HomeMy WebLinkAbout039-300-0093C0- 00q
AFFIDA VIT REQUESTING DUPLICATION OF PLANS
(California Health and Safety Code Section 1985 1)
The official copy of the building plans may not be duplicated without written permission from the certified,
licensed, or registered professional, if any, who signed the plans and the building owner.
I hereby request duplicate copies of the building plans on file with the Butte County Building Division for
Permit Number - -21462 —1?o , and the building known as c--)A(ACi
(Residence or Business Name)
I am aware of the following three provisions of the Health and Safety Code as follows:
1. That the copy of the plans shall only be used for the maintenance, operation, and use of the building.
2. That drawings are instruments of professional service and are incomplete without the interpretation
of the certified, licensed; or registered professional of record.
3. That subdivision (a) of Section 5536.25 of the Business and Professions Code states that a licensed
architect who signs plans, specifications, reports, or documents shall not be responsible for damage
caused by subsequent changes to, or use of those plans, specifications, reports, or documents where
local governmental agencies, are not authorized or approved by the licensed architect who originally
signed the plans, specifications, reports, or documents, provided that the architectural service
rendered by the architect who signed the plans, specifications, reports, or documents was not also
approximate cause of the damage.
Current Building Owner: tt A , V SS
Design Professional of Record:
Signature of person requesting copies:.
Printed or typed name of person requesting copies: A. V-, sS
Date: Address: �'?��}� �✓r`c� ,�JZ
gReaseU t C SCI -2-19-
Reason
on for requesting duplicated set of plans: 'Par- -Q - u c -e_ re g no el e_ [
For Building Department Use
❑ Owner Permission received - Date Sent.
❑ Professional Per� c d - Date Sent.
Receipt Numb ^missib'
DakReceived:
DateReceived:
California Health and Safety Code
19851 Inspection of records; duplication of plans
a. The official copy of the plans maintained by the building department of the city or county provided under Section 19850
shall be open for inspection only on the premises of the building department as a public record. The copy may not be
duplicated in whole or in part except (1) with the written permission, which permission shall not be unreasonably withheld
as specified in subdivision (0, of the certified, licensed or registered professional or his or her successor, if any, who signed
the original documents and the written permission of the original or current owner of the building, or, if the building is part
of a common interest development, with the written permission of the board of directors or governing body of the
association established to manage the common interest development, or (2) by order of a proper court.
b. Any building department of a city or county, which is requested to duplicate the official copy of the plans maintained by
the building department, shall request written permission to do so from the certified, licensed, or registered professional,
or his or her successor, if any, who signed the original documents and from (1) the original or current owner of the building
or (2), directors or other governing body of the association established to manage the common interest development.
C. The building department shall also furnish the form of an affidavit to be completed and signed by the person requesting
to duplicate the official copy of the plans, which contains provisions stating all of the following:
1. That the copy of the plans shall only be used for the maintenance, operation, and use of the building.
2. That drawings are instruments of professional service and are incomplete without the interpretation of the
certified, licensed, or registered professional of record.
3. That subdivision (a) of Section 5536.25 of the Business and Professions Code states that a licensed architect who
signs plans, specifications, reports, or documents shall not be responsible for damage caused by subsequent
changes to, or use of those plans, specifications, reports, or documents where local governmental agencies, are
not authorized or approved by the licensed architect who originally signed the plans, specifications, reports, or
documents, provided that the architectural service rendered by the architect who signed the plans, specifications,
reports, or documents was not also approximate cause of the damage.
CL The request by the building department to a licensed, registered, or certified professional may be made by the building
department sending a registered letter to the licensed, registered, or certified professional requesting his or her permission
to duplicate the official copy of the plans and sending with the registered letter, a copy of the affidavit furnished by the
building department which has been completed and signed by the person requesting to duplicate the official copy of the
plans. The registered letters shall be sent by the building department to the most recent address of the licensed, registered,
or certified professional available from the California State Board of Architectural Examiners.
e. The governing body of the city or county may establish a fee to be paid by any person who requests the building department.
of the city or county to duplicate the official copy of any plans pursuant to this section, in an amount which it determines
is reasonably necessary to cover the costs of the building department pursuant to this section.
f. The certified, licensed, or registered professional's refusal to permit the duplication of the pians is unreasonable if, upon
request from the building department, the professional does either of the following:
1. Fails to respond to the local building department within 30 days of receipt by the professional of the request.
However, if the building department determines that professional is unavailable to respond within 30 days of
receipt of the request due to serious illness, travel, or other extenuating circumstances, the time period shall be
extended by the building department to allow the professional adequate time to respond, as determined to be
appropriate to the individual circumstance, but not to exceed 60 days.
2. Refuses to give his or her permission for the duplication of the plans after receiving the signed affidavit and
registered letter specified in subdivisions (c) and (d).
19852 Fees; limitations
The governing body of a county or city, including a charter city, may prescribe such fees as will pay the expenses incurred by the
building department of such city or county in maintaining the official copy of the plans of buildings for which it has issued a building
permit, but the fees shall not exceed the amount reasonably required by the building department in maintaining the official copy of
the plans of the buildings for which it has issued a building permit. The fees shall be imposed pursuant to Section 66016 of the
Government Code.
19853 Exclusion of banks, financial institutions or public utilities
This chapter shall not apply to any building containing a bank, other financial institution, or public utility.
.. / .
• ��' '` PERMIT N0.
2462—:8 P E
# PERMIT EXPIRES
L�
OWNER John Goddard
$H� owner
CONTR.
1
LOCATION (A.P. 39-36-9
1345 Marian Ave., Chico
T
x1777 i--.
41
fL} '
e i f
Temp. Power Pole_
Called PG&E
Temp. Elec. Serv.—
Called PG&E
Temp. Gas Serv.
