact fees as shown on attached schedule. .............................. ' 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer ................... 14. Sanitation and plot plan approval 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. .......... . 19. Driveway permit (construction approval required prior to occupancy). ...Pfe_l'gPeaio;,equ�--- 20. Pre -inspection for required. . . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner _) ............ 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 09. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . . 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 yo sue the erp!ItWesp as follows: ! Mer. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date q �� 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 i'snce: (Ci 1. Index permit for above items No. 2. Additional items required: item not checked above). Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date Plans checked by Date Plans approved by � �.- Date Sets of of plans on hold in File cabinet AP folder Copy, - Department of Public Works COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNL9 95965 - TELEPHONE (916)5387541 OWNER l/ 5 C�� C/ (/ A. P. NO. —d PROPOSED BUILDING USE / l� C7 / DATE REC.7 DATE REC I. School Distric Fees (paid at District Office) ,,;....7 2. Sheriff Fees / ( paid at Building Department) R //� Residential ... .....Z _x unit amt. Commercial(per sq.ft.) X =$ sq.ft. amt. .3. Urban Area Fees (paid at Building Department Residential (per unit) X 4 Ir units amt. Commerical(per se -ft.) X =$ sq.ft. amt. 4. Recreation District Fees (paid at District Office) 5. Drainage District Fees (Contact Land Development) 6. Other 7. 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 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 9161538-7541 APPLICATION AND PERMIT ASSESSOR EL NUM R _ zONIN O]� — 3 BUILDING PERMIT OWNER/ 'q ELEPHONE D S GIG l//S �jILA 33 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRE CID N T R AC T0R *S A� TELEPHONE �AI CTRA TRACTOR LIN DORES/S a,— Z Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS (Jfj U Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap I 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 1 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehor Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installatioa� Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions Of Chapt. 9, Div. 3 of the Business and Professions Code and my license is In full force and effect. License No. Classification ElI, 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 Main service 200ATO1o00A) 37.50 OCCUP.✓y\ NEW CONST, / DWELLING OR AODNS. ACC. SLOGS. // l 3.6itsq.ft. NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC ITS @ 5.00 /POWER APPARATUS e I SINGLE OUTLET CIR. EX. OCcup(OUTLETS OR FIXTURES 20 760 FIXED APPLNS. Ex. Occup. OU LETS RESID )REA.) I 3.00 Temporary service 15.00 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. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling g Hood 6.50 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 iny way accrue against said County in consequence of the granting of this perm t. X Date 0 v 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. �n] Mobile Home Installation Fee $ �r v Energy Inspection Fee $ ` OCC CONST TYPE TOTAL FEES D O� HAz 0FEES IMP FL000 CDF PARCEL PD HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC BY PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. Z� Z& � WNITC-D.P.W., YELLOW-ASD[SSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT BUTTE COUNTY SCHOOLS IMPACT FEE.CERTI"ICAT-ION FORM - (One Form Per Building) School District— _ 4Q Building Depantment No. -0/3 Jurisdiction City A.P. Number Property Owner V -7 Property Location/Address Lot No. Subdivison Footags. Residential Development Sq No. of bVing MHi Addition roup Units Sq. Footage Commerciallindustrial =J (Including Exterior New Addition Roofed Areas) Repro t r 560 ing Depardt 61, Ana r e by District identification No. School Dtifi istrict cei, es that -6.6cv- (AppIcant) umber) (Street Address) (City) (State) p code) by payrnent of $ , has complied with the requirements of FAesO*urlcn No. e. feet, representing squar Dat District Personnel) school ePresentative Data Paid by check Nurnber -67 Bank Number Paid by Cash if, subsequent to thQ SchOot Distrix tAepre,;entative signingJthis Butte County Schcals Impact I -Ge Cet-tification Form, the School District Is notified by the applicable Local Planning Agency that this project Is being reviewed under the California Environmental Quality Act (CF -QA), this project may be subject to �.-Lje the Vs schools. , its im t on he s0hool distric additional school fees to full MW White (applicant), Yellow (bufliding department), Pink (school district) jeeformmkl (4192) teL2Z-t729 T 6 •0--1 301.'%13' 3 W 0 H 3 -1 I:; -r ID W 9 V : 0 T F1 H 1 :7G I - d 3 S Al. . - � �l vT 725 Scare ,t'�.��.r: ;✓ :-mea---�.-•_ :�•.,. 6 A. 1 -id) A 72f3��ec d. �ot� , 9i0 asap 2 3$ L x7" 0 ) OAR Location of structures & equipment shall be as shown` A permit wil—I b reauirect for thF & dear of ag@mss installation of the mobilehome. I MY. St c>—g yjqRP 126M\C> /a0 7A NX Thio On Of Pima aw kept on the job at all ttmee MM bs � make arty abanges or altera o2t� tam I elY� 0 Works. Gbuat�y of samg a'am Lb D t otP11b1>tip nj ErOUS � L>F 2/0 am an M�saS & W0 r p s Be In w IiUTrE COUNTY &Matdauft w= P&soognized c�oaa Pra Uow wid i of QuaU y Pres*rgvd for the 8pecMed use 3UILDING DEPARTMENT I - in the Unfform Buuding, Plumbing & MsahankW Pow Oodanal the Natlor a a Bleatrioal Coale. se i✓n e APPROVED DP OD 3o s9 A414u av r1t.F i c.. i �e `C C. .:T •l• +tee pay R r + a 1 ' 1 5r � f 1 R a ra •r .i t' Com` C . Y W i3 i c.. i pay R r + a 1 ' 1 5r � f 1 R ra . Y i c.. pay R 5r � f 1 R 1. Owner's Name: 2 3 BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541 MOBILEHOME INSTALLATION SHEET . - '4 i9 i A[/1 S - . – Installer's Name: AAS Is the site currently under permit? Yes ® No (If yes, furnish permit number 9 a / ) OR Is the site an existing site? . Yes No IN (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes No F-1 (If no, clarify 5. What is the mobilehome electrical rating? --------------- Amps 6. What is the mobilehome site service rating? ------------- 7 0-0 Amps 7. What is the mobilehome site circuit breaker rating? ----- t D-0 Amps 8. Is there any other electric load to be served by the mobilehome site service? -------------------------------- Yes (If yes, identify the,,load and size: (Load) 9. What is the mobilehome site gas pipe size? -------------- 10. What is the type of gas service? ------------------- Natural El 11. What is the gas pipe length from meter or tank to the No (E4 —(Amps) (in.) LPG 2] mobilehome?--------------------------------------------- (ft.) (D12. What is the mobilehome gas demand? ---------------------- (BTU) *(This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) TV IDN �r �� NOB11 EHOME SUPPORT DATA If other than single wide, -4.40)-AlQ Z Mobilehome Mfr. furnish Setup Mcdel No. 01CAt 2,ZDO Year 1 Width Z 6 (ft.) Box LengthG76 (ft.) Tagalong or Expando Size ft. x ft. On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). FOOTINGS (check one 4Xl. Wood -pressure treated or foundation grade.2. Other (specify) � SUPPORTS (check one) 1. Concrete block. F-1 2. Other (specify) Pier Footing Sizes and Locations SINGLE -WIDE Main Beams I,ne 2 — ---- — — — � Main Beams — — — — — — — Tag or Triple � to na L• Line 1 Line 1 Piers: Line 1 Ooeninsts: Size -Min- ------------ „ Size -Min. ------------------ j'L ,x2 Spacing -Max.- -"-"--- _ Each Side of Openings From Ends -Max. ----- With Width Over --------- Line 2 Piers: Line 3 Piers: (Under Bearing Wall Only) Size -Min- ------------ Z 11 1 Size -Min ------------------- Spacing -Max---------- 11 Spacing -Max .--------------- _ From Ends -Max.------- From Ends -Max.------------ Line 3 Roof Loads: Size -Min - ------------ I Z..x C Ilx 3011 11X 'y� Location (From Front) Line 4 Piers: Line 5 Piers: (Under Bearing Walls Only Size -Min.------------ „ Size -Min ------------------- Spacing-Max ---------- ------------------Spacing-Max.--------- , ,1 Spacing -Max.-------- ------- ' From Ends -Max.------ From Ends -Max .----------- e 5 Roof Wads: Size -Min. ------------ x Location (From Front) rA 6 '• •lI _ / COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. / 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 ' APPLICATION AND PERMIT /-A ASSESSOR PARCEL NUMBER ZO NG 039-290-013 BUILD ERMIT OWNER . Stan L. Graves/ TELEPHONE 342-1633 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 4439 Dayton West, Chico 95928 - CONTF-" --• TELEPHONE Owner CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 20.