Called PG&E
JOB
FINALED�
/(Signature)
a <
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To a .Building De t
From: En
v-U'onmental HeM
1-. r
Subject: S'�2.rJll @c^t Cl o
ra n a,e
Owr
OFF—
P2-1; aPp_'oved for . r
. ..ewage Liisccsal olei ural for:
4 3 t e Supply L/
s�
Wafer Supply
F; nal C '`
:a ince UaKt.'o.H;
Water Supply
Clearanr, for _, bedroo
_ it
Clearan O for addition o"
�S
To a .Building De t
From: En
v-U'onmental HeM
1-. r
Subject: S'�2.rJll @c^t Cl o
ra n a,e
Owr
OFF—
P2-1; aPp_'oved for . r
. ..ewage Liisccsal olei ural for:
4 3 t e Supply L/
s�
Wafer Supply
F; nal C '`
:a ince UaKt.'o.H;
Water Supply
Clearanr, for _, bedroo
_ it
Clearan O for addition o"
r
y
Scratch
COUNT; OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
Service
BUILDING BUILDING (Cont'd)
PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwa l l
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Prov. for ph sically
handica ed
Conformance of ex.
structure
Appliances
Gas Piping & Test
Temp. as
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Roucih
Relnf. Steel
Final
Fixtures
Bond Beam
FIRE SPRINKLERS
Motors
Framing
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heatino
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
MOBILEHOME UTILITIES ------------------
Elec. Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
=E ME INSTALLAT12N - - - - - - - - - - - - - -
Support
Elec. Continuity
Water Piping
Drainage
Gas Piping
DATE
611tIA19
REMARKS OR CORRECTIONS
��e�P /D �G��eG�'�o� .,�izr�e ���� e�4'� cru G✓.��
(NOTE: An entry must be made on this form each time you visit the job site.)
l
a
RESIDENTIAL (Sing9:b and -Duplex) S
C
Date UNDERFLOOR Plans OK'exept k.'s
Dato� FRAMING (Continued)
1. Zcning requirements-Satbacks-Easemenis
/-tine Firewall & Openings___ -
2. Fig., Main; Soils-Steal-Elec. Grnd.- " Fig. Depth
_
xt. Docrs-Ons 3'-Chack Garage --3rd story, 2 exits
3. Fig., Garage; Soils-Stsel- " Fig. Depth5
th-Headroom-Pisa-Run-l.andirg-Fire Protection
`
_
4. Fig., Porches & Decks; Soils-Steei- Q" Fig. Depth
I ood on Roof Overhang -Attic Access --Rafter Ouirigcars
5. Stemwalls, Main; Steel-8lockouts-Wrapped-Slab
6. Ster,.wails, Garage; Steel-Blockouts-yfrapped-Slab
d=ng-Nailing-Veneer
53'JSq=o Mash -Drip Sorg.,-Fdn. Vent;-Underflr. Acoria
7. Piers -Fireplace Fig. -Steal
. Glazing Area -Glass Protection-SRyligitis--Plastic
B. D.yi.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
mitts; Nailing_ -Softs
9. Gas Pipe; Size -Anchors
10. Water Pips: Test-Anchors-R=_gulator-Seryice Test
11. Electric; Underground
_
12. Plenums & Ducts; Clearance -Malarial -Support -ins.
_
13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -81 Date Card -BI Date �`—
CaDat9 Card -BI Date
Ct!d-E1 pDate
Card -BI Date Card -BI Date
Data FINAL (Plans) OK except N's
Card -8I Date Card -81 to
Dais P14%!P14%!Li I N G (Permit) OK ex.#Kt Ws
6 xt. Steps -Door & Sidelight Protection -Landings
Smoke Detector
*719 7M wa' r Ht.; a t -Ac s --C .. s on Air
Furnace; Vents -Clearance -Comb. Air-Ccnnector-
In Garage; Above Floor -Ducts -Meeh. Protection
1 laser Pips; Te rs-Nail action
❑.V1.V-Ftt - ail Protection
��sdroom Exiting
ina• pa_ as T�:t-First Floor-Tuh _ s
G.F.I. & Bath Fixtures & Tub Access
& Shower, 2nd Floor -Tub Accesa
61. Elec. Trim & Subpansl; Breaker Sizes -Labels
1 as Pipe; Size & Anchors
_ ey/5tairs & Rails
-A43/F=irepiace or Steve; Clearances -Hearth
i
-61r-i°lec. Outlets at Wocd Panel; Int. & Ext.
_- I Daia QCard-81 Date
FtiKit. Fixt. & Appliance; Grrd.-Air Ga Cooking Clearanre
Cs:d-3I DateCard-31 Date i
Q5/Elec. Outlets & Receptacles at Kit. Courter
Daie ELEC .ICAC Permit OK except q's
_6Wv—•earag9 Fire Door; Swing -Landing -Closer
��. Duct in Garage -Damper
F' era'& Transformer Clearance -Ins. Protectiontr.
Hir.; Vents -Clearance -Comb. Air -Conn:�tcr-P.R.V.-
In Garage; Above Floor-Nlech. Protection
-
Spacing -Lights &Switches at Doors
Ei . Receoxes
—oxer
Plh., Elec. & Mech. Equip. Listed for Location
2 & No. No. of Conductors -Stapled
. Etec. Receptacles in Garage: (G.F.I.)-Romex Protee.
2 no.,.ex Installed.rlose to Edge of Studs & C.J.
^ •
i. Eip. Grcund made up w/Meth. Fasteners -gond Gas & Water
,ppliaWir Circuits In Kitchen & Conductor Size
-
7 nsulation-Foam-Looi<ed in Attic [j Yes
•Z7.-U.Rails & Deck Construction -Post Caps
dn. Vents & Crawl Kole Door-Drainags & Wood -Earth Clearan.;o .
Looked under Floor ❑ Yes
-
Wire Size / / ga. or AI-A.C. Wire Size / ga. Cu r AI�
2 ange Circ. / / g�z• yCC or A Oven -£'ire / / ga. Cu or Al,
Insulated Nautral [e ., No
75. Following insild.: Drivg� C] No; ,'talks es ❑ No;
g
Planters ❑Yes Nn; Creasing Drug. Problems ❑Yes No
2 ar icy Riser Conde rs & Gr -Alain D nnect
—lucco; Brown -Finish
— 2 ;uip.VClearances; Pane ls-Motors-Msch. Equip.
- . A.C. Unit; Disconnect-Clrnces.-Brkr. & Cond. Size -115V Outlet
Oset Light -Shower Light
Vents Above Root; Plbg.-Appliance-Firepl.-Clearance to Oprgs.
Ylater wall; Disconnect, Electrical, Plumbing
_
80.�ct=_rior Elac. Trim; G.F.I. Receptacle -Underground
Card E -I Oats Card -81 Date
Ventilation throughout House _
G ass Prutection
Card 6-I Date Card -BI Data
Dat MBC ICAL (Permit) OK except X's
_
.
89'Corrections from Previous inspections
84. Gas Test-h!etars Tagged; Gas-5chic
er & Sewer Connected -C/ t ode D
A.C. D u&j s; - In VTP ion & Sup
an. Fan; Exhaust above Insulation
Epargy Compliance Certificate-• to^.ar Certificates
O!frain & Overflow; Size Grade
urnace- e�l!Acce omb. r-R,3turn ent-115 at
tic Access & Platform if Furnish in Attic
Card -51 Data 'Card -BI Data
Card -BI Date j ard_H1 Date
_
Card -BI _Osie Card -BI Date _
Card -BI Data `7 C BI 0,,.p
Date FRAtdING(Plans) OK except p's
�C:!rd-51 Da!a Card -61 Data —
i Co r n! a[ Final:
3 Its; Proper Material & Anchors
�0
Of
3: Studs -Nailing, Spacing & 6racing-Plates-Sound
-'/a!
3 �rir,g walls over Girders & Floor Nailing
Draft Stop in t'ialls (rat proof) _
_
Fire Stops; Furred Ceilin( svStairs-Cha es
ler
!a & Bearin
j'
_eam-Siza�&
4 an-Pa3t�gS-A. =Co n rs
{
�I+xr.dsist-l+kcr-Trus-6+e-Mq-P.ca --c._ - Sh[ >—R!
_- -
::e .=ca Ties or Typ u=-Vepl3ce Throat
Nic,Access; Some A4W,action-D fTp-_In3. grsTf els
i
_--
,
1'lindows ar Exi tint Doors -S+ t. &Dim Cons
47) 1 Fire Protection Framing -II
I)I}_
r
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORK�r
695 Oleander Avenue, Chico — Phone 343-4211, Ext. 70
7 County Center Drive, Oroville Phone 534-4541
Skyway and Elliott Road, Paradise Phone 877-3435
CORRECTION NOTICE
BUILDING OR PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
COUNTY OF BUTTE
DE-nARTMENT OF PUBLIC WORKS
695 Oleander Avenue, Chico — Phone 343-4211, Ext. 70
7 County Center Drive, Oroville Phone 534-4541
Skyway and Elliott Road, Paradise Phone 877-3435
CORRECTION NOTICE
rom
BUILDING OR PROPERTY ADDRESS
A routine inspection Indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work Is completed. If you have any question pertaining to. this
matter, or need additional explanation, please contact this office immediately.
I I
7
�6c J�IM� Date
nsp torL
County of Butte
DEPARTMENT OF PUBLIC WORKS
695 Oleander Ave., Chico — 343-4211, Ext. 70
7 County Center Dr., Oroville — 534-4541
Skyway and Elliott Rd., Paridise — 877-3435
CORRECTION NOTICE
(0 112 - 1�0
Building or Property Address
A routine inspection indicates that the following
violations of County Ordinance exist at the above
address and should be corrected. Please notify this
office when correction of work is completed. If you
have any question pertaining to this matter, or need
additional explanation, please contact this office
immediately.
............
............................
...... ..... .............. :��' . . ...... .
0,11. ......... X ........................
r .. 4 ................
ay�
............
..................................... ......... / .. ....... .....................................
......................... ......................................................
........................................................................ ..... . .................
..............
Date.F=04'42.. inspecto .. . .... . ...........................
Do Not Remove This Tag
(400-41
i
h
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE -
BUILDING OR,PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
Inspector
r
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RESIDENTIAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS
AT S- X11 LI A72- 0-�P-V L GFS
(location)
BU ILD ING PERMIT NO .��� A.P. NO .
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED.PLANS:
(Check each item or write N/A if not applicable)
INSULAT ION : r
Slab Edge v' n-
Fdn. Walls PIA
Floors X-4 r*
Wallsy
Ceiling/Roof
Ducts C/
Circulating Pipes t/
APPROVED HEATER (/
APPROVED WTR.HTR
GLAZING:
Single Glazed
Special (Insulated).
CERT. & LABELED WDS.
& SLIDING DRS.
WEATHERSTRIPPED DRS. LI/t7
BACK DAMPERED FANS .1/
INTERMITTENT IGNITION DEVICES
CERT. APPLIANCES
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name :•+u c� S6(;MWD
Signature of ( lease print)
Insulation Applicato
State Contract rs
\j License No.
General Contractor/Owner Name 60 0 m 0
Signature of (please print)
General Contractor/Own Date
State Contractors -
License No. ai
i�, *6
�0
DD 0
THIS CERT IF ICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
C
COUNTY OF BUTTE-'DEPARMENT OF PUBLIC WORKS
7 County Center Drive - Oroville 'California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT N0.
ASSESSOR PARCEL NUMBER
p
ZONING
� -
BUILDING ERMIT
OWN R
TELEPH(;O7NE
.SQ. FT. OCC. UILDING VALUATION
OWNER'S MAILIN ADDRESS
CO NTRACTOR'S NAME TELEPHONE
4/cv
CONTRACTOR'S MAILING ADDRESS '
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is
FilingFee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF Duplex -1 Mobilehome❑ Other
SPECIFY
Building sewer
Lawn sprinkler system
5.00 v
TYPE OF WORK
New ❑ Addition Q,,Remodel ❑tI lities ❑ Installation ❑ Other
Describe work: � ��� / �� --�
-
Permit Fee
$ 3 O
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
00V OR
Main service 100 AMP ORSLESS
5.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST.
ODWELING R AODNS. (ACCLBLDGS-CCUP. M)
20 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
ElI 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
4K 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
CI LET
NON -RESIT R (MULTI*DUT
2.50 ea
NEw CONSTR. (POWER APPARATUS s1
NON-RESID. SINGLE OUTLET CIR. i
EX. Occup OUTLETS OR FIXTURES BAL@1
IXED APPLNS, OR
Ex. Occup.(oUT LETS (RESID.) EA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee
$
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's -Compensation Insurance or a Certificate
of Consent to Self -Insure.
1KI 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.
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
S
Contractor
I certify that I have read this application and state that the above.information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby. authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes. 9
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this.permit.
X D Date t4 l�
�
Signblur of pplicant — Ownerg_ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
_
TOTAL PERMIT FEE $
OCCUP. GROUP
I TYPE OF CONST.
PARCEL
PO
NO
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
IRECTOR OF PUBLIC
BY
PERMIT EXPIRES Dat
the applicable provi-
resolutions to do'
fees have been paid.
WORKS
Date 7n?,
�-7
��7 X
Receipt No. .5 l�
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA. 95965 Phone: 916-534-4541
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 in the envelope provided at your
earliest opportunity to avoid unnecessary delay in processing and issuing your build-
ing 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) , ?p
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
C
1'
Signed:
Property Owner
Social Securi y number_
Date _ 2 �
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
' r permitted to issue the permit.
.—:.1-�e-...:;.aR;...n.'".ir+iF-1riY'wti`t--�+f�j-iect-v.�,1'rt �:.►�'^r�..��+.,) . T�. �.. w^�xF�,.,.t,:,y„r,., f•,�'f•G.•_,:s.�z,.;3 --r.�..-.....: �..�•.�'4rYa,....•,.�.'�►%..��
COUNTY OF BUTTE - DEPARTMENT 05"P PUBLIC WORKS - BUILDING DIVISION") ) .