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 20.00 PLUMBING PERMIT Filing Fee 15.00 4451 Dayton West Rd., CHico Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 SF ❑ Duplex❑ MobilehomeE Other Mobile Home S I G I W @ 15.00 45.00 SPECIFY TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti Iities ® Installation❑ Other ❑ Permit Fee $ 60,00 Describe work: (3 Bedroom) MHU _ Contractor ( 44 ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 18.50 Main service 200A TO 1000A) 37.50 CONTRACTORS LICENSE LAW NEW CONST./ DWELLING OCCUP.61 ( 3.6asq.ft. I declare under penalty of perjury (check one): OR ADDNS. ACC, BLDGS. NEW CONSTR ULT' -OUTLET @ 5.00 ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business NO N•RES'D BRANCH CIRCUITS POWER APPARATUS hSINGLE and Professions Code and my license Is In full force and effect. (OUTLET CIR. License No. Classification Ex. Occup(OUTLETS OR FIXTURES 20 76 I, as the owner, or my employees with wages as their sole compen- FIXED APPLN S. OR Ex. Occup. OUTLETTSS (RESID.) EA.) � 3.00 sation, will do the work,and the structure is not intended or offered Temporary service 15.00 for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- Mobile Home Facilities 15.001 15,00 ors. (Sec. 7044) Misc. Wiring g '15.00 ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ 48-50 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 15.00 ❑ The permit is for $100.00 (valuation) or less. Heating r I have placed on file with the County of Butte Building Department u a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. Cooling g I shall not employ any person in any manner so as to become subject Hood 6.50 yam. to the W. C. laws of California. Ventilation 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 Permit Fee $ provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Energy Inspection Fee $ Butte to enter upo the above-mentioned property for inspection purposes. occ CONST TYPE I also agree to ve, indemnify and keep harmless the County of Butte against TOTAL E $ 1/8. 5 all liabilities udgments, costs, n expenses which may in any way accrue HAz DFEES IMP FLO CDF PAR O HO 'ss agai st ai ounty in consequ ce of the granting of this permit. X- DateSigna This permit is hereby issued under the applicable provi- ur of licant - Ownrsions ❑ Contractor❑ AgeAn el of the Butte County Code and/or resolutions to do OSHA ons over 5'0" deep an or construct- work indicated above for which fees have been paid. ion of strucurestoverr39storiesoinehe ghtt DIFIECTPR OF PUBLIC WORKS Receipt No. 122708 By Date7-,? - 9 PE T XPIRES Date �- p _9 q WHITC-D.P.W., YELLOW-A55E9sOR, PINK -INSPECTOR, GOLDENROD -APPLICANT —�{—yJ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95885 - Telephone: 9113.'538-7541 APPLICATION AND PERMIT PERMIT NO. .„"M%7- ?, - -` O/ZONINGBUILDING PERMIT OWNER LtPHONE SO. FT. OCC. BUILDING VALUATION MAIL_ ING OREss jir \L L J . - NTRAC .OR'S AM / „/=� fi:L PNo C� V C6RACTOR• M SIN ODRESs l/�f� l7� Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 1 LENDER'S MAILING AOORESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ o. d Energy Plan Checking Fee $ ARCHITECT OR ENGINEER -3 MAILING ADORE33' Penalty $ BUILDING AOOR S Permit fee PLUMBING PERMIT Filing Fee 15.00 E ach Trap 5.00 Solar or heat pump water heater 20.00 LOT NO.. SUBDIVISION NAME PARCEL MAP Water piping . 7.00 Each oas water heater or vent 7.00 US OF STRUCTURE ' Gas piping system 1 - 5 outlets 5.00 SF ❑ Duplex❑ Mobilehom Other Building sewer 15.001 SPECI FY Mobile Home S I G @ 1.5.00 TYPE OF WORK New ❑ Addition ❑ Remodel Utt�llitie Instailation❑ Other ❑ Permit Fee $ Q 69 Describe work' Contractor ELECTRICAL PERMIT Filing Fee 15.00 . • Main service 2600V 00A OR LESS 200A OR LESS 18.50 Main -service 200ATO1000AI 37.501 CONTRACTORS LICENSE LAW NEW CONST. / OWELLING OCCUP.3) 3.64 sa.tt. I declare under penalty of perjury (check one): OR AOONS. 1 ACC. SLOGS. vEW CONSTF. ' UL.I.OUTLET 'ITS @ Soo ❑ 1 am licensed under provisions of Chapt. 9. Div. 3 of the Business NON.RSSIO BRANCH r'IRC POWER APPARATUS d ) and Professions Code and my license is in full force and effect. SINGLE OUTLET CIR. 1 License No. Classification Ex. OCCUp(OUTLETS OR FIXTURES 20 76d 1 RA 17I, as the owner, or my employees with wages as their sole compen- Ex. Occup. OU LETS (RE51FIXED APL S.0 pEA.) 1 3.001 sation, will do the work,and the structure Is not intended or offered Temporary service 1 15.00 for sale. (Sec. 7044) Mobile Home Facilities 15.00 ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) Misc. Wiring 15.00 ❑ I am exempt under Sec. Business and Professions Code •_- -------- I Os....lf Cum ! I / 7 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. (J 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. 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 wV accrue against said County in consequence of the granting of this�71�/# � X Date Signature of Applicant — Owner Contractor ❑ . Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct. :on of structures over 3 stones .n height. Receipt No. / 61< - tt•a.P.W., YCLLaw.nee -.%K•."sPtc Taw. aaLocmaoo_AP-LIcAMT Contractor MECHANICAL PERMIT Filing Fee 15.00 r Heatlna I I Cooling Hood Venti lation Permit Fee Contractor S Mobile Home Installation Fee $ Energy Inspection Fee $ o« I CONjT TYPt i I TOTAL FEE $ 6.50 This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date COUNTY OF BUTTE - Department of Public,Works 7 County Canter' Drive, Oroville,,CA 95965 OWNER -BUILDER VERIFICATION Attention Property Owner: Phone: 916-538-7541 An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) Lyzaz 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Property Owner - Social Security Num Date /,,)I NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. August 3, 1992 To Whom It May Concern: COUNTY 0� aL'TT BUILDING CEPT AUG 0 4 1992 Gigi (Gisele) M. and Dennis C. Davis have our permission to obtain necessary permits for new construction on our property on the West end of Dayton West Rd., Section 29, Township 21. Signed: Mary E.' raves r , ^rd„`+'.. �t'a., d� , �� i ,r�r.+•hatw�'�Ii��ti�w.'T+ �af�nS}-'-f ...r,.. _ �...i-r.�z'v,r�l'1 ..w C11 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER `� G��/ A. o. 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 BY 1 1 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 Form . ........................................... . 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 and manufacturer's installation instructions, 2 sets. ........... 10. Fees of$ .......................................... W 'pact fees as shown on attached schedule . .............................. lifornia Department of Forestry plan approval/fees......................... ood elevation letter (100 year flood by C fornia Engineer..nitation and plot plan approv / C Health Department . ............ty of Chico plumbing permit-!'. . ...... ermit.!''...................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ......... 1 Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. ... ... . Pre -Inspection reque-s 20. Pre -inspection for required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner _) . ........... 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 permit rocess as follows: Ma'I owner. Mail to contractor. Telephon and hold for pickup at,”,H office. Deliver with inspector. Other Parcel Creation�� Acreage Applicant Date 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 _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter y Date Plans checked by Date Plans approved by Date Z Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works Planning. Department AUG 4 1992 AGRICULTURAL AFFIDAVIT OroVille, California El LPLOYER/EMFLOYEE Please read the following carefully before signing: Section 241-21.2 Agriculture Employer/Employee (Applicable only in zones A-5, A-10, A-20, A-40 and A-160) An individual who verified, by personal affidavit and by affidavit of his employer, that he is, or will be, employed at least thirty- two (32) hours per week for at least sixteen (16) weeks per year, or'that his primary source of annual income is, or is anticipated to be, derived from, any of the following described occupations: (a) The preparation, care and treatment of farm land, pipelines or ditches, including leveling for agricultural purposes, plowing, discing and fertilizing the soil; (b) The sowing and planting of any agricultural or horticultural commodity; (c) The care of any agricultural or horticultural.commodity. As used in this subdivision, "care" includes, but is not limited to, cultivation, irrigation, weed control, thinning, heating, pruning, or tieing, fumigating, spraying and dusting; (d) _The harvesting of any agricultural or horticultural commodity including, but not limited to, picking, cutting, thrashing, mowing, knocking off, field chopping, bunching, baling, balling, field packing, and placing in field containers or in the ve- hicle in which the commodity will be hauled on the farm or to the place of first processing; (e) The assembly and storage of any agricultural or horticultural commodity including, but not limited to, loading, roadsiding, banking, stacking, binning and piling; (f) The raising, feeding and management of livestock, fur -bearing animals, fish, -frogs and other aquatic animals, and bees in- cluding, but not limited to, herding, housing, hatching, milking, shearing, handling eggs and extracting honey; (g) The operation, conservation, improvement or maintenance.of such farm and its tools and equipment. AGRICULLJRAL AFFIDAVIT E: ITLOYEP Employer. Stanley L. & Mary Graves Phone 342-1633 Employer's Address (Present) 4439 Dayton West Rd., Chico, CA 95928 Name of Owner Stanley L. & Mary E. Graves Owner's Address 4439 Dayton West Rd., Chico, CA 95928 Owner's Assessor's Parcel No. 039-29-13 Building/Environmental Health Permit Description and Number Date Issued By Planning Department Approval: Date -1 e2-- 9"2- Zone A P H 0 Dwelling on AP#, Q39-2�'iC�� 0313 I? , do declare, subject to the penalty of perjury, that I am the employer of Dennis --C. Davis --- address (present) 4451 Dayton West Rd.