7 COUNTY CENTER DRIVE - OROVIL4, CALIFORNIA 95965 - TELEPHONE: 916/534-41541
PERMIT APPLICATION DATA SHEET
Permit No. y
OWNER `ice J A. P. No. _521�
Proposed Building Use / S
Permit Fee Based Upon: Complete Contract Price b DPW Valuation
Othe v
ain)
L �y
Building Inspector /i�/f _� Date
At time of permit application, I was advised the-lbllowing data must be submitted prior to permit processing
and/orissuance: DATE RECEIVED APPROVED
.1. All items have been submitted. . . . . . . . . . .
2. Plot plans in duplicate/triplicate. . . . . . . . . .
3. Complete plans in duplicate/triplicate. . . . . . . . .
4. Complete engineered plans and calcs.
5. Plans with Energy Design Compliance Statement. . . . . .
6. State Energy Forms No.
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . . . . . .
9. Letter of signature authorization. . . . . . . . . . .
10. Sanitation approval from' Health Dept. . .
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance. . . . . .
13. Contractor's License Information (no., name style, classif.)
6)1G-A�1-4. Owner -Builder Verification (Given to owner 0,-Ivf to owner ❑
15. Improvements may be required. . . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . . .
. .
Pre-Inspec. request to
17. Pre -Inspection for' Required. Building Inspector
18. Other
When you issue the permit, process as follows: Mail to owner. _
Telephone and hold for pickup at office.
_z___�Other d
Applicant
Date)
Mail to contractor.
_Deliver w/inspector.
Date 7A /j L
I
Copy of plans sent -Health Dept., Fire Dept., Other Date
During the plan checking process, the following data must be submitted prior to permit issuance.
(For required items not checked above at time of application, circle item.)
1. Index permit for above Items No.
2. Additional items required:
(Contractor, Designer, Owner) was advised of above required data by
By
Plans checked by -
Plans approved by
Other
Copy—DPW
Telephone
Date _
Date _
Mail Other
Date
inter -Depart ental". e'morandum
To: % Wt- iIQ.►J�'Gi�Ui F::e=eVtrlk
s4:f
'
6 I l%� /�� �C� W✓L , �✓v� !CSI
SUBJECT:
13
DATE:
my- c'ovZ� �e u2s aVO�v 10
Cj" Rba i e oldrv- -S -ar PA'S /a)hoK
r I / CL new "�� �
lqo- -,cu,. Wve
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a.G'11� — �h s CSS Q44/0 -V 0 74 Je. e,/ f �
- ����. � • - ,,� a.-�. ,f.. `/cam S�.�.:.e. _ __. � . _ _ ___- � : • -
-rr�e- b'.q
NC -W 7-S
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doo
COUNTY OF BUTTE-- DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
ZONIN
BUILDING PERMI
OWNER
11.1
ITELEPHONE
SQ: FT. OCC.1 BUILDING VALUATION
OWN M (LING A DRESS
CON RACTO 'S AME TEI_F, PI!O^JC
9 165D e
CONT CTOR 5 MAILING ADDRESS
CONSTRUCTION LENDER
UNKNOW
Fireplace
Total Valuation $
LENDER'S MAILING ADDRESS
-=---�
Permit Fee
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$ -
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ -.?,e1,9,
BUILDING ADDRESS
PLUMBING PERMIT
Filing Fee 3.00
Each Trap
2.00 ,LXD
Repair drainage or vent piping
2.00
GD
Water piping
:ZC0 2,
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
j -Zr 00
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
-- 0
Lawn sprinkler system
2.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ . Uti lities ❑ Installation ❑ Other
Describe work:H06f 69=__ eQ& A5: /r -.VA
/11 /lit) G0Iic-T AWN A5,
ermit Fee
$
Contractor
' ELECTRICAL PERMIT
Filing Fee 3.00
-Main service ioo AMP OROR SLESS
5.00 S v
Main service EA. ADD•L too AMP
2.50
NEW CONST. DWELING
OR AODNS. ( ACCLBLOGS.CCUP.&�
22 sq ft 36 �Z6
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.
cense No. Classification
V1,1as 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 CON5TR LTI.OUTL
NON-RESID BRANCH CIRC 1T5
2.50 ea
NEW CONSTR. POWER APPARATUS &
NON.RESID. (SINGLE OUTLET CIR.
Ex. OCCUp(OUTLETS OR FIXTURES 50@�
BAL@1OQ
FIXED APPLNS. OR
Ex. Occup.(OUTLETS (RESID,) EA.) 2.00
Temporary service 1 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
Permit Fee $ .129
Contractor
WORKMEN'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self Insure.
/I shall not employ any person in any manner so as to become subject
�
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 3.00
Heating SQ& 07U
1,00 op
Cooling -H 2_
/ 7,$Q a
Hood
/ 2.00 e2 .20
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 CountyotDr�/
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against d ounty cons ence of th granting of this permit.
I S--:,/� V
X !!�� l� 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 3cstories in height.
Mobile Home Installation Fee $
Land Development Fee $
TOTAL PERMIT FEE $ is
OCCUP. GROUP
I TYPE OF CONST.
N
PARCEL PD
HDssE
/ u
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
By.
PER EXPIRES Date _
the applicable provi-
resolutions to do
fees have been paid.
WORKS
-Date O
—3 -
Receipt No. a 7 3
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
�1.
COUNTY OF BUTTE — DEPARTMENT=OF PUBLIC WORKS —BUILDING DIVISION
s . i 7 County Center Drive — 0rovilhe�Califo7ynia 95965 — Telephone 534-4541 t
PERMIT APPLICATION DATA SHEET
Permit No.
OWNER—�_T/%//,,•(Z_:> A. P. No.
Proposed Building Use
Permit fee based upon: Complete Contract Price r -DPW Valuation
Other (explain)
Building Inspectors J./,��i" 1Y, Date 4;7//S/<-/-)
At time of permit,application, I was advised the following data must be submitted prior to permit processing and/or
issuance:
DATE RECEIVED APPROVED
1.
All items have been submitted...................................................................
2.
Plot plans in duplicate/triplicate...............................................................
3.
Complete plans in duplicate/triplicate...................................................
4.
Complete engineered plans and calcs.....................................................
5.
Plans with Energy Design Compliance Statement ............................
,6.
State Energy Forms No. ....................
7.
Statement of Intent for Non -Heated & AC Buildings ...................
8.
9-" 9.
Fees of $..................................................
Letter of signature authorization... 6
10.
Sanitation approval from of%/,G0% Health Dept....
11.
Planning approval for
12.
Certificate of Workmen's Compensation Insurance ........................
s' 13.
C=o WI Ir/Z_ i a sell n ormation (no., name style, ,e male,. 1wAi4- v�2�FIG rion!
classification) ...............................
14.
Improvements may be required. Contact Land
Development Section of Dept. Public Works (see
addressbelow).................................................................................................
15.
Pre -inspection for required. Pre-inspec. request to
bldg.inspector (date)
x,/16.
Other l�rf/4� %' VEGOi7/`f.�/U7 ,��� I&IAY F3,E
When you issue the permit, process as follows: Mail to owner Mail to contractor.
, ./Telephone and hold for pickup at /01;1/10 office. Deliver w/inspection.
Other
✓ S` �J
Applicant I'k' Date Jr-
Copy of plans sent Health Dept., Fire Dept., Other Dater
During the plan checking process, the following data must be submitted prior to permit issuance:
(For required items not checked above at time of aplicc ion, gircle item.)
1. Index permit for above Items No. 11d
2. Additional items required:
(Contractor, Designer, Owner) was advised of above required data by Telephone
Mail
Other
Date
rlans cneCKed by
Plans approved by
OTHER:
Copy/DPW
Date
Date
To: Building Department
From: Environmental Health
Subject: Sanitation Clearance
LOA
Owner Location
Plan approved for: Sewage Disposal
5!;tf for:
Clearance for bedroom cobtla/tome.D Other
Clearance for addition of
31- 34 - 1�
AF#
dater Supply
Water Supply
Water Supply
Note**
Sanitarian Pate
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA. 95965
Attention Property Owner:
OWNER -BUILDER VERIFICATION
a9-36-,9
Phone: 916-534-4541
An "owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information in the envelope provided at your
earliest opportunity to avoid unnecessary delay in processing and issuing your build-
ing 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) S .
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 a r- �/�-l� �-e-Y�l�
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 �)o
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 S cur.tj
DateC0X�/ 9 -
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
permitted to issue the permit.
cot].
ltpr 0 Op Burr,,
pupt,/c I#vs
W(
JUN 3
1980
PO
OWNER
A.• ' GENERAL
Zoning requirements
,_-L� Valuation.
Signature by R.C.E.
RESIDENT IAL ,PLAN CHECKING GUIDE
(S.F., DUPLEX, & MISC. ONLY)
Bldg. Permit #
A.P.
(sideyards and parking). G�
or Architect (if required).
B. PLOT PLAN
�omplete parcel size and dimensions.
/2: Setback$, sideyards, easements, etc.
Other buildings or structures.
Grading, fills, drainage.
C.' FLOOR PLAN
Complete to scale plan with dimensions.
i
Required windows for light and ventilation (Sec. 1405).
e uired windows for second exit (Sec. 1404).
lovable glazing for energy requirements (20% max. per.State law).
man impact glass (Sec. 5406).
quired room sizes, ceiling heights (Sec. 1407).
C.I.'s in baths and exterior outlets (Sec. 210-8).
Lig fixtures, switches, receptacles, and exterior receptacles for maintenance of
echanical_ equipment.
Locations of water heater, heating & cooling equipment, other electrical or gas
equipment, and plumbing fixtures.
Garage firewall, door size, and closer (Sec. 503(d)(4)).
1 - 3°0" exterior exit door (Sec, 3303d).
Fireplace location,
Smoke detectors (Sec. 1413) .
D. STRUCTURAL DETAILS
Foundation plan complete enough to construct building.
Floor construction details complete enough to construct building.
�! Elevations and wall construction details complete enough to construct
Roof construction details complete enough to construct building.
Fireplace construction details and calcs if over one-story in height.
Sufficient data and details to satisfy energy insulation requirements
building.
(State law).
E.MISJGFLLANFOUS ITEMS TO LOOK_ OUT FOR
CC`X plywood on exposed locations and overhangs.
` Stair-uny details (Sec, 3305)
Guard-rail details (Sec, 1716) .
rich or stone veneer (Chapter 30).
."xterior plaster - weep screeds (Sec. 4706 & 4708).
ropes roof pitch for root covering (Chapter 32).
after ties or bearing ridge beam,
�arage door or porch header sizes.
dequatc bracing.
Living area over garage - complete 1 -hour separation required including supporting .
galls and posts, etc, k
Two (2) exits on three-story dwellings (Sec. 3302).
CPO
7D
PERMIT APPLICATION• WORK SHEET
Permit No.
OWNER A. P. No.
Zoning Use Proposed gL1LlA I&W5C dR/ axts7-1QJ6 Approved
FitiDTN eF-FT �+F� Fi2� Not approved
Permit fee based upon: 1. Complete contract price.
2. Partial contract price (explain).
3. DPW Valuation (show):
At time of permit application, the applicant was advised the following data or information must be
submitted prior -to permit processing and/or issuance:
Date received
1. All items have been submitted. --------------------------
2. Plot plans in duplicate/triplicate. ---------------------
3. Complete plans in duplicate/triplicate. -----------------
4. Complete engineered plans and calcs. ----------------'----
5 Fees of $ --------------------
_� 6. Letter of signature authorization. ----------------------
7. Sanitation approval. ------------------------------------
8. Planning approval for --
9. Workmen's Compensation Insurance Certificate. -----------
10. Contractors license information. ------------------------
11. -Parcel declaration, recorded copy. ----------------------
12. Access declaration. -------------------------------------
13. Aunt Minnie information. ------- :
Deed of access, recorded copy. --------------------------
15. Deed of parcel creation, recorded copy. -----------------
16. Parcel map, recording data. -----------------------------
17. Pre -inspection request for --
18. Improvements - plans required & DPW approval. -----------
19. Other ------ -
By Date ZN242
Bldg. Inspector
During plan checking process, the following data
or information must be submitted.prior to permit
issuance:
1. Index permit for items
above and in addition the following:
2. Applicant advised by Telephone
Mail
Other -
3.
4.
Plans checked by_
Plans approved by
Date
Date
When permit is issued, process as follows:
1. Mail to owner.
2. Mail to contractor.
3. Deliver with inspection.
4. Telephone and hold
for pickup @ office.
5. Other
Before permit issuance, all of the following
items must be signed or marked NA:
1. Zoning use
2. Legal parcel
3. Envir.Health - Date Plans Sent
A. Sanitation
B. Restaurant
C. Other
4. Public Works - Date Notice Sent
A. Street Imp.
B. Drainage
C. -Permits & Fees
D. Other
5. Planning
A. Use Permit
B. Variance
C. Other
6. Other Agencies - Date Plans Sent
A. Fire Dept.
B. Other
.,• BUTTE COUNTY.DEPARTIENT OF PUBLIC WORKS
• SPECIAL INSPECJIQN REPORT ,
Owner: A. P.