-, Chinn on AP# 039-29-13 and that I will be employer under Section 24-21.2 for at least a to 9) - thirty-two (32) hours per week for at least sixteen (16) weeks per year on AF -tut --239-29-13 Signed , Ci Da -led AGRICULTURAL AFFIDAVIT E? PLOYEE Employee Dennis C. Davis Phone 342-163.3 Employee's Address (Present) 4451 Dayton West Rd. Name of Owner Stanley L. Graves Owner's Address 4439 bay -ton West Rd., Chico, CA 95928 Owner's Assessor's Parcel No. 039-29-13 Building/Environmental Health Permit Description and Number. Date Issued By Planning Department Approval: Date O- P�2- 92 Zone 4-4Z) Dwelling on AP# 039 -2°f Q-0 I, Dennis C. Davis , do declare, subject to the penalty of perjury, that—I am the employee of Stanley L. Graves address (present) 4439 Dayton West Rd., Chico, CA on AP# 039-29-13 and that I will be employed under Section 24-21.2 .for at least a to g thirty-two (32) hours per week for at least sixteen_ (16) weeks per year on APS 039 - 29 - 13 Signed Dated Se A TO Buildific Department FROM: Environmental Health SUBJECT: Sanitation'Clearance Owner Loc tion AP# Plan Approved for: Sewaqe Disposal Water Supply Fold final for: Water Supply Final clearance O.S. for: Water Supply Clearance for 3 bedroom mobile home. OtherGY�11 l�� _ 8-z�-�z Sanita-rian Date I Ot'', I I Q0 L — 11P I1 I QILLLJJJJI DINING 1 1 KITCHEN UTILI00 BEDROOM 6525 *6024 ROOM II11' a" LJ No.2 1 t' 4"3 BEDROOM =� �EMENPFF IWAliNNNEN11' 2" CENTER L— KITCHEN I I SNACK BAR • 2 23'.8"' I CATHEDRAL CEIEING NITCHENIOININGNVING ROOM GIC BATHS - CATHEDRAL CEILIN(, MASTER BEDROOM I LIVING ROOM 1 ••i 20 SQ. FT.) No. , 1 26' 0" � BEDROOM No. 3 I I I I I I --1 I n APf Vi 6w -� butte u� OVAL TUB ,„I . o o I II C �l iT UTILITY I I II 2200) * 56 / O� 10'•KITCHEN I II DINING VViI ROOM FAMILY ROOM B 8" L11 \ 3 BEDROOM CENTER KITC N ---- —' SNACK BARMNTPt FAMILY ROOM 2 zs'• 6' CATHEDRAL CEILING BATHS • \� \ i cTO YO LIVN10 ROOM ------ CATHEDRAL CEILING MASTER 1,437 SQ. FT.) BEDROOM LIVING ROOM BEDROOM O BEDROOM No. 1 16' 0" N0.3 A No. 2 3s�s-a ,a• 2., a0 j . , NKIOL FESS s �C�nA dC� yrs O. S3344-5 00 — ------------- 0 jI I DINING I B ROOM KITCHEN UTILITY TY A O 10% 8" l' a. BEDROOM No.2P9$ UrFN2201N *6026 1 3 BEDROOM t CENTER KITCHENI °"NTPV 25' 6"' avI SNACK BARCATHEDRAL CEILING rLOPTTEPTAIN.ENT CENiE MR, TIt[HENIOININGILIVING POO. DEN • 2 BATHS ' MASTER —� BEDROOM CATHEDRAL No. , I , CEILING ,a 0 LIVING ROOM II I BEDROOM (1.539 SQ. FT.) 20' 0' I t0E8.. i No.3 I ,5 a.. 'tkR 4�YA tf -2,ci L�,' II I I O© to DPW AGRICULTURAL STAM1ENT OF ACKNOWLEDGEi` NT 92-34989 _R.etu%rn FOR RESIDENTIAL DEVELOPMENT Sectpn 26-8.1 of the Butte County. Code requires this acknowledgement be iecorded prior to issuance of a building permit. 1 c)2.-034989 1 Rec Fee The property described herein is adjacent 1 Check to land or included within an area zoned for agricultural purposes, and residents Recorded 1 of this property may be subject to incon- Official Records I veniences or discomfort arising from the County Of 1 use of agricultural chemicals, including, Butte 1 but not limited to herbicides, pesticides, Candace J. Grubbs 1 and fertilizers; and from the pursuit Recorder 1 PUBL. of agricultural operations including, 2 a 54pm 4 -Aug -92 1 5.00 5.00 XX 1 but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property.- situate in the County of Butte, State of California, described as follows: The West half of the East half of the the Southwest quarter of the Northwest quarter of Section 29, Township 21 North, Range 1 East, M.D.B. & M., if Section lines were produced. EXCEPTING THEREFROM, one-third of all minerals in, on or under said parcel as reserved in the deed from Walter B. Var_nes to L eN;,i A. Ben.oi_t, -.t 1tx, rPcorrl.,-H. ()ctohc�r 29 ., 1.9AR in Book 486 of Official Records, at page 67. Date: 8/3/92 PROPERTY OWNERS: Stanley L. Graves or Mary E. Graves State of CA ) On this the 3RD day of August 1992 before me, the SS. undersigned Notary Public, personally appeared County of BUTTE ) ------------------- OFFICIAL NOTARY SEAL ELIZABETH A. RIDLEY Notary Public — California r3UTTE COUNTY My Comm Expires OCT 14,1994 V RP Ry Mary E Graves Personally known to me. F1 Proved to me on the basis of satisfactory evidence. to be the person(s) whose name(s) subscribed to the within instrument and acknowledged that executed the same for the purpos erein contained. IN WITNESS WHEREOF, I hereunto set my han an fficial^seal. / Present A.P. No. r�3q 13 otary Pubic END OF DOCUMENT 039-29-0-013 92-2679 BPEM GRAVES, Stanley & Mary 4451 Dayton West Rd, Chico �. contr: Dan DAvis rebuild ag worker sf COUNtY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, Callfornla 95885 - Telephone: 916.`538.7541 APPLICATION AND PERMIT PERMIT NO. A5593111OR PARCKL NUM59R ' ZONING A-40 BUILDING PERMIT OWNER Stan Graves TELEPHONE 342-1633 SQ. FT. OCC. BUILDING VALUATION 1,200 R 64,000.00 _ OWNER'S MAIL NG ADDR SS 44 Daton West Rd. Chico 95928 CONTRACTOR' Si NA ME TELEPHONE 894-5317 CONTRACTOR'S MAILING ADDRESS A/ / 1679 N Hooker Oak Ave. Ch co 5 2 J(l6 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation 64,000. 0 Filing Fee $ 15.00 LENDER'S MAILIN ADDRESS Permit Fee $ 435.00 ARCHITECT OR ENGINE -ER LICENSE NO. Plan Checkin Fee $ 217.50 Energy PI Checking Fee $ 20,00 ARCHITECT OR ENGINEER+ MAILING ADDRESS Penalty $ BUILDING ADDRESS Perm fee $ 687,50 PLUMBING PERMIT Filing Fee 15.00 t''� ach Trap 5 5.00 25,00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 7,00 Each qas water heater or vent 1 7.00 7.00 USE OF STRUC URE SFER Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 1 5.00 5,00 Building sewer 11 15.00 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New LX� Addition ❑ Remodel ❑ Utilities ❑ Itallation Other ❑ Describe work: Replace AG Worker SF _ Permit Fee $ 74,00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 0 Main service 200A TO to00A) 37.50 CONTRACTORS LICENSE L 1 declare under penalty of perjury (check one): ❑ I am licensed under provisions of Ch t. 9, Div. 3 of the B iness and Professions Code and my licen a is in full force and a ect. License No. C1 sification ❑ I, as the owner, or my employee with wages as their sole compen- sation, will do the work,and th structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclus' ely contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONST. / DWELLING OCCUPM OR AODNS. l ACC. BLOGS. / 3.64sq.ft. 42.00 NEW CO ISIS ULT' -OUTLET 5 00 NON•RESI BRANCH CIRC ITS @ POWER APPARATUS (SINGLE OUTLET CIR. Ex. Occup(o OR FIXTURES 20 76 dA FIXED A Ex. Occup. OUTLETS (RESID )REA.) 1 3.00 Temporary service 15.00 bile Home Facilities 15.00 Mis �Yirin g 15.00 Permit F $ 75.50 - WORKMENt COMPENSATION INSURANCE I declare under penalty of pey (check one): ❑ The permit is for 00.00 (valuation) or less. ❑ I have placed oA file with the County of Butte Building Department a Certificate Workmen's Compensation Insurance or a Certificate of Consent to/Self-Insure. I shall not ploy any person in any manner so as to become subject to the W. laws of California. Notice to Appiica If after making this statement, should you become subject to the W. C. prov' ions of the Labor Code, you must forthwith comply with such provisions or thA permit shall be deemed revoked. I Contractor MECHA AL PERMIT Filing Fee 15.00 Heating .00 Cooling 1 9,00 9,00 FHood 1 6.50 6,50 Ventilation 2 .50 9.00 Permit Fee $ 48.50 Contractor I certify that have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County Of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemni nd keep harmless the County of Butte against all liab' Iti s, judgments, st ,and expenses which may in any way accrue again ai County in con F0nce of the granting of this permit. - X , Date 2� Si natuA - E]Agent � Applicant re of 9 PP owner Contractor ❑ An OSHA ion of structurestover r39stories oin height ons over 5'0" deep and demolition or construct- Mobile Home Installation Fee S Ener Inspection Fee $ Energy p '\40. 00 /` YPE TOTAL F $ 92 HAz DiEES IMP FL 0 COF PARCE HD SSUE This permit is hereby issued under the ons of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable resolutions have been WORKS Date provi- to do paid. Receipt No. 117788 PC $297.9 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT I I c COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIAA95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET %� !� ,fit �+ OWNER r /�� 7 (:/� C / i VES ,A. -R No. 6 3 7 Proposed Building Use Building Inspector Date 11 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ........................................ Plot plans, 3/4 sets, signed by preparer of plans. ..... omplete plans, 3/4 sets, signed by preparer of plans. e.0 }. .rPA* I./P6... . 