Address: Date of Inspection
Yl -
Tenant• 11%t, Inspector
Building cation:
Type of Inspection requested:
1.. Housing 2. Financing 3. Change of Occupancy to
177 4. Other (specify) 1_ r
Present use.of buiidin
A, Sanitation (Housing)
1. Water closet:
2. Lavatory:
3. Bathtub or shower:
4. Kitchen sink:
5. Hot and cold water to fixtures:
6. Heating facilities:
7. Natural light and venfil ion:
8. Room and space requirement
9. Bedroom window or door for econd exit:
10. Infestation of insects, vertu , or rodents:
11. Connecti.or''to sewage disposal: -
12. Connection to water -,supply:
13. Rubbish and garbage facilities:
14. Comments:
B. Structural
1. � and footings•
2. Floor construction:
3'. Wall construction:__
4. Ceiling and'roof constructidn:
5. Fireplaces:'
6. Comments: •. • _ ,
c:. tiectricai
1. Service and ground:_
2. Receptacles:
3. Fusing:
4. Comments:
. F
D. Plumbing
1. Fixtures connected and vented:
2. Gas water heater:
3. Gas heating.vents:
4.. Comments •
C
(cnntimiP�i nn harlrl '
E. Other
1. Maintenanc4 a4id- epa -* U
r
2 . F ire ar s
3. Safety hazards:
4. Weat}).er -
5. Underfloax=ae ve�t-tscion:
6. Comments:
F. Commercial Buildings
1. Roof covering:
2. Distance to property lines
3. Physically handicapped:_
4. Restroom floors and walls:
5. Exits:
6. Improvements :
'1. Z on ing
8. Couments:
G. Field Problems or Violations ?
1. Problem or :violation (give complete description): l
2. What ac ion taken (give replete description) :
3. What action recommended:
A. i_nfortaation only _ fi1e.
B. Hold for ten (10) days, then wri!-e latter.
C Wxite letter.
D.
w
• ORDER NUMBERsa,t,Q
1 REG. R.U. JINCIDENT NO. START MO. DATE .
Z Q 1, — Iz� —
FIRE NUMBER FI
REG. R.U. NO. thru '
;-16 (1/80)
s.. ORIGIN LOCATION
SEC. TOWNSH� RANGE
N IRE
2 ZLPS A ow
S
INCIDENT TYPE
IRfiFALSE ALARM r.
4A RESPONSIBILITY (AT ORIGIN)
,R COUNTY
Sri 1 -Q -it ,
SME:
o e o 4 .40
MILES
2
IRECTIORZFROM
_ .S
❑IN NATIONAL FOREST, FIRE DIST., CITY 8 STREET NO.,
ETC.
�ir1/ ^9A9/*q.t.) ' ,dR
DIRE T PROT, RESP.('D.P.R•) — STATUTORY
BURNED
iit. STATE ZONE RESPONSIBILITY
f9 ❑ WILDLAND BURNED OR THREATENED
%'r:�:r«::,;.:., . . •.;!,:
fSTATE SCHEDULE A D.P.R.�❑
❑ DISTRICT
❑UNPROTECTED
�❑ OTHER AGENCY D.P.R. ` ❑ CITY
8C ::
COUNTY
LOCAL ZONE
ACRES BURNED
7a 2S SCHEDULE A D.P.R. ❑ U.S.F.S.
VEG.
�❑ OTHER AGENCY D.P.R. (Unincorp) ❑ B.L.M.
TYPE 1 b
FEDERAL ZONE ❑ 81A'
TIMBER
❑ Military) O.P.R. ❑ N.P.S.
❑[:]OTHER FEDERAL
SCHEDULE A D.P.R.
WOOD
❑ MISCJOTHERVZONE•) ❑OTHER
;
JCAUSE (STARTS IN O 0OROONLY)
OW not start In 1 2 5 or B ❑ SMOKING ❑ EOUIPMENT
❑ LIGHTNING ❑ DEBRIS ❑ PLAY W/FIRE
❑ CAMPFIRE ❑ ARSON ® OTHER/MISC.
LAND USE(START3 IN OROONLY)
0 2
❑ Did not start tnO 2 8 orO ❑ FOREST INDUSTRY
DOMESTIC []RECREATION
EST R ATtON
RANCH -FARM C30THER INDUSTRY- COMRCL.
❑ DUMP ❑WILDLAND
ROAD NON-
WILOLAND
UTILITY, RAILROAD E30THER
DAMAGE ( t
7 ,
f -I NO DAMAGE IN
flMBER &/OR
WILDLAND VEGETATION
(_Other than TAYG)
AGRICULTURAL PROD
(Other than T 8 Y G)
bWELLINGS
&/OR CONTENTS
OTHER STRUCTURES
VOR CONTENTS
VEHICLES & CONTENTS
OTHER
TOTAL
/ o OR a ONLY)
Number
of
Yah/OwIg 1
$ DA161A
earest
,2 8/or
SA ACRES OF VEGETATION
BURNED
DIRECT
AGENCY PROTECTION
%'r:�:r«::,;.:., . . •.;!,:
ACRES BURNED
GO TO
8C ::
C�
ACRES BURNED
VEG.
b
TYPE 1 b
TIMBER
OTHER
WOOD
TOTAL
LAND f
BRUSH,•>':
iiF S:
GRASS '.
86
SIZE CLASS '>
PROD.
COF
ElA .25 ACRE OR LESS
TOTAL
'
B 26-9
ACRES
❑ C 10-99 ACRES ?<
STATUT.
RESPON. O ACRES BUANED '•:
❑ 0100-299 ACRES
OF
z>
❑ E 300-999 ACRES
STATE
'<
❑ F 1000-4999 ACRES
U.S.F.S.
❑ G 5000 ACRES OR MORE
B.L.M.
B.I.A.
>.:
W.P.R.S.
(Ex -BOR)
OTHER '
FED.
.y;
OT R
HE
t
TOTAL,
, ON ARRIVAL
❑ t VEGETATION FIRE ❑ OTHER, GO TO 10
SIZE ' . DISTANCE (Origin to head)
ACRES FEET.:
WEATHER (ESTIMATE AT SCENE)
WINO DIRECTION FROM TEMPERATURE.
M.P.M. OF
OVER PLEASE
COF 7540-130-0116
7440.rA J.8'J 3fllt tV.D
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS P MIT
INP.