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. En ineered truss details and layout in duplicate (required prior to plan check). .... obilehome ata acturer's installation instructions, 2 sets. ........... �• Fees of$ ......................................... 1 Impact fees as shown on attached schedule . .............................. 2. California Department of Forestry plan approval/fees. ....................... . lood elevation letter (100 year flood) by Ca � ornia Engineer. . 14. Sanitation and plot plan approval Health Department . ............� S 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: . ........ AaovEontact Land Development about (A) Improvements (B) Drainage. ........... 9. Driveway permit (construction approval required prior to occupancy). ..io; . Pre -Inspection requeis 20. Pre -inspection for required. to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification).` 22. Certificate of Workmans Compensation Insurance. 23 wner-Builder Verification (Given to owner Mail to owner _) ............ 4. Recorded copy of Agricultural Acknowledgement Statement . ................ . 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 Z� -4f :Z-- ICd When the er i. rocess as follows: Mail too ner. Mail to contractor. elephon3 nd hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date 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 p,p(mit 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*virtail Counter by�ba a �� Contractor, designer, owner, was advised of above required data by _ phone — mail Cou ter by Date Plans checked by Date Plans approved by (L_ Date��Z Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works TO Buildina Department FROM: Environmental Health SUBJECT: Sanitation Clearance -• �Q�� Owner � Location AP# Plan Approved for: Sewaqe Disposal Water Supply L Hold final for: Final clearance O.K. for: Clearance for bedroom .-fie home. Other Water Supply Water Supply RESIDENTIAL PLAN CHECKING GUIDE 8/91 (S.F., DUPLEX & MISC. ONLY) q �- Bldg. Permit # OWNER C.7fzAVES - A.P. # 39- a - 13 Plan Checker 921L GENER 1. oning requirements: (sideyards and number of permitted living units). 2. Valuation. 3�11ans signed by designer. � Proper description of work on application. existing violations on property. Items on data sheet. (W.C., fees, Health, Developer Fees, License law, etc). ar-ded notice of violation. PLOT PLAN 1 1 mplete parcel size and dimensions. 2. Setbacks, sideyards, easements, etc. 3r/ Other buildings or structures. ' rading, fills, drainage. 5': Flood hazard.. Special conditions on creation map, (noise, CDF, fire sprinklers, non-comb- ustible, and foundations). FAU & FAS road setback. Building or utilities across lot lines (Record form). FLOOR FLA omplete to scale plan with dimensions. Rquired windows for light and ventilation (Sec. 1205). 3. Re fired windows for second exit (Sec. 1204). ylights (Chapter 34 & Sec. 5207). S'mpact glass (Sec. 5406). i6uired room sizes, ceiling heights (Sec. 1207). 7. GF n baths, garage, kitchen, and exterior outlets (Article 210-8). 8 ight fixtures, switches, receptacles, and exterior receptacles for main - ten rice of mechanical equipment. 9 ocations of water heater, heating and cooling equipment, other electrical or gas equipment. �@. age crew -11, door size, and closer (Sec. 503(d)(3)). 1 1 - 3'0" exterior exit door (sec. 3304 (f). 2— rep and wood stove location, alcoves, and clearance. 1 . S e detectors (Sec. 1210). 1 Plumbing fixtures, water closet clearances and shower size. STRUCTURAL DETAILS 'Y Standard bracing or engineered design (Table 25V) usual shape, size, or split level house requiring lateral design. .tory requiring balloon framing and/or engineering. ree story building requiring engineered calculations and plans. 5[. --Foundation plan complete enough to construct building. oor construction details complete enough to construct building. elevations and wall construction details complete enough to construct building Roof construction details complete enough to construct building. -9:— ep ce construction details and talcs if necessary. 1 13ad!ter ties or bearing ridge beam. 1 Garage door or porch header sizes. 1kStud heights. 1 Adobe soils - special foundation design. 1 Retaining walls requiring design. 1 Special Inspection required. RESIDENTIAL PLAN CHECKING GUIDE MISCELLANEOUS ITEMS TO LOOK OUT FOR - 1 —Steri va-y details: landings, rise and run, head clearance, handrails (Sec. 3306). -2.—Gua-rdtail details (Sec. 1711 & 3306(j) . -31$riek-or stone veneer (Chapter 30). error plaster - weep screeds (Sec. 4706). Proper roof pitch for roof convering (Chapter 32). 64 -Roof covering type - (fire hazard). J. --beam s�sulation - protection. 8K 36" halls and stairways. area over garage - complete 1 -hour separation including supporting walls and posts, etc. exi s on three-story dwellings (sec. 3303 & see 1 Attic access and ventilation (Sec. 3205). 1 rf'ioor access and ventilation (Sec. 2516). 1 . Combustion air for fuel burning appliances - L.P.G. requirements on duplexes. I erg'y design. 1 Flashing at all exterior openings. responsible area requirements. 0 s - 8/91 required on garage side Mezannines - 1716). requirements. COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) CZ 2. I (have/have not) 4eae,,signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) construction: Name Address to provide the proposed Phone Contractors License No. City • 4. I plan to -provide portions of 'this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City _ Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Prope Socia Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California--Health-and Safety Code. This verification must be completed and returned to our office before we are per- mitted t issue the a it. = Point Svstem•Summary: Climate Zone LL_P-2R ��U l S �LC—SI lOCruG� Dace rruiect Title BUILDING DATA North Glass Area c Glass Conditioned Floor Area 12.00 Number of Stories East 'I io_ 1.33 Slab/Raised Floor SLAIh i South l it 3. i Check all applicable Unit Type condition(s): i West 712� (e) 0 [IeSingle Family Detached (SFD) (j Addition Alone Skylight [ [ Single Family Attached (SFA) (j Exisung Building I Total ( [ Multi -Family (IVF) (I Existing -Plus -Addition c%rORF. CARD 1. Ceiling Insulation 2. Wall Insulation 3. Raised Floor Insulation -,. Slab Edge Insulation _. Infiltration 6. Glass Heat Loss 7. Shading (Shade Open) a. North b. East C. South d. West e. Skvlitmt 3. Shading (Shade Closed) a. North b. East c. South d: West c. Skyli(ht t). Interior Thermal Mass 10. Exterior Wall Mass 11. Heating System Zonal Control'.'( Y..' 12. Cooling System Zonal Control'' i Y % N 13. Nater Heating Form Rcvi.ed March 199!4 Measures 310 or R -value C-vaiuc )_ or R -value U-vaiuc I or ,: -vaiuc N 0) [ or R -value Standard P,6 UrgAw Type Glass �e --4p X 11,33 X 3. It X X 3,00 x X .&T C -vaiue ?o Total Giass SC Eff. % GLl'ass a = -7! 1-1 2.- 6q % Glass Sc Eff. % Glass X .75 H -15_ .3 X I,vo 3 �3. X = �•.�� 3.00 X X = Intenor Mass/CPA Extcrior Wall Mass .•-7 g X = SG or I ISPP Duct Effficicncy Effective S1: or IISPI' = SEIR Duct Elficiency EiffectiveS1:I:R Point Scores T bL Point Total: Sum 1-6 A 3 W ....3 Sum 7-10 -t- 13 Gertificaie of Compliance: Residential (Page 1 of 2) CF -1R T)A LA S R -ES i n Ent C,(!E-: lis 19 2- ProjectTitle Date 4 '13 9 D Ary ro N - WOS T- Poi . G H c Project Address ,q /7�.owe5 OCrs' �C)t]� Budding Pemiit # Documentation Author ) l Telephone 5 YS rem I I Checked By /Date PO 1 0-F Compliance Method (Package, Point System or Computer) Climate Zone Enforcement Agency Use Only GENERAL INFORMATION Total Conditioned Floor Area:,`� O ® Building Type: Single Family Hotel/Motel (check one or more) Multi -Family (less than 4 stories) Addition Multi -Family (4 or more stories) Existing -Plus -Addition Front Entry Orientation: East / South / West / All Orientations (circle one or more) Number of Dwelling Units: Q til e Floor Construction Type: Sl */ Raised Floor (circle one or both) Infiltration Control: tand ' ight (circle one) BUILDING SHELL INSULATION Component Insulation Location/Comments Type R -Value (attic, to garage, typical, etc.) Wall .............. Wall .............. Roof ............. Roof ............. -�� -- Floor ............. Floor ............. Slab Edge..... to orals✓ GLAZING Shading Devices Glazing Area Glass Type Interior Exterior Overhang Framing Type Orientation (ssf) (single, double) (roller blind, etc.) (shadescreen, etc.) (es/no) (metal/wood) Front.... Front.... ( ) Left...... (ry) Left...... ( ) Rear..... GS) I Rear..... ( ) Right... (W) Right. Skylight....... - Skylight:...... • ... - _ _ .. _;Y•� _ QSµ _ -- . THERMAL MASS • _ _ -.. _ _ - - -. Type/Covering Area Thickness (slab/exposed tile, etc) (sf) (inches) Location/Description (kitchen, bath, etc.) - '::�'s'.-'v{� ...s. ~ Certificate of Compliance: Residential (Page 2 of 2) CF -1R HVAC SYSTEMS 1,1 /e z - Date Minimum Duct Type (furnace, air Efficiency Location Duct Output Manufacturer/ Model # conditioner, heat numv) (SE. SEER.HSPF) (attic. etc.) R -Value (Btuh) (or aooroved eaual) 16. ®r Wil— . :.