County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 �_�
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
,.1�2
ZONING
,s"
BUILDING PERMIT
OWNEW
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS -�
. 0
CONTRACTOR'S NAMEq
L
TELEPHONE
CO RACT 'S MAILING ADDRESS
®iovr 3G
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
.$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee$
PLUMBING PERMIT
Filing Fee 10.00
3 /
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00 1Qr�
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
O.00ea
TYPE OF WORK
New ❑ Addition ❑ R`e_moddel ❑ U- ti-liti/es ❑ Installation❑ Other ❑ !,
Describe work: le�dLa.l (n
C
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
e00V OR LESS
Main service 100 AMP OR LESS
10.00
Main service EA. ADO'L 100 AMP
2.50
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
1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,pnd the structure is not intended or offered
for sale. (Sec. 7044)
❑ 1, 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 OCCUP.ai)
OR ADDNS. ACC. BLOGS. , h¢sgft
NEW CONSTR. U TI.OUTLET 2,50 ea
NON -R ESID .BRA CH CIRC 5
/POWER APPARATUS d
(SINGLE OUTLET CIR. I
20050t
Ex. Occup OUTLETS OR FIXTURES eA 030
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESIDJEA.1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
EV—The permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement,should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
agai st said County i c nsequence of the granting of this permit. ('
\) Date ���� `��
Signatu\Aw of Applicant — Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $
Occup.
CONST.TY
scNooLJ
FLOOD
PARCEL
I PD
I ND
I ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt Nony� ;Z;;7
WNITE-O.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
' .'..�...,, , ..•�,t _ZCtiSj'�tti�- '•'C,a' ;`'v„ *iii `�''t.. ., r.Ilk
r
-,COUNTY OF BUTTE - DEPARTMENT OF;PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLEl.CACIF,6 NIA 95965 - TELEPHONE: 916/538-7541
PERMIT APPLICATION DATA SHEET
OWNER
Proposed Building Use
V
Permit No.
/A. P. No T-E� V____/�
Building Inspector Date �� ` j 4-7
i
At time of permit application, I was advised the following data must be submitted prior to permit processing
and/or issuance: DATE RECEIVED APPROVED
1. All items have been submitted. . . . . . . . . . . .
2. Plot plans in duplicate/triplicate, signed by preparer of plans. _
3. Complete plans in duplicate/triplicate, signed by preparer of plans.
4. Complete engineered plans and calcs, with wet signature on plans.
5. Plans with Energy Design Compliance Statement. . . . . .
6. School District "Fees Paid" Stamp on Floor Plan.
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . . . . . .
9. Letter of signature authorization. . . . . . . . . . .
10. Sanitation approval from _ Health Dept. . .
11. Planning approval for (A) Use: (B) Parking: .
�12. Certificate of Workmen's Compensation Insurance. . . . . .
13. Contractors lf-icense Information (no., name style, classif.)
—14. Owner -Builder Verification (Given to owner 0, Mail to owner ❑ )
_..._15. Improvements may be required. . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . . . . .
Pr -I. request
17. Pre -Inspection fore'_.. _ _..._._. _ Required- BueldingeInspector to
18. Recorded copy of Agricultural Acknowledgment Statement,
19. Driveway Permit. _
20. Plot plan approval from city of_
21.
22.
`When you issue the permit, process as follows: Mail to owner; Mail to contractor-
Telephone�%J�/� and hold for pickup office, Deliver w/inspector.
Other
ate)
Copy of plans sent Health,Dept.; Fire Dept., Other Date
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1- Index permit for above items No.
2_ Adr itinnal items renuired-
Contractor, designer, owner, was advised of above required data by_phone---nail—counter by date
Contractor, designer, owner, was advised c? above required data by—phone —mai l—counter by date
Plans checked by
Copy—DPW
Date Plans approved by
Sets of plans on hold in File cabinet AP folder
Date
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) L
2. I (have/have not) )!2,, Y--, 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 Own
Social Security Num er
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 to issue the permit.
COUNTY CIF* BUM
OFFICIAL RECEIPT' N? 03079
DrpARTMSMT'I9GVTNG RECEIPT
ZZA.,
Received fr
Om tw
The Sum of
For
.qemived:
CASH
CHECK
Received By
Title
By
c. �i orbic/ loAJ
16
V � .
File No.
BUTTE COUNTY (For Action 1, 2, 3)
Public Works Dept, (For Information te
Director
Dep. Dir.
Sec.
Rd. & Br. Mtce.
Shop & Yards
Bldg. Insp. Admin. 1-10
Design Engr.
Bridge Engr.
Constr. Engr.
Surveys
Mopping
Transp.
Land Dev.
Drng. /S.I.
Sub.& P 1. Mops
Permiti
Addr.
r
r
s
1
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C -cc:-�_
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11
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
AGRICULTURAL BUILDING EXEMPTION PERMIT
Ii qO.ERMIT N
l'
Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to
house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not
be a place of human habitation or a place of employment where agricultural products are processed, treated,
or packaged, nor shall it be a place used by the public.
ASSESSOR PARCEL NO.
ZONING
OWNER
PHONE NO.
OWNER'S AD RESS
LOCATION OF BUILDING
3 v
USE OF BUILDING
K V Fri It, 4liZC-E coo c�
SIZE OF STRUCTURE
x -SQ. FT.
TYPE OF CONSTRUCTION:
WOOD FRAME STEELCONCRETE OTHER (Specify)
TYPE OF SIDING
ROOF COVERING
FLOOR TYPE
ESTIMATED COST 0 CONSTRUCTION
AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County
Ordinances as follows:/� /_FRONT `�I�---�.�--
6 /
SIDES �,, REAR
AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields.
AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet
from a mobilehome, and 23 feet from a commercial building.
AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and
a mobilehome, and 40 feet from a commercial building.
I declare under penalty of perjury that the building will be used as stated above and the proposed use
conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will
contact the Department of Public Works and will obtain any necessary permits, inspections, and approvals to
comply with the requirements in effect at that time and before occupancy.
Date 1_2 - 2 —S?!] Signature of Own di
Permit Fee - $25.00
The above described AG Building is exempt from a building permit.
Receipt No. ���� Director of Public Works
By Date
White - DPW, Yellow - Assessor, Pink - B.1., Goldenrod - Applicant
eount* q Our
OROVILLE, CALIFORNIA
GENERAL CLAIM
CLAIMANT: Claudia Johnston
ADDRESS: 1345 Marian Ave.
CITY & STATE: Chico, CA 959?8 IMPORTANT:
SEE INSTRUCTIONS
December 9. 1987
DATE OF CLAIM: ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
Owner has decided not to do work. (Bldg Permit Appin. #3875-87P,
Receipt #03079, dated 11/30/87', A.P. #39-36-09).
Total permit fees paid -------------------------- $30.00
Retain filing fee------------------------------- 10.00
Refunddue-----------------------------------------------
TOTAL
$20.00
I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this
claim Is true and correct as stated. p ,1 ^�
1 �°
Dated this ........�....... day of 19�.-.{.. et� �1r�.. Ca --1 j T�
S! ature of Clai t
I, the undersigned, hereby certify that. to the best of my knowledge, the services or articles specified above have been performed or de-
livered and that there is a Budget Appropriation y❑,, or Specific Board Approval 0 (Check one) f e as
Dated this ............. 9t 1............. day of ...P.§. .4JAb.Qr... 19 ... Vat ...Qrsxil.le.... Cell(. .. ........ ..
.... . .. ..................................................
Department Head or Auth d D eputy
Dept. E:p.
Code ..............�AidQ-QQ2........ Code..............42.10500.............PAYABLE FROM ............... Const......Pesiu%ts................................. FUND
DO NOT WRITE BELOW THIS LINE _ AUDITOR'S USE ONLY
DEPT. & SUB. PROJ.
SUB. OBJ.
CLAIM NO.
INV. NO.
INV. DATE
ENCUMB.
GROSS AMT.
039-360-009=F p2-3032
RICHTER, TODD , °
1345 MARIAN AVE., CHICO
RE -ROOF ° `"
I,
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COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT 02-3032
C
ASSESSOR PARCEL NUMBER
039-360-(M
ZONING
51..1
BUILDING PERMIT
OWNER
Todd Rinhtpr
TELEPHONE
11443-1831
SO. FT. OCC. BUILDING VALUATION
OWNERS MAIUNG ADDRESS ..
1345 Marian Aim WhilLo CA 95928
30 so 1800.00
CONTRACTOR'S NAME
owner
TELEPHONE
"
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $ 1800.00
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $ 41.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
1345 Marisa AVe Chico CA 95928
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Fling Fee 20.00
Each Trap 7.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater 23.00
Water piping 15.00
Each gas water heater or vent 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: Re -roof
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home I S I G W @20.00
PERMIT FEE $
'
ELECTRICAL PERMIT Fling Fee 20.00
Main Service zoOA OR LESS 23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.PSING
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
,�y Date /D z /
X / i�j
Signature of Applicant - Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over stories in height. ^
Main Service 200A TO 1000A 46.00
NEW CONST. DWELIJNG OCCUR so
OR ADONS. ( a ACC. BLDS. 3.5¢FT;
No..ESIDT' MULTI.OUTLET @7.50
OWELEPPARATUS
a R AOUTLET CIR.
20 p 1.00
EX. OCCU OUTLET OR FIXTURES BAL @ .50
Ex. Occup. ourLETsFIXED APPRESIDLNS. . OER 0. 1 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wirina 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 61.00
HAZ. I D. FEES IMP I FLOOD I CD F PARCEL PD HD ISSUE
This permit is hereby issued under the applicable provisions
in the Butte &Ounty Code and/or Resolutions to do work
indicated ebo((,ie for which fees have been paid.
(� V
By /. Date
PERMIT EXPIRES ON t d1 L t✓
Date
Receipt No. i •
WHITE-D.D.S.-B.D. CANARY=ASSESSOR r PINK -INSPECTOR OLDENROD-APPLICANT
SR&.12/96)
z�tOUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive Oroville, California 95965 • Telephone (530) 538-7541
APPLICATION AND PERMIT 02-3032
PERMIT N0.
ASSESSOR PARCELNUMBER
039_1i;0_009
ZONING
VIP
BUILDING PERMIT
OWNER
Todd Richtpr
TEL90AME
SO. FT. OCC. BUILDING VALUATION
. OWNER'S MAILING ADDRESS
2345 Marian Ave Chico CA 95928
30 sq 1800.00
CONTRACTORS NAME
owner
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $ 1800.0
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $ 41.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
1 345 Mari
Marian AVe Chico CA 95928
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: Re -roof
Gas piping sy2tem 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home ISI G1 W1
@20.00
PERMIT FEE S
ELECTRICAL PERMIT
Fling Fee 20.00
800V R LE
Main Service 200A OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
L w for the following reason:
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permitis issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number •
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that f I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
.�^
X / p� Date /� 2%
Signature of Applicant -A Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 storiep i height.
Receipt No. °
WHITE-D.D.S.-B.D. CANARV-ASSESS R PINK -INSPECTOR GOLDENROD -APPLICANT
Main Service 200A TO 1000A 46.00
NEW CONST. DWELLING OCCUP. SO
OR ADDNS. & ACC. BLDS. 3.5¢FT.
=REOSI.T MULTI-OCUTLEi 97,50
8SIPONGWERLE APPARATUS
OUTLET CIR.
20 @ 1.00
Ex. Occup. ourLEr OR FDcruREs SAL @ .50
Ex. Occup. oFlxuT,E�°TSA AEs ).1 5.00
Temporary Service 23.00
Mobile Home Facilities
20.00
Misc. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
C0NST. TV PE
TOTAL FEE $
HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE
This permit is hereby issued under the applicable provisions
of the Butte unty Coil nd/or Resolutions to do work
indicated ab a for wh'Eh fes have been paid.
By� Date
PERMIT EXPIRES ON
Date
E
A setback of 5 ft. from the
property lines and.a setback
of 50ft. frorn, the road
conterline shall be clear of
structures or equipinent 0
for a 2 ft.; eave overhang.
`VI,
v
T-
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e
A- — —
herrn STATE Mm
T SMAL ENERGY REQUIRDAPM for Aft bL
Of ------- I -q-0 ...... sq. ff..A Degree Days, and .... Design Tp,-!-,
Insulation: G!az:--g:
Slab edge - - - - - -
Fdn. Walls - - - - - - P sq. 't.
Flaz,s - - - - - - - - z---------- f t .
walis - - - - - - - - P
LEO
Ceiling/Roof R—Iq,00 Vu,
IIJr Circulating pipes -ktw IN t,% u J
Ducts Table 10-D WM.C.
NOTE -.—AD Materials & Workmanship S.�c:jl n ve
----
Accordance with r,2 cs arV4 Hfg. & A.C.: Exha�,-J Fans T
Type
of a qualify prescri'i,2c: -% —- Gas Nois
Use in the BTU Max.
Uniform Building, Plumbing Mechaniccl Codes and Wfr. Hfr. Type pr) F All Appliances cerfifilk!"
fhe National Electrical Code. O+her:
ved-C 0'. /10 J 00 elejytc.
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