� c Maximum Furnace Heating Output: Btuh HOT WATER SYSTEMS Tank Manufacturer/Model # System Type (storage gas. etc.) Capacity (or approved equal) Special Feature(s) R-12 External Blanket On Storage Tank (Yes or No)_ SPECIAL F'EATL'RES/REMARKS (Add extra sheets if necessary) COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to -comply with Title 24, Chapter 2-53 and Title 20, Chapter 2, Subchapter 4, Article 1 of the California Administrative code. This certificate has been signed by the individual with overall design responsibility and the building owner, who shall retain a copy of it and transmit the certificate to any subsequent purchaser of the building. When this certificate of - compliance is submitted for a single building plan to be built in multiple orientations, all building conservation features which vary arc indicated in the Special Features/Remarks section. Designer Name: Title/Firm: Address: Telephone: Lic. #: (signature) (date) Documentation Author Name: Titic/Firm• Address: 0. QO yC 3 ZN D u t24A-ryt , r -A 4.29 3 R Telephone: R9 E -1 o t3R ��•"(9 9i (sig azure)L41—� (date) Revised July 1990 Building Owner Name: Title/Firm: Address: Telephone: (signature) (date) - Enforcement Agency - Name: _ ......_.._ ... Agency: Telephone: (signature or stamp) (date)". • PERMIT NO. 6868e 78B_" _f PERMIT EXPIRES T� OWNER Stanley Graves CONTR. owner UK 39-29-13 ,LOCATION (A.P. S/S Dayton West Rd., app.l mi.W.of Ord Ferry Rd., Durham t 3 i� - 6t6 1771. ri r,. ti 9 t i Temp. Power Pole Called PG&E � Tem. Elec. Serv. f /Called PG&E T mp. Gas Serv. JOB FINALED (Date) All tze� (Signature Footin s COAfi$ BUTTE - DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD EL&CTRIC)kI- BUILDING- ABUILDING (Cont'd) PLUMBING etback Nrewall II Pipin ►ms Pa a ets st Floor ain Bldg. Res oom Finish 2 Floor ootin s Windo s 3rd loor St mwall - Sidin To out Sla Roof She hlnq Water PlAna Piers Roofing Sewer Garage Fdn. Vents Fixtures Footin s Stemwal I Garage Vents Insulation Water Htr. Heaters Slab Car rt Po Footings Slab Prov. for ph slcal handica ed Conformance of ex. structure X Final V Appliances Gas Piping & Test Tem .1 Gas Sanitatlon Patio FIR P ACE Final r Footin s Footing EL&CTRIC)kI- Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam RE SPRINKI ERk Motors Framing Test Water Htr. Stucco Final Subpanels/ Mesh MECHANICAL Grd. FaV6 Prot. Scr ch Heatind Servic B n Cool/ng T p. Pole F nish DuTts nder round In rior Lath entilation Permanent oor Closer Final kinal MOBILEHOIVIE UTILITIES FXj� � ti - -- Elec. Service /L �!'9i7� p Elec. Pedestal Q � Water Piping 1,-,2—If- Sewer —/ Gas Piping 12,i.1 - -7,P E ME INSTALLATION - - - - Support Elec. Continuity J Water Piping Drainage Gas Piping?� DATE REMARKS OR CORRECTIONS �v� y U•(/aC� �`/d d�/c� r �� o Z Y �� G*z rte. xe. s �SsU� Itf 7y� 0 (NOTE: An entry must be made on this form each time you visit the job site.) •MOB ILEHOME INS-TALLAT ION ' INSPECTION CHECK LIST 1. Is the mobilehome located with required' separation from lot lines and buildings and generally conform to plot plan? Yeses No T , 2. Does the mobilehome have required clearances above ground? ('Sec.5085) Yes t --_No I. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5.082 & 5083) Yes k/- o 4. Is the mobilehome level? (Sec. 5088) Yes No 5. If more�t an a single unit, are crossover connections properly installed? (Sec. 5088) Yes 4_�O 6. Water A. . Is flexi.le connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes No B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yesy No C. Backflow - If coach is not State of California approved, does station have backflow device and pressure -relief valve? Yes_ No I A. 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes•//No B. Does it have minimum" per foot slope and is it properly supported? Yesi---N—o' C. Are any leaks detected in drainage system after r •n 3 -gallons of water through each, fixture including washing machine standpipe?..Yes o D. If coach is not State of California approved, does station have required trap and vent? Yes No 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobileh me gas line inlet without reductions other than the mobilehome connector. Yes_ No ,� B. Test OK as per following procedure? Yes V No 1. Open all appliance connector valves. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes No MOBILEHOME DATA Manufacturer and/or Namestyle &OM Length Sc y Width Vehicle Serial No. /0 75- zU'f61-0 State Identification No. 042 lJ FrG �o Additional Information or Comments: 9. Electrical A. Is service large enough to provide adequate amp.era,ge-to mobilehome (must equal rating of rage-to mobilehome with a minimum of 100 amp)'and othe& ties on lot, i.e., water pumps, garage, cabana, etc.? Yes B. Is there proper clearances•around panels? Yes�o_ C. Is power supply cord or feeder assembly properly fused? Yes 1/�o <0 D. Is continuity test satisfactory as per the following procedure? Yes_ 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power -supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the. mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation? 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle &OM Length Sc y Width Vehicle Serial No. /0 75- zU'f61-0 State Identification No. 042 lJ FrG �o Additional Information or Comments: COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 51 under permit number % for the following location: r Owner 4 r Owner's Address Mobilehome Mfg. - Model Year Insignia No. / f / / Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works L / ' Date '! )`'/JY By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS County Center Drive - Orovi Ile, California 95965 Telephone: 534;4541 APPLICATION AND PERMIT A 11//, authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date ignatu of Per/mitee or Agent Receipt No. 1 F` (�y 0 L 0 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant 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. DIRECYOR bF PUBLIC WORKS By Date f Z - 4 ding permit expires Date / Z -- L(- �� BUILDING Owner Vt SQ. FT. OCC. BUILDING VALUATION Mailing Address iy Telephone No. Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address r� 6 _ 5��, W��S Plan Checking Fee&/or Penalty Permit Fee ®end - PLUMBING No. @ FEE 101 PERMIT FILING FEE $3.00 b Each Trap 1.50 Repair drainage or vent piping 1.50 A. P.No. ,+ �'on rj Taning & a Ing Water piping 1.50 , Each gas water heater or vent 1.50 Fk�s 1M'G` So Fire Dept. Fire Zone Use ermit Gas piping system 1 -5 outlets 1.50 , EQA Parking Plans Parcel Declaration Parcel ap 60' R/W Improvem Each additional outlet .30 Building sewer 5.00 , �� Bldg. aFT ns Rec'd PorcefApproval Plans Approval Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES OTHER ❑ Permit Fee $ $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600v OR LESS 100 AMP OR Less 5.00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD•L 100 AMP 2.50 6 OVER Main service OVER 25.00 AMPP OR LESS O Main servlce EA. ADD•L 100 AMP 1.00 NEW CONST.OR ADDNS. ACCLBLDGS.LING CCUP. S+\ 20sq ft // CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name le of: style NEW CONSTR MULTI -OUTLET NON-RESID, ( BRANCH CIRCUITS) 2.50ea NEW CON STR. (POWER APPARATUS 8 NON-RESID. SINGLE OUTLET CIR, EX. OCCUR{OUTLETS OR FIXTIIRES 100 Ex. Occu FIXED APP LNS. OR p• OUTLETS (RESID•) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 4.,jaa- V 1 � I am exempt from the Contractors License Laws of the State of California. Permit Fee $ , Q $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑1 have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 Land Development Fee $ TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date ignatu of Per/mitee or Agent Receipt No. 1 F` (�y 0 L 0 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant 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. DIRECYOR bF PUBLIC WORKS By Date f Z - 4 ding permit expires Date / Z -- L(- �� g CQUINITY OF BUTTE — DEPARTMENT OF PUBLIC WORKS r 7 County Center Drive - Oroville, California 95965 Telephone: 5344541 /� �<i 6' APPLICATION AND PERMIT ^oC_ �./ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X kJ",Jk . UA..,-� (,h Date Signature of Permitee or Agent Receipt No. 1 FrE!V- White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant 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. jai R OF P BLIC WORKS BAZIJ DaatteeA %-/ /7f Building permit expires Date —Z 2 BUILDING Owner G R A vLE S ` 57-AU`E SQ. FT. OCC. BUILDING ALUATION Mai I i ng Address Telephone No. Contractor CL-EN1oNS DAM M06jLe fJoMe- S-Al_GS Mailing Address ,2933 ESNLq AJA 1)= c4,,® Fireplace Total Valuation Telephone No. 3 3-19�Q Permit Fee - Building Address $o�,.rga Plan Checking Fee &/orPenalty Permit Fee PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. 3 .► oning & Planning 0, Zoning Water piping 1.50 Each gas water heater or vent 1.50 It �es swft ttvr I Fire Dept. Fire Zone 'Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 l Bldg. �' Rec'd Parcel royal PI s Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER [0 permit Fee $ $ o�- ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main servic'a eoov OR LESS 100 AMP OR LESS 5.00 Single Family ❑ Duplex ❑ Mobil Home ® Others ❑ Main service EA. ADD'L too AMP 2.50 Main service OvER eoov 25.00 too AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONST. ( DWELING OR ADDNS. ACCLBLDGSCCUP. h� 20sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name st lf: y e o G.L 4c_MOIVS- 0A j11 r ltj oB iL4f 4169KE ,%IG.ES NEW CONSTR. (MULTI -OUTLET 1 NON.RESID BRANCH CIRCUITS! 2.50ea NEWCONSTR. POWER APPARATUS B NON .RESID. SINGLE OUTLET CIR. Ex. Occup{OUTLETS OR FIXTtIRES 5 L�j EO/ FIXED APPLNS. OR x. ccu 2.00 p•\OUTLETS (RESID.) EA) Temporary service 10.00 Mobile Home Facilities 35 3 G 26 License No. Classification �" Misc. Wiring #6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ®I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 e is 3aoc TOTAL PERMIT FEE $-30 ICS authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X kJ",Jk . UA..,-� (,h Date Signature of Permitee or Agent Receipt No. 1 FrE!V- White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant 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. jai R OF P BLIC WORKS BAZIJ DaatteeA %-/ /7f Building permit expires Date —Z 2 MOBILEHOME SUPPORT DATA If other than single wide, Mobilehome Mfr. �G��/K furnish Setup Model No.197&-2V6,-- 3 fti2 Year 1178 ftfiN it- 8017 Width (ft.) Box Length (ft.) Tagalong or Expando Size ft. x ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets'(if not on file with the County of Butte). All center supports measured from -.front of mobilehome unless otherwise specified. Footings (check one) Single n ® 1. Wood either A A pressure treated or +U ,s O �S[x3ty foundation grade. (ft.)(in:) (in.) (in.) El 2. Other (specify) Center support locations - Center support footing sizes Supports (check one)" (in.) 1. Concrete block. 2. Other (specify) (in.) (in.) 4 ---Tagalong or Expando, show support details. r (ft.)(in.) in. in. (2 x3 D -- Typical Support (in.) (in.) Footing Size (ft.)(in.) (in.) (in.) S rr -- Max. Pier Spacing Max. Overhang (ft.) (.in.) BUTTE COUNTY BUILDING DEPARTMENT *If center piers are other than drawn above, APPROVEDp- draw in locations, spacing, and dimensions. e I BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: S'r,4AJ L 4E Y a R AIA Ry 4AV E 9 2. Installer's name: (�LEM0A)S'-&qV1 S f1 0 elLF +OME .SncE_ 5 3. Is the site currently under permit? Yes // No'/ / (If yes, furnish permit number OR Is the site an existing site? Yes / / No 7W (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes -No ( If no, clarify 5. What is the mobilehome electrical rating? ----------------------- / U O Amps 6. What is the mobilehome site service rating? ------------------------ ,2 O 4 Amps 7. What is the mobilehome site.circuit breaker rating? ------------- / o n Amps 8. Is there any other electric load to be served by the mobilehome site service? -----------------------------=--------------------- Yes / / No 4XI (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- 3J!/ (in.) 10. What is the type of gas service? ------------------------------Natural / / LPG / x/ 11. What is the gas pipe length from meter or tank to the mobilehome? /,� (ft.) 12. What is the mobilehome gas demand? ------------------------------ (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) (BTU) COUNTY OF BUTTE — ..DEPARTM&r_7`i OF PUBLIC WORKS ' 7 County Center Drive — Oroville, California 95965 Tel ephlone: 5344541 / APPLICATION AND PERMIT / 1 am exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. IVf I certify that in the performance of the work for which this Ics permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. 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. YX Date Signat4 of Permitee or Agent Receipt No. U 1!3116 70 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Permit Fee $ MECHANICAL No. @ PERMIT FILING FEE $3,00 Heatinq Coolin Ventilation Hood 1 2.00 Permit Fee $ $ Land Development Fee $ TOTAL PERMIT FEE $ 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. CTOR OF P BLIC WORKS By Date z�Z&W_2!9 permit expires Date 7� BUILDING Owner �� SQ. T. OCC. BUILDING VALUATION Mailing Address d (p Tele p one o. 1 3 Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee V r Building Address '— �j Plan Checking Fee &/or Penalty Permit Fee Z PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. �^ '�+ r Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 FW I Fire Dept. I Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 s ec Parcel A roval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER tg Permit Fee $ 'L ELECTRICAL No. @ FEE ry L PERMIT FILING FEE $3.00 600V OR LESS Main service 100 AMP OR LESS 5.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD -L 100 AMP 2.50 Main service OVER e V AMP OR LESS 25,00 Main service EA. ADD'L 100 AMP 1.00 NEW CONSDWELING OR ADDNST ( ACCLBLDGS.CCUP. Y) 20sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: NEW CONSTR BRANCH CIRCUITS) NON.RESID (MULTI BRANCH CIRCUITS) 2.50ea NEW CON STR POWER APPARATUS &, NON-RESID. (SINGLE OUTLET CIR, Ex. OCcuo(OUTLETS OR FIXTURES 011 BAL@1 FIXED APLNS. Ex. Occup.( OUT LETSP(RESID )REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 1 am exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. IVf I certify that in the performance of the work for which this Ics permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. 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. YX Date Signat4 of Permitee or Agent Receipt No. U 1!3116 70 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Permit Fee $ MECHANICAL No. @ PERMIT FILING FEE $3,00 Heatinq Coolin Ventilation Hood 1 2.00 Permit Fee $ $ Land Development Fee $ TOTAL PERMIT FEE $ 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. CTOR OF P BLIC WORKS By Date z�Z&W_2!9 permit expires Date 7� t,2 Re, .7-14:-zin-�50ris P�z*31 N,:2. on which =bi3.*z hom-* is to he loci: ads S ,*. e z -.: -:-MfU"zr b*fo--,a igning: _: . F A, .., -�, zead eIG following vas Section 1.1--d "dac,,zing t-'acilities Unc.IA:d,'A._ng =bila hamas) to accaxn=clata only to I mploveas P- th nd -,L: families rmP1qv_-,nd- by the owner or r- -e 1, -.Or of t17-0 v::C-72i*Mz r*v_4&:;d f urthe r . th at housing ,o,-4i_-L_Ut-v 4-61halt, b ---s .1 zc-zassc:*.- to lzha rte.nt-211ding and shall. to the PrCv"Ision to required yard and open zpac* 1c:'t -_nWal CrdL!i,=CQ ITO. 143.3 O."Natna: GI 7 D P who varif-I eli-St b PaZ:S01.141 I ZYMIUZ EMPLOM-0. An. individual y and bljv a:Z,_F_Idzvit 0? hir, -nm-ployar, that he is, or will ba - ? . r - sk 4.0r. at ezzl, )Z 16 5 p�ar year, or G t hoi, p:2 e.0 prixz�y so,=cz of canual Incomm iz, o1 is, antiCipated to 'Da, frwa, any thle, Zollixwirig dzzcArihed oCCrqan:;:,4.0.nr, I) Th!;,- propanatica, came, and 1--raatme-nt of farm lzuId, pi -lines C_ or. ditchcz, inalud-ing _1_3vsling for agricultural pux7.,osez, pjo-,,jing, discing, and EcrtiI41.3i.ng AChe Eoll;% 2, ?hQ zowing and planting of any agricultural oshorticu,11-tM7_3 . I =.odlty; (3) "Tho c-,ra. of any ag-,icultural or hortiCUltu--al caramodity. As- -,=Q_I in thliz subdiviSion, *Care' includes, but is not limited to, cultivation, ilrrigatio"-, wood. cwntrol, thinning, heating, p-"=-RZ,g- & ly or UaLv:,r, ft=igatllng, pralTb.ag, and dusting; ,!4) Thoma harusating of. aany egric"altural or horticultvral com-=,dityj including but not, 21— mi to, pIcking, cutting, lt_hreshincj, mowing, I -Mocking off, fiald ch-_'1pinq, b�=hing., balingv balling, rLaId paCking, and placing Ln is 23d cantainarz oz in that vall-aic-78 in _ih`ch thr. ba haaaed on tho farm or to the. p? ccs O:z . .6. - p 5) rThIt C'Z euny Agri c-altural 0Ar hortj-U,_I:, ot imitn d to, ica. ding., 'Loads <11ng, king..�zmd pllinq Th -s of liviza-Atoc.k., f, -,r d bG,57, --ing .ash, f! ic,:, and i - t -tar aquatic wximajs, ar, I I-lut not I.Iritzd to,h!.3zding, houaing, hatching, lZilk-1-mg, • _h•- zing 2amne:.1-ing egqn. and nxr-c-tjrg .'13:Cy. IJ Tho 0-porn.`_-ien, im-prov.ament or rAintonanca of an its tools z-.qd Y, -!Oct to n that I raijida at _ - -- - �� o:^� - � pest appl-iad for and_ -a. - t� e appl ca . onj .Oz hou-Se ag f 9.Ci ..hiss . an p -opez dy ; den tiPied in . >gc-:tan 3,' dm! -5 con-22orm to Sact.®n 2,l®d az. idantifiad in Section 4 Cl.,.=i3 appiiva%l= and Agricultvxmaii. Employes as deli 3d, in Ordinance . 0 6�=-i_7. d iiea. sc iaptSoa.o and nu`•9iia/e :a d. . i8 aid • .t 4j4� al'aL y iG± of zma Qf A , r.dzs's l a M_vn ourch"od primo is to b iocatod.: r read the following cau�fully b�nforc signing: (AgriCU_'? tn=2.) ReTalat':"as_s ; SacA:on 2.1-d c1lo-i : ado ra3:�.ing s trCl,l it.J@Z Unc2 rd -In g = ila ham-na, to acc �c%ia ar1Ay An taas^1.►z.� fa- dies 1zmP1gyv-d lay the cwner oy:' . cpg �Myor of th pry �e�so and rrQ idad further that Lucia housing. facility shall be c��sid d zC=3So -- to the nein t dl Gana and, shall. corq:,_-T-A to ih ; P= isian pewtalias�.ng :'.o required, yard and. 'open. spaco for d�hlbngsn G:: d4'n =ca Na. 1433 stastoa : "1. • :'t AGR1CU ,'.6 .?1Z FiFLOM ME: A--.% a d`?divi duals who va Pifics , by pap zonal '�!'U- Sv t mod by ay43dawi,t oil his wa1oyer, that 2 as, or will ba; p2 Y,70d at. least 3' ho*mss p°3r wazk. fo: at leant 16 �a�e3:s per year, or. ''.: n�t "14 a primo wy Source of annuz". incomm iz, or 4.3 anticipated to b2, da -.,173d fr=, ray of the ZV11+cwing dsycribed occvpations : 363 b11 --s- _prwpa=Uon, c =-rz, and treatment of.. b8 = land, J)iCT"" lvne 1 , or. ditches, innludlasg lavel3rg for ag;;icultural purposes, plojj ng, discing, and i'ortil•i,zi g the soil; (2) Thcs sowing and pl :.,ti.�ag.•of any agricultural or horticul,.taza.1 cadi dt ; (3) The corn of -any aq icultural or horticultural -c®mrr:odity.. As �t ed in his zRbdivizion, *sera' includes, but is not limited to, cultivat an, Kira .oma, woed control, thinning, heating, Pruning; or ricinT, f=�.gati,ng, pr yiz-g, and dusting; M Tap harvesting of .Mny ag-4-Taltural or horticultural cora odity,, including bur nateliribnd to, picking, cutting, threshing, =wing, brio :ising off, fi,ald chappd .:g, b<;r_.^.hinq, baling, balling, gild packing, and placing La rued cGntai rifle 3 or in the -vehicle in which th'z: cc ;3ity will ba lhaai ad on the farm or 'to the place of 45) ii?• =;zcr-7-ily 9.d as a^.d ag.ic-altural or horticul- tural iac1;:_U=6-.g huvlt. not limited .iso, lcading; rroad~id;n ^_: ing r` 's+ bin : g- z?: L' .lig; �s j, ,baa:_....g, b n_s, G� �e F -A 1CJ�'+'Si`.t'�Tlt cis 1i4f�'iL"�tvt'.I , gi3B. h �— ng ?._*�11�iT:'ems, �h, frO�� and t::�s:Sr aquatic a_nizals, and bae. s�1C�`iil• a.'.< l.�li!' ii�tb. �yTi'; is L:/'i tflp lz�l�dy housing, t1Y�:Ct:1i .�, �� milking, .hz.- inq, reneging egS=3 , and cr. ,ac -ting honey. =:ars: tion, "�s cr=9a �.eni imn_oVaMeat or zLAlntananee of an -1 ac;UIp:�t." w r - of' Wsriury, 'that 1 raside at and that the p✓rvit app' ied for undsr this application, Cor housing facllitlss on property idantif ed'in Section 2, dms conforn. to Section 2.1-4. as idontifiod in Section 4 Of thl s - applic atic-n and Agricultitaa'i -I=playee as d.£; nad in Ordinwca No. 1439. 6 Pormid and numbsjr Data issued By �,i, - - R x \ 1 - 1. Ceiling Insulation 2. Wall Insulation Single- Number of stories Number of stories R -value One Two Three R-0 -103 49 32 R-19 8 -4 -2 R-30 -2 -1 -1 R38 0 0 0 U -value 8 6 4 0.50 =176 -84 -54 0.30 -102 -49 32 0.10 -26 -13 8 0.08 -18 -9 -6 0.06 -11 -5 -4 0.04 -4 -2 -1 0.02 4 2 1 0.00 11 5 3 2. Wall Insulation 3. Raised Floor Insolation Insulation In Floor Single- Single - Number of stories R -value Family Family Multi - R -value Detached Attached Family R-0 -68 -51 -34 R-11 0 0 0 R-13 2 2 1 R-19 8 6 4 U -value -144 -70 -46 0.80 -153 -114 -76 0.50 -91 88 -46 0.30 -47 -36 -24 0.10 0 0 0 0.08 4 3 2 0.06 9 7 5 0.04 14 11 7 0.02 19 14 10 0.00 24 18 12 3. Raised Floor Insolation Insulation In Floor Controlled Ventilation Crawlspace -4 Number of stories Number of stories R -value One Two Three R-0 -17 8 -5 R-11 -3 -2 -1 R-19 0 0 0 R-30 3 1 1 U -value 4. Slab Edge Insulation 4 12 0.60 -144 -70 -46 0.50 -120 -58 38 0.40 -95 -46 30 0.30 89 -34 -22 0.20 -43 -21 -14 0.10 -17 -8 -5 0.08 -11 -6 -4 0.06 -6 -3 -2 0.04 -1 0 0 0.02 4 2 1 0.00 10 5 3 Controlled Ventilation Crawlspace -4 3 -1 Number of stories -1 R -value One Two Three R-0 -11 -7 -5 R-5 -4 -4 3 R-11 -2 -2 -2 R-19 -1 -2 -2 4. Slab Edge Insulation 4 12 - Number of Stories -20 R -value One Two Three R-0 0 0 0 R-5 8 5 2 R-7 8 6 .3 F2 factor 0.90 -4 3 -1 0.80 -1 -i 0 0.70 2 2 1 0.60 6 4 2 0.50 9 6 3 0.40 12 8 4 S. Infiltration (Air Leakage) specification Paints Standard 0 ,6. Glass Heat Loss I Total U -value IPercent .51 to .41 to .31 to 0.30 or Glass Single Double .60 .50 .40 less 50 -121 -53 -39 -24 -10 4 40 -90 37 -26 -14 3 8 35 -75 -29 -19 -9 1 10 30 81 -21 -13 -4 4 12 29 -58 -20 -12 -3 5 12 28 -55 -18 -10 -2 5 13 27 -52 -17 -9 -2 6 13 26 -49 -15 -8 -1 7 14 25 -46 -14 -7 0 7 14 24 -43 -12 -5 1 8 14 23 -40 -11 -4 2 8 15 22 -37 -9 3 3 9 15 21 -34 -7 -2 4 10 15 20 31 -6 0 5 10 16 19 -29 -4 1 6 11 16 18 -26 -3 2 7 12 16 17 -23 -1 3 8 12 17 16 -20 0 4 9 13 17 15 -17 1 6 10 14 17 14 -14 - 3 7 10 14 18 13 -12 4 8 11 15 18 12 -9 6 9 12 15 19 11 -6 7 10 13 16 19 10 3 9 11 14 17 19 9 -1 10 13 15 17 20 8 2 12 14 16 18 20 7. Shading (Shade Open) EReetive Pes t Glass (percent slam x SC) Effective Sugle- Slab Floor Fdfecdve Pecertt Glass Mass Family %Glass North East South :West Skylight 18 5 1 4 1 na 16 4 2 5 1 na 14 4 2 5 1 na_ 12 3 3 5 2 na 11 3 3 5 2 na 10 2 3 5 2 1 9 2 3 5 2 2 8 2 3 5 2 2 7 1 3 4 2 2 6 1 3 4 2 3 5 � -4. 6 3 -11 4 -14 2 3 1 3 3 0 1 Z -6 3 2 0 0� / 1 -4 3 1 -1 .,, -1 -1 -1 2 0 -1 -2 -4 -2 0 na = not allowed 1 -4 0 2 lB. Shading (Shade Closed) Sugle- Slab Floor Fdfecdve Pecertt Glass Mass Family (percent Haas x SC) Mass Effeclive Attached /CFA One Two Three lilacs NoM East South West SIWWI 18 -14 -48 -69 -64 na 16 -12 -42 59 -55 na 14 -10 -35 -50 -46 nor 12 8 -29 -40 -37 na 11 -7 -26 -36 -33 na 10 8 -23 -31 -29 -74 9 -5 -20 -27 -25 -65 8 -5 -17 -23 -21.. -56 7 -4 -14 -19 -18 -4. 6 3 -11 -15 -14 38 5 -2 -9 -1t -10 -30 4 -1 -6 8 -7 -23 3 0 -4 -5 -4 -16 2 1 -1 9 3.5 -9 1 1 1 1 1 -4 0 2 3 4 3 0 na - not allowed 3 7 8 10 9. Interior Thermal Mass Interior Sugle- Slab Floor Raised Floor Mass Family Stories Multi Mass Stories Attached /CFA One Two Three one Two Three 0.0 -8 5 -4 -2 -1 -1 0.1 -8 -5 -3 -1 0 0 0.3 -7 -4 -2 0 1 1 0.5 -6 3 -1 1 1 2 0.7 -5 -2 -1 1 2 2 i 0.9 -5 -1 0 2 3 - '3 1.1 -4 -1 1 3 4 4 1.3 -3 0 2 3 4 5 1.5 -3 1 2 4 5 5 2.0 -1 2 4 5 6 7 2.5 0 3 5 7 7 8 3.0 1 4 6 8 8 9 3.5 2 5 7 9 9 10 4.0 3 6 8 9 10 10 4.5 3 7 8 10 11 11 5.0 4 7 9 11 12 12 5.5 5 8 9 11 12 12 6.0 5 8 10 12 13 13 6.5 6 9 10 12 13 13 7.0 6 9 11 13 13 14 7.5 6 10 11 13 14 14 8.0 7 10 11 13 14 14 8.5 7 10 12 13 14 15 10. Exterior Wall Thermal Mass Exterior Wall Sugle- Sirgle- Sum of 14 R -value 119] U -value [0.037] Family Family Multi Mass Detached Attached Famly 0.00 0 0 0 0.20 0.40 3 5 2 4 1 3 0,60 8 6 4 0.80 1.00 10 13 8 10 5 7 1.20 13 12 8 1.40 1.60 12 10 13 13 9 11 . . 1.80 10 12 12 200 10 11 13 11. Heating System SE or HSPF (assumes ducts In aide) 0.90 8.25 32 28 24 20 17 13 1.00 9.17 37 32 28 24 19 15 Zonal Control Adjustment System Type Resistance 10 9 7 6 4 3 Other 6 5 4 3 2 2 12. Cooling Sywm No Cooling System Installed SEER Sum of 14 R -value 119] U -value [0.037] X 4. Slab Edge Insulation (assume, duets In attic) -25 or -24 to -14 to -4 to +6 to 16 or SE HSPF less -15 -5 +51- +15 more 0.72 6.60 0 0 0 0 0 0 0.75 6.88 3 3 3 2 2 1 0.80 .7.33 8 7 6 5 4 •3 0.85 7.79 13 11 10 8 7 5 0.90 8.25 17 15 13 11 9 '"7 f 0.95 8.71 _ 20 18 "" 15_ 13 11 8 9 7 6 4 Effective SE or HSPF 120 15 (SE or HSPF x duct efficiency) 5 Effective -25 or -24 to -1,(ID' 4 to +6 b 16 or SE HSPF less -15 5 +5 15 more 0.30 2.75 -73 -64 -56 .47 -38 -30 na 3.41 -45 _"14 -29 -24 -18 0.40 3.67 -34 -30 -26 -22 -18 -14 0.50 4.58 -10 -9 8 -7 -5 -4 0.56 5.13 0 0 0 0 0 0 0.60 5.50 5 5 4 ' 8.0 9 2 0.70 6.42 17 15 13 11 9 7 0.80 7.33 25 22 19 16 13 10 0.90 8.25 32 28 24 20 17 13 1.00 9.17 37 32 28 24 19 15 Zonal Control Adjustment System Type Resistance 10 9 7 6 4 3 Other 6 5 4 3 2 2 12. Cooling Sywm Zonal Control Adjustment 10 8 7 6 4 3 No Cooling System Installed SEER .Stories R -value 119] U -value [0.037] X 4. Slab Edge Insulation (assume, duets In attic) _/,.,,.� One -5 Stn of 7-10 -4 -3 -2 -Z or -24 to 14b .4 ID 46 to 16 or SEER less -15 -6 +5 +15 more 8.0 -14 -12 -10 -8 -6 -4 8.5 -9 =7 8 -5 -4 -3 . 8.9 -5 -4 -4 3 -2 -2 9.0 .4 3 -3 -2 -2 -1 9.5 0 0 0 0 0 0 10.0 4 3 3 2 2 1 ' 10.5 7 6 5 4 3 2 11.0 10 9 7 6 4 3 120 15 13 11 9 7 5 -13.0 20 .17 11 14 12 9 6 WSB 5 Effective SEER 3 2 2 (SEER xduet efficiency) POU 8, 5 SI;» of 7-10 3 3_ Effective -25 or -24 to -141* -410 +6 b 16 or SEER less -15 -5 +5 +15 more 5.0 -30 -25 -21 -17 -13 -9 6.0 -12 -11. -9 -7 -6 -4 6.6 -5 -4 -4 3 . -2 -2 i 7.0 0 0 0 0 0 ' 8.0 9 8 5 4 3 9.0 16 14 12 9 7 5 j 10.0 22 19 16 13 10 7 11.0 26 23 19 15 12 8 12.0 30 26 22 18 14 9 13.0 33 29 24 20 15 10 Zonal Control Adjustment 10 8 7 6 4 3 Point System Summary: Climate Zone 11 SCORE CARD Measures Point Scores 1. Ceiling Insulation 36P or Z R -value 1381 U -value [0.030] Z' 2. Wall Insulation 13 or R -value [11 j U -value [0.0981 3. Raised Floor Insulation No Cooling System Installed Sc .Stories R -value 119] U -value [0.037] X 4. Slab Edge Insulation or _/,.,,.� One -5 -4 -4 -3 -2 -2 Two + 3 3 ;. 2 2 2 1 Single-Familylfetached and Attached TYPE 1 MASS AREA lnteriorlV`nssICFA Unit Size (so '1200 $ COND. FLOOR AREA Water 0199 TYPE 2 MASS -1700 2200 2700 Heater Uedit or 1 b b ' to or. , Type Type less.11699 2199 2699 more SG None 0 1' 0 0.. 0 0 or Solar 12 " 8 . 6 5 4 HP HWR' 8 5 4 3 3 0% WSB 5 3 3 2 2 35% POU 8, 5 4 3 3_ SE None 37 -24 -18 -15 -12 0% Solar -1 -1 -1 0 0 1.3 HWR -18 -12 -9 -7 -6 2.7 WSB-.. -25 -16 -12 -10 8 > POU -1- _._12 4.8 -9 -7. -6 IG None' --5' -3 -2 -2 -2 j Solar 7_ -: 5- -4 3 2 j POU _3 2 1 1 1 IE None -28 19 14 -11 -9 0.6 Solar 8 5 4 3 3 2 POU -10 -6 -5 -4 -3 3.S Multi -Family (individual units) 4.1 4.3 4.5 4.8 ' Unit Size (s 5.2 5.4 Water 30% 699. 700 1200 1700 2200 Heater Crus or b to b , or Type _ Tyl?a _ less 1199 1699 2199 more SG None 0 0 0 0 0 or Solar 14 7 5 4 13 HP HWR _9 5 3 2 2. 3.4 WSB 9 4 3 2 2 4.9 POU 9 5 3 2 2 SE None -45 -23 -15 -11 -9 23 Solar 2 1 1 0 0 ab HWR --25 4.4 4.6 4.8 5.1 I WSB 5.7 -13 8 =6 5 1.1 POU -23. 12 -8 6 -5 IG None - 8 ; -4 . _.. -3 2 2 3.9 Solar:, 6 3 2 1 1 5.3 POU _1 ' 0 0 0 0 IE None . 30 -15 -10 ' -8 8 i' Solar= 18 9 6 4 4 4.2 POU , 8 -4 -3 -2 -2 5.6 5.9 6.1 63 65% 1.1 1.3 Point System Summary: Climate Zone 11 SCORE CARD Measures Point Scores 1. Ceiling Insulation 36P or Z R -value 1381 U -value [0.030] Z' 2. Wall Insulation 13 or R -value [11 j U -value [0.0981 3. Raised Floor Insulation or Sc Eff % Glass 4,v R -value 119] U -value [0.037] X 4. Slab Edge Insulation or _/,.,,.� R -value (0] F2 factor [0.77] S. Infiltration Interior Mass/CFA 0 6. Glass Heat Loss 3.3 3 Type -[double] U-value[0.65] _� % Total Glass [16] Sum 15 X . rrre 2 PASS TYPE 1 MASS AREA lnteriorlV`nssICFA $ COND. FLOOR AREA TYPE 2 MASS AREA $ Exterior Wall Maas ND . L OR AREA t7?ix 3 SE or HSPF li (l. l.utse•t. 21 I...pet" a.bl [0.72J6.61 HSPF [0.56/S.1S] 9.9 X z = 1-3 % TYPE 1 MASS WINC a 4.2. l e: e■ osod slab) �_ Type [SO) Credit [none] 0% 6% 10% 15% 20% 25% 30% 35% 40% 45Y. 50% 56% 60% 6946 70% 75% 80% 85Y. 90% 05% 100% 105% 110% 115% 120% 125• 0% 0 0.2 0.4 0.6 0.8 1.1 1.3 1.5 1.7 1.9 21 2.3 2.5 2.7 2A 3.2 3.4 3.8 9.8 4 4.2 4.4 4.6 4.8 5 5.3 Me 0.2 0.4 0.6 0.8 1 1.2 1.4 1:8 1.9 21 23 2.5 2.7 2.9 9.1 3.3 3.S 3.7 4 4.2 4.4 4.6 4.8 5 5.2 5.4 20% 0.3 0.6 0.8 1 1.2 1.4 1.6 1.8 2 2.2 24 27 29 3.1 3.3 3.S 3.7 3.9 4.1 4.3 4.5 4.8 5 5.2 5.4 56 30% 0.5 0.7 0.9 1.1 1.4 1.6 1.8 2 22 24 28 2.8 3 3.2 3.S 3.7 39 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 5.8 Me 0.7 0.9 1.1 1.3 1.5 1.7 1.9 2.2 24 2.6 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.1 4.9 5.1 5.3 5.5 5.7 5.9 .50% 0.9 1.1 1.3 1.5 1.7 11.9 21 23 25 27 9 32 3.4 3.6 ab 4 4.2 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 55% 0.9 1.1 1.4 1.6 1.8 2 2.2 24 2.6 28 9 32 3.5 3.7 3.9 4.1 4.3 0 4.7 4.9 5.1 5.3 5.6 5.8 6 6.2 60% 1 1.2 -1.4 1.7 1.9 21 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.8 4 4.2 4,4 4.6 4.8 5 5.2 5.4 5.6 5.9 6.1 63 65% 1.1 1.3 1.5 1.7 1.9 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 5.5 5.7 5.9 6.1 6.4 70% 1.2 1.4 1.6 1.6 2 22 2.5 27 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 5.2 5.4 5.6 58 6 6.2 64 75% 1.3 1.5 1.7 1.9 21 2.3 2.5 2.7 3 3.2 3.4 SS 3.8 4 4.2 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 8W. 1.4 1.6 1.8 2 2.2 2.4 26 2.8 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.0 5.1 5.4 5.6 5.8 6 6.2 64 66 85% 1.4 1.7 1.9. 2.1 2.3 25 2.7 2.9 3.1 3.3 3.5 3.8 4 4.2 4.4 4.6 4.8 5 5.2 54 5.6 5.9 6.1 6.3 65 67 90%' 1.5 1.7 2 2.2 2.4 26 2.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 5.1 53 5.5 5.7 5.9 6.2 6.4 66 68 95Y. 1.6 1.8 2 2.2 2.5 27 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 5.2 5.4 5.6 5.8 6 6.2 6.4 6.7 6.9 10D% 1.7 1.9 21 2.3 25 28 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 53 5.7 5.9 6.1 6.3 6.5 6.7 7 105% 1.8 2 2.2 2.4 2.6 28 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 5.6 5.8 6 6.2 6.4 6.6 68 7 110% 1.9 2.1 2.3 2.5 27 29 3.1 3.3 3.6 3.8 4 4.2 4.4 4.6 4.8 5 5.2 5.4 5.7 5.9 6.1 6.3 6.5 6.7 6.9 7.1 115% 2 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.6 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.5 5.7 5.9 6.2 6.4 16.6 6.8 7 7.2 120% 2 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.4 4.6 4.8 5 5.2 $.4 5.6 58 6 6.2 6.5 6.7 6.9 7.1 7.3 125% 2.1 2.3 25 2.8 3 3.2 3.4 3.6 3.6 4 4.2 4.4 4.6 4.9 5.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 6.7 I 7.2 7.4 Point System Summary: Climate Zone 11 SCORE CARD Measures Point Scores 1. Ceiling Insulation 36P or Z R -value 1381 U -value [0.030] Z' 2. Wall Insulation 13 or R -value [11 j U -value [0.0981 3. Raised Floor Insulation or Sc Eff % Glass 4,v R -value 119] U -value [0.037] X 4. Slab Edge Insulation or _/,.,,.� R -value (0] F2 factor [0.77] S. Infiltration Standard 0 6. Glass Heat Loss 3.3 3 Type -[double] U-value[0.65] _� % Total Glass [16] Sum 15 7. Shading (Shade Open) a. North b. East c. South d. West e. Skylight B. Shading (Shade Closed) a. North b. East c. South d., j West e. Skylight 9. IntefiirThermil Mass 10. Exterior Wall Mass - 11 . 11. Heating System Zonal Control? ( Y / N ) 12. Cooling System Zonal Control? ( Y / N ) 13. Water Heating hass %t0Glass x t 7-7 = SC Ef:4-�.I' I.3 �'T( 1.0 X Zr (r 0- X Glass Sc Eff % Glass 4,v X t •-� _ _/,.,,.� t X 2+?i 3.3 X = Z r v D X TYPE 1 MASS AREA lnteriorlV`nssICFA $ COND. FLOOR AREA TYPE 2 MASS AREA $ Exterior Wall Maas ND . L OR AREA t7?ix 3 SE or HSPF Duct Efficiency [0.78] Effective SE or [0.72J6.61 HSPF [0.56/S.1S] 9.9 X z = 1-3 SEER [9.SJ Duct Efficiency [0.74] Effective SEER S C? Type [SO) Credit [none] Sum 7-10 3 O Point Total: D or Certificate of Compliance: Residential Climate Zone 11 Project Title 4'Z • Z(p%9 DA)r-m m WEST i2 -o Building PTIM11, a Project Address K IG Chedted By / Date Documentation Author Telephone Enforcement Agency Use Only BUILDING DATA Glass Area % Glass North -7 Z, , O Conditioned Floor Area 1'X00 Number of Stories _ East /4 / r 3 Slab/Raised Floor SLB-,- Number of ,Units South All 3 , ¢ [Y{ Single Family Detached (SFD) [ ] Addition Alone West O 3.3 [ ] Single Family Attached (SFA) [ ] Existing Building Skylight 4 O [ ] Multi -Family (MF) [ ] Existing -Plus -Addition Total 11..Q BUU,DING SHELL INSULA710N Component Insulation Location/Comments Type R-Value �J Ottie. -to garage. typical, etc.) Wall .............. T' J f'p/IJP T Ti�.L Roof .............-30 %% T7 Roof............. _ Floor ............. Floor ............. _ Slab Edge ..... GLAZING Shading Devices Glazing Area Glass Type interior Exterior Overhang Framing Type Orientation (sf) (singl% double)(roller blind. etc.) (shdescretsn, etc.) (yett/no) (metal/wood) North ( ) 1- Dal, • MT L North ( ) _ East East South Sou th ( ) West ( ) ak West ( ) Skylight....... Q_ THERMAL MASS Type/Covering Area Thickness (slab/exposed, tile. etc.) (So (inches) LOcatiofl,/Description (kitchei% bath. etc.) HVAC SYSTEMS Minimum Duct Type (furnace, air Efficiency Location Duct Output ManufactureMM COUNTY conditioner, heat pump) (SE, SEER.HSPF) (attic. etc.) R -Value (Btuh) (or approved equal) Evart . , 7'2, � sr"BUILDING DEPARTMENT Maximum Furnace Heating Output: .3 Z33 Btuh HOT WATER SYSTEMS Tank Manufacturer/Model # System Type (storage gas. etc.) Capacity (or approved equal) Special Feature(s) AA SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) Mandatory Measures Checklist: Residential MF -111 NOTE: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (•) may be superseded by more stringent compliance roquuements tilted on the Certificate of Compliance. When this checklist is incospo ated 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 DESIGNER ENFORCEMENT Building Envelope Measures §2.5352(a): Minimum ceiling insulation R-19 weighted avenge. 62.5352(b): Loose fill insulation manufacturer's labeled R -Value. ' 62.5352(c): Minimum wall insulation in framed walls R-11 weighted average (does not apply to exterior mass walls). 62.5352(k): Slab edge insulation - water absorption rate no greater than 03%. water vapor transmission rate no greater than 2.0 perm/inch. 12-5311: Insulation specified or installed meets California Energy Commission (CEC) quality standards. Indicate type and form. §2.5352((): vapor barriers mandatory in Climate Zones 14 and 16 only. §2-5317: Infiltration/Exftltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Doors and windows certified. c. Doors and windows weatherstripped: all joints and penetrations caulked and sealed §2-5352(e): Special infiltration barrier installed to comply with §2-5351 meets CEC quality standards. §2-5352(d): Installation of Fireplaces 1. Masonry and factory -built fireplaces have; a. Tight fatting. closeable metal or glass door b. Outside air intake with damper and control e. Flue damper and control 2. No continuous burning gas pilots allowed. HVAC and Plumbing System Measures §2-5352(8) and 2-5303: Space conditioning equipment siring: attach calculations. 12.5352(h) and 2-5315: Setback thermostat on all applicable beating systems. • §2-5316(x): Ducts constructed, installed and insulated per Chapter 10. 1976 UMC. 12-5316(b): Exhaust systems have damper controls. §2-5314(c): Gas-fired space heating equipment his intermittent ignition devices. §2-5314: HVAC equipment. water heaters• showerheads and faucets certified by the CEC. §2.5352(1): Water heater insulation blanket (R-12 or greater) or combined interior/exterior insulation (R-16 or greater): fust 5 feet of pipes closest to tank insulated (R-3 or greater). §2.5312(Exception 1): Pipe insulation on steam and steam condensate retum dt recirculating piping. §2-5318(d): Swimming Pool Heating 1. System has: a. On/off switch on heater. b. Weatherproof instruction plate on heater. e. Plumbed to allow for solar. .2. 75 percent thermal efficiency. 3. Pool cover. a. Time clock. 5. Directional water inlet Lighting and Appliance Measures 62-5352(1): Lighting - 25 lumens/watt or greater for general lighting in kitchens and bathrooms. 12-5314(c): Gas fired appliances equipped with intermittent ignition devices. §2-5314(-): Refrigerators, refrigerator -freezers, freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This certificate of eomplianct lists the bual ft feattm and performance specifications needed to comply with Title 24. Chapter 2-53 and Tide 20. C llaktr2. Stibchapter4. Article I of the California Administrative code. This certificate has batt signed by the individual with overall design responsibility and the building owner. who shall retain a copy of it and transmit the certificate tD any subsequent purchaser of the building. Designer Building Owner Name: Name: Tatwall t •fib• Address: Address: Telephone: Telephone (signature) (date) (sitnatum) (date) • Documentation Author Enforcement Agency Name: Name: ride um: Atelier: Address: Telephone: