HomeMy WebLinkAbout039-540-03139-543) '3759-90 PqE, - M
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C
BLACK, Jim
9
9445 Dwyer Ct,�Dur'ham
(new sf) I
39-54-31"'.
Permit#4235-90B
(fire sprinklers sf
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039-540-031 PERMIT#95-1438
DILBECK, William
9445 Dwyer Ct., Durham
Cont; Jim Black c7
New Carport
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01-2422
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DILBE
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9445 DWYER C
CONT:
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ONT: JIM BLACK
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DETACHED SHOP W.
039-540-031 02-2233
DILBECK, WILLIAM
9445 DWYER CT., DURHAM
CONT: ADONIS POOLS
POOLAIL -0(0
IN —.01F
039-540-031 06-1223
DILBECK, WILLIAM
9445 DWYER CT, DURHAM
Cont: SIERRA ROOFING
RE ROOF
B07-1823 039-540-031
MISCELLANEOUS Wall Furnace
GAS FIREPLACE TO REPLACE WOO1
9445 DWYER CT
DILBECK WILLIAM Q & JO L
,;-- - (r-
o3a - 540��
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31
P- .
v Man
jm
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 9445 DWYER CT
Owner:
Permit No: B07-1823
APN: 039-540-031
DILBECK WILLIAM C & JO L
Issued Date: 08/27/2007 By KCG
Permit type: MISCELLANEOUS
9445 DWYER CT
Subtype: Wall Furnace
DURHAM, CA 95938
Expiration Date: 08/26/2008
Description: GAS FIREPLACE TO REPLACE WI
(530) 345-5006
Occupancy: Zoning:
Contractor
Applicant:
Square Footage:
MC CAULEY ROBERT CONSTRUCTION
MC CAULEY ROBERT CONS'
Building Garage Reindl/Addn
1221 WEST WIND DRIVE
1221 WEST WIND DRIVE
t
CHICO, CA 95926
CHICO, CA 95926
t
Other Porch/Patio Total
(530)864-3399
(530)864-3399
FEE INFORMATION "
DBM Heater (Wall) $58.00
Total Charged: $58.00 Fees Paid: $58.00
Balance Due: $0.00 Receipt No: B4382
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
MC CAULEY ROBERT CONSTF 443580 / B / 07/3 2009
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am lice sed under provisions of Chapter 9
(comma ' with Section 7000) of ivision 3 the Business an rofessions Code, and my license
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 700D)
is in force nd act.
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
08/27/2007
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
Cont ctofs Signature Date
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
WORKERS' COMPENSA N DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
the work himself or herself or through his or her own employees, provided that such improvements
❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
HAVE
❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
❑
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractor's License Law dows not apply to an owner of the property who builds or improves
My Workers' Compansation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
Carrier: Policy Number: Exp. Dale:
Tnot be completed if the permit is or one un re ollars ($100) oror estIAM
EXEMPT under Section B. 8P.C. for this reason:
�:sectioTnHATed
TIFYN THE PERFORMANCE OF THE WORK FO WHICH THIS PERMIT ISSSUED,
I shall not employ any person in any manner soas t�lbecome subject to the Workers'
Compensation laws of California, and agree that if I should b come subject to the workers'
X 08/27/2007
compeDsetrop provisions of Section 3700 if the Labor Colf, I shall forthwith comply with those
Owner's Signature Date
prov' ons.
V4+1
XLW 08/27/2007
I hereby certify that 1 have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
1
SignatuAe Date
SATION COVERAGE IS UNLAWFUL,
WARNING: FAILURE TO SECURE WORKERS' COAENALTIES
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMI AND CIVIL FINES UP TO ONE
injury, including death, and property damage caused arising out of, or in any way connected with
HUNDRED THOUSAND DOLLARS $100,000 , INON TO THE COST OF COMPENSATION,
( )
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
t is
DAMAGES AS PROVIDED FOR INSECTION 3706E LABOR CODE, INTEREST AND
use or occupancy of any sidevAlk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
unt to enter the above n ned property for inspection purposes. I hereby certify that I am the
prop wrier o a ri act on the property owner's behalf.
'r Me-,I,,9�0 08/27/2007
'eof'A
CONSTRUCTION LENDING AGENCY
_--- _- - -- - , -
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
am Alittee [SIG Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
❑ Owner icontractor OR; E]Agent for Owner Agent for Contractor
FILE COPY
Lender's Address City State Zip
�6QT BUTTE COUNTY
0 o DEPARTMENT OF DEVELOPMENT SERVICES
0 0 BUILDING PERMIT APPLICATION .
o. o OFFICE #: (530) 533-7541 FAX #: (530) 533-2140
cv--ab- a A FEE WILL BE REQUIRED AT TIME OF APPLICATION
�: .� Website: w. tw.buttecounty.net/dds
0(J�� **PLEASE PRINT CLEARLY**
. OWNER INFORMATION
Last Name D yZ 8�C KFirst
Namur/
Mailing Address 9yy5 'DWY15R
city z�n ,41 M
.-I
StateGA
"p 9.593F .
Phone Sy S.- .-006
Fax
E-mail
CONTRACTOR
Name Re) 43ER.T /N d,!iAe4'4Z
Address �22� W�S7- UIIAZD �Iz.
City GN`G D
State 5,4
Zip
Phone �c,��66 �-�
Fax _
E-mail
Lic. # y�3s�
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
�dNE
Address
Zip 9Sg .
City
Fax
State
Zip
Phone
Fax
E-mail
State License Number
APPLICANT INFORMATION
Name' m e-e"/jaLEY
Address 1-/1i4'0 Ak
City GyIGO
State
Zip 9Sg .
Phone3ys�66 y 7
Fax
E-mail
PERMIT
NO.
BIN #
PROJECT LOCATION
AP# 000
Property Address 9y!%S wxriz CT
City j04, /AM
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK:
�%I„0 rv►� ,st/D � T PILO !��
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
For office use only:
Zoning
Flood Zone
SRA
Yes
No
Occ.
Type Const.
NOTES
V" RESIDENTIAL
-
039-540-031 02-2233
PERMIT NO.
— DILBECK, WILLIAM
9445 DWYER CT., DURHAM
t
CONT: ADONIS POOLS I
POOL
,ry
1
P �
i, •
.
r6 - oe 1301201cl� Ry
�G
SPECIAL CONDITIONS
;i
CHECKED
BY
SRA
°
FLOOD CERTIFICATE REQ.
= #
FIRE SPRINKLERS REQ.
t,
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
i
i.
LI O
JOB FINALED (Date
Signature
b<
J=OK '
0 = Not OK
Not . =
Not Readyable
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2. 'Soils; Special MH Support Sketch
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3.- Sewer; Location -Test -Fall -C/O -Concrete
3.
4.
Water; Location -Test -Easement Needed (Sketch)
4.
5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
6.
Gas; Location -Test -Wrap;-/ /" L 'ft.
/ P Nat. or/ /;L "ft./ P LPG
7.
Well Clearance& Disconnect
8.
Utility Clearance
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
Date
Roof; Shthg-Roofing
Card B-1 Date Card B-1
Date
Ext.; Steps -Doors -Landings
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OKexcept #'s
1.
Zoning Requirements -Setbacks -Easements
Date
2.
Footings; Size -Spacing -Marriage Line
Date
3.
Gas; MH Test -Demand -Valve -Connector
Date
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
5.
Drain; MH Test -Fall -Flex Connector
27Soils;
6.
Water; MH Test -Regulator -Connector
3.
7.
Water and Sewer Connected -C/O. to Grade -HD Approval
4.
8.
Gas and Electricity Tagged • .
5.
9.
Tie Downs -Type -Installation Cert.
6.
10.
Exits; Insp;-Sketch
7.
11.
Cert. of Occupancy
8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Blocking
4.
Gas; MH Test -Demand -Valve
5.
Electricity; MH Test
6.
Water; MH Test -
7.
Water and -Sewer Connected
8. Gas and Electricity Tagged -
9. Exits
10.
License Decals
11'.
Verify #'s with Office -
Date
Card B-1 Date. Card B-1
Date
Card B-1 Date Card B-1
9. Health epartment Approval
10. PI .; Cir. Test -Water Supply Test.
11 ight Niche
12. Enclosure; Fpainq-Alarms
Date'/ q///`9/}- Card B A•� (/ /- Date Card B-1
�2_ Dp�
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3.
Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4.
Wood Awn.; Posts- Beams- Rftrs-Connectors
Shthg-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
7.
Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
12.
Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POO (PI ns) OK except #'s
Se cks-Easements
27Soils;
Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-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 Conduit
9. Health epartment Approval
10. PI .; Cir. Test -Water Supply Test.
11 ight Niche
12. Enclosure; Fpainq-Alarms
Date'/ q///`9/}- Card B A•� (/ /- Date Card B-1
�2_ Dp�
J=OK
= Not AK
- =Not Applicable
. = Not Ready
RESIDENTIAL
Date
UNDERFLOOR (Plans) OK except #'s
Date
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-Blockouts-Wrapped
6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
Date
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
Date
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
Date
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
Date
16. Insulation
(Single & Duplex)
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
17. Water Htc; Vent -Access -Combustion Air Baffle
18. Water Pipe; Test & Anchor -Nail Protection
19. D.W.V.; Test Fittings & Anchor -Nail Protection
20. Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sixe & Anchors
23. Fire Sprinkler; Test
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
24. Fixture & Transformer Clearance -Ins. Protection
25. Elec. Receptacles Spacing -Lights & Switches at Doors
26. Size Boxes & No. of Conductors Stapled
27. Romex Installed Close to Edge of Studs & C.J.
Date
28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
Date
29. 2 Appliance Circuits in Kitchen & Conductor Size GFI
Date
30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral El Yes O No
32. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels-Motors-Mech. Equip.
34. Clothes Closet Light -Shower Light -Spa Light
35. Smoke Detector
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
36. A.C. Ducts Insulation & Support
37. Vent Fan, Exhaust above insulation
38. Condensate Drain & Overflow, Size & Grade
39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
40. Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
41. Sills Proper Materials & Anchors
42. Walls Studs -Nailing Spacing & Braces -Plates -Sound
43. Bearing Walls over Girders & Floor Nailing
_
44. Draft Stop in Walls (rat proof)
45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46. Headers & Beams -Size & Bearing
Date
FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng.
49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins Baffles
51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59. Glazing Area -Glass Protection -Skylights -Plastic
60. Shear Walls; Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
64. Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66. Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71. Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74. Elec. Outlets & Receptacles at Kit. Counter
75. Garage Fire Door; Swing -Landing -Closure
76. A.C. Duct in Garage -Damper
77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78. Plb.; Elec. & Mech. Equip. Listed for Location
79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80. Insulation -Foam -Looked in Attic
81. Guard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor O Yes
_
83. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes D No
84. Stucco Brown -Finish
85. A.C. Unit Disconnect, Electrical -Plumbing
86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87. Water Well, Disconnect, Electrical, Plumbing
88. Exterior Elec. Trim, G.F.I. Receptacle -Underground
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
94. Energy Compliance Certificate -Other Certificates
95. Address Posted
96. Fire Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card 3-1
Date
Card B-1 Date Card 3-1
Comments at Final:
.,.. .., .. ....... ,,. it �.��,
COUNTY OF BUTTE
BUILDING DIVISION ,
DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE =f
OWNER - PERMIT NO.
A(routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please call for re -inspection when correction of
work is have an you completed. If
p y y questions pertaining to this matter, or need additional
explanation, please contact the Building Inspector as indicated below. —.
4
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4�
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t
Date ' 0 `� Inspector
1
REV 4/05 Phone #
ash;
4'
r
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
COUNTY OF BUTTE "
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES" ,
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
C- C/-,/ 6a- X 33
OWNER PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately. `
Date / 2 Inspector
REV 106 2
r+'c
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 P5RMIT [VO.
(Rev. 12/96) APPLICATION AND PERMIT f 4II.3
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
owNr a -
William Dilbeck ,-
TELEPHONE
34�-500G
SO. FT. OCC. BUILDING VALUATION
DwN944 uNG yerDRESS Court Dtsham1 & 95938
CONTRACTOR'S NAME
Adonis is
TELEPHONE
85.-1197
CONTRACTORS MAILING APDRESS
17 Phes co CA 95973
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$189.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$ 23.00
BUILDI. NGAD�RESS �t
1�j, 2,
�f�
Energy Plan Checking Fee
$
PERMIT FEE
$ 2OO
LOT
Lj
SUBDIVISIONS NAME 118-57/59 7-35-90
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE 1.01 ae
SF ❑ Duplex ❑ Mobilehome ❑ Other PAPl
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00 15. OU
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: Pool Master 507-97
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
920.00
PERMIT FEE
$ 355.00
ELECTRICAL PERMIT
Filing Fee 20.00
LESS
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.
�'
License Class Cr - i Lic. No. / i (r r � �4
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 e-:1 r' t' f "' L T,'7 ;• ' L ,..,e-1
Policy Number _
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X I L t J Date/ C" G
Signature of Applicant - [3Owner ❑ Contractor ErAgent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service zooA To ,000A
46.00
NEW CONST. DW EWNG OCCUP. s0
OR ADONS. ( a ACC. BLDS. 3.50FT,
. I.OUTLET 97.50
pEOSIDTMULT
POWER APPARATUS
a SINGLE 0 IT. CIR.
Ex. Occup. OUTLET OR FIXTURES 820 @ 1.00
Ex. Occu .OuxT EDs AE�sInoR� 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
Pool electric 30.00
PERMIT FEE $
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 317.00
HAZ.
D. FEES IMP FLOOD CDF PARCEL PD HD ISSUFa
V
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
f /
Byy' /�/
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
/
p 1 -7 ,
Date J ^'- /�`�
� /-,
Dere
Receipt No. � L 10 711 /
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
FA,
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP061223
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
LICENSED CONTRACTORS 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
Issued Date: 05/23/2006 APN: 039-540-031-000
the Business and Professions Code, and my license is in full force and
effect.
�- CKJ Q�
License Class : I License Number: �YV
Site Address: 9445 DWYER CT DUR
Date: 5' 'O b Contractor: iff i G •�4 t"1
Map Index:
Description: RE -ROOF 43 SQ.'S COMP
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: DILBECK WILLIAM C & JO L
to its issuance, also requires the applicant for such permit to file a
9445 DWYER CT
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
DURHAM, CA
7000) of Division 3 of the Business and Professions Code) or that he or
95938
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
1, 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 (Sec. 7044, Business and Professions
Applicant: SIERRA ROOFING
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
P O BOX 252
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
CHICO, CA 95926
year of completion, the owner -builder will have the burden of
(530) 342-1863
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
Contractor: SIERRA ROOFING
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
P O BOX 252
❑ I am Exempt under Article 3 of the Business and Professions Code
CHICO, CA 95926
(530) 342-1863
Date: Owner:
License #: 688803
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
Architect:
is issued.
❑ I have and will maintain workers' compensation insurance, as
Engineer:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carder and policy number are:
Carrier: _:c. 5 - J -
Total Square Ft: 0 S. F.
)I QQO i 034 j
Policy#:
Valuation: $0.00
❑ I certify that in the performance of the work for which this permit is
Census Code:
issued, I shall not employ any person in any manner so as to
become subject to the 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 provisions.
Ithose
Z.
Date:
Applicant:
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
�d
r
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Res ions do work indicat a ve for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
BY Date: LS _1q,L
PERMIT EXPIRES ON: r -71'2./n
Address:
Date
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly au agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substanc is orm or ocument of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection p oses.
Print Name:(' 1 G -( VA u Signature:
`� - Q
Date: e
❑ Owner '9 Contractor ❑ Agent for Owner ❑ Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICATION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last Name I `I
j
irst Name i� 1
U �
Address q 5 -0 � �
UState/
City f A
;
�`1
Zip
I
Phone 3
Fax
E-mail
CONTRACTOR
Name
Name
Address ? 025
2
City ` O
City
State/
ZipQ Z-7
Phone�a,Z � �
Phone
Fax S_Iq
E-mail 5
E-mail
Lic. #
688 0
Class
APPLICANT SIGNATURE
X
For office use o :
ARCHITECT/ENGINEER
Name
/icer A C -i'Q R_
Address
City
Occ.
State
Zip
Phone
Page
Fax
E-mail
Date Approved:
State License Number
APPLICANT SIGNATURE
X
For office use o :
APPLICANT INFORMATION
Name
/icer A C -i'Q R_
Address
City
Occ.
State
Zip
Phone
Page
Fax
E-mail
Date Approved:
APPLICANT SIGNATURE
X
For office use o :
Zoning
Pro ,,e s
'Cross
Flood Zone
Street
SRA I Yes
I No
Occ.
Type Const.
Subdivision Name
Map Book
Page
I Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
Page 1 of 2
PERMIT
QO.
6-122-3
BP
BIN #
PROJECT LOCATION
AP# 0 9-5,Y62 ^D 5
Pro ,,e s
'Cross
Street
WORKER'S COMPENSATION
Policy Number
Carrier
T55
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
J
Addres.
Description or Scope of Work:
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
required.
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked,and other department costs are not
refundable.
Received by— Amount: Bldg
SRA
Receipt #: � 7-� / Sheriff
SMTP
Other
.56 Total —
REV B-12-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit., INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxesl
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate,.wet-stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
❑ 1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑ 2.
Impact Fees. -
❑ 3.
California Department of Forestry plan approval (if required).
❑ 4.
NPDES Form.
❑ 5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 6.
Contractor's license information. (Number, Name Style, Classification).
❑ 7.
Worker's Compensation Carrier and Policy Number.
❑ 8.
Owner -Builder Verification (if required).
❑ 9.
Letter of Signature authorization (if required).
❑ 10.
Recorded copy of Agricultural Acknowledgment Statement.
❑ 11.
❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO.
❑ 12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSMILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 P MIT o.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCELNUMBER
_
039-5 -
ZONING
-
BUILDING PERMIT
DWVilliam Dilbeck
TELEP ONE
345-5006
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
9445 Dwyer Court Durham CA 95938
CONTRACTOR'S NAME
Adonispool-2
TELEPHONE
891-1197
CONTRACTORS MAILING
RIE12 Phesan Run Chico CA 95973
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$189.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$ 23.00
BUILfJI,N�i AD�RESSS
y(F4 'I'hY,"ni'er Court Durham
Energy Plan Checking Fee
$
$
PERMIT FEE
$
LOT t&.
[}
SUBDIVISIONS NAME 118-57/59 7-35-90
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
1 7.00
USEOFSTRUCTURE 1.01 ac
SF ❑ Duplex ❑ Mobilehome ❑ Other POOL
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00 15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: Pool Master 507-97
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
920.00
PERMIT FEE
$ 35.00
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 f0 and effect.
G-- 3 �� {� g ��
License Class Lic. No. V
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 insurarle carrier nd Ii number e: 1
Carrier tr%C)G �' � (( ` " b'�. T�4T'E U: C
Main Service TO
46. 00
CCU000A
NEW CONST. DWELLING OCCUP.
W:
OR ADDNS. ( 8 ACC. BLDS.
SO
so
3.5¢FT;
NEW
FEOSIDT. MULTI -OUTLET
97,50
POWER APPARATUS
8 SINGLE OUTLET CIR.
Ex, Occu OUTLET OR FIXTURES
BAS p I; o
Ex. Occup. oirrLEEDrs A.,6.) EA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
Pool electric
30.00
PERMIT FEE
$ sn no
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEI:
$
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 performai a of the work for which this permit is issued, I shall
not empl any per n in n manner so as to become subject to workers'
co pen 'on I s f Ca 'rf i , and agree that if I should become subject to the
w ers c p ion pr i ions of section 3700 of the Labor Code, I shall
fo wit cc pl th se r visions.
%/
X Date/ t» �'l C —0Z.
Signa r of App (cant ❑Owner ❑Contractor Agent
An OSHA permit is required for excavqtions over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee is
OCC
CONST. TYPE
TOTAL FEE $ 317.00
HAZ.
D ES IMP FLOOD CDF PARCEL PD HD SU
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
r
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
�rDate .Z ✓ 02
Date
Receipt No. %
WHITE-D.D.S.-G.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
Feb 01 02 08:13a
P.1
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 - Telephone (530) 538-7541 P IT NO.
taev.,2/96) APPLICATION AND PERMIT �
ASSESSOR PARCEL NUMBER039 5 ZONING's _ BUILDING PERMIT
� 1
OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION
oWNo+9s M/�SlNO_ A�DRES9 y� �
w C-�
�-
CONTMCTOR'9 NAMF� JO�� �� ✓�
_..COMM'S "u,CTORON"u,UAppR/r�4Jla � J(— U ��-- C///(C> g�
CONS TRUCTION LENDER 7L_�J
LENDERS WALING ADDRESS
ARCHITECT OR ENGINEER LICENSE NO.
ARCHITECT OR ENGINEERS MAILING ADDRESS
–BUIIDWO ADORESB • .'`1 C
-i U2j1625 131123z),S015I) 4- )2 -,-L--
LOT NO. SUBMISIONS NAME OEL MAp
USEOFSTRUCTURE I.dl A(-
SF
LSF ❑ Duplex ❑ Mobilehome ❑ Other ,oma •`�
SPECIFY
TYPE OF WORK
Now ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work:
L X o5
" PERAIT FEE PIAL®
SRA • .
SHERIFF
®TH�
AMOUNT RECemb
*REC'W T NJ#Aft
" TO a him INTO COm"A
Receipt No.
WHITE-O.O.S.-B.O.
Total Valuation Is
PERMIT FEE
S
Fling Fee
$
20.00
Permit Fee
$
g
Plan Checkin Fee
$
Z
Energy Plan Checking Fee
S
NON -REBID. L;Ur45 1.
IO.
. .
5
-•
PERMIT FEE
$
Ex. Occup.
PLUMBING PERMIT
20 p Loo
SAL 0 .SO
Fling Feel 20.00
Each Tr
5.00
7.00
Solar or heat um water heater
Mobile Home Facilities
23.00
Water piping
15.00
Each gas water heater or vent
15.00 �'
Gas piping system 1 - 5 outlets
15.00
Building sewer,15.00
Mobile HomeS G W
Q20.00
PERMIT FEE 1 $ YJ
MECHANICAL PERMIT I Fling Fee 1 20.00
Hood I 1 6.50 I I
PERMIT FEE I S
Mobile Home installation Fee Is
Energy Inspection Fee S
occ � T• TM� TOT L FEE $ /
�_• D. FEES IVP FLOOD I C PAR L I HDtrissue
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-pald.
By
PERMIT EXPIRES ON
Date
[Date)
PERMIT FEE
S
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service
aOOV OR LESS
tow oR LEN
23.00
Main .Service
200A TO i000A
46.001
NEW C S.T.
—EU.INo OCCUP.
6 Z. =.
3 5 SO.
NON -REBID. L;Ur45 1.
IO.
MULTI.OUTLET
7.501 �..—_..
POWEA APPARATUS
6 SINGLE OUTLET CR,
I
Ex. Occup.
O nU-f OR FORURES
20 p Loo
SAL 0 .SO
Ex. _Occup.
APPUIS. OR
olmt7n mlo. Ew
5.00
Temporary Service
_
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE 1 $ YJ
MECHANICAL PERMIT I Fling Fee 1 20.00
Hood I 1 6.50 I I
PERMIT FEE I S
Mobile Home installation Fee Is
Energy Inspection Fee S
occ � T• TM� TOT L FEE $ /
�_• D. FEES IVP FLOOD I C PAR L I HDtrissue
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-pald.
By
PERMIT EXPIRES ON
Date
[Date)
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: ��� '` ASSESSOR PARCEL NUMBER / ✓ J /
/ 4?/6 -�
Proposed Building Use: r Aft Counter Technician: Date:
Item required in order to apply for a permit. All boxes MUST be checked O marked NA in order to apply.
VVans, 3 or 4 sets, signed by the preparer of the plans.
ete plans, 3 or 4 sets, signed by the preparer of the plans.
ered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. c g
ered truss details and layouts in duplicate. No faxes!
compliance design and supporting documentation in duplicate.
homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or
foundation plans, all in duplicate.
7.. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate.
(D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer.
Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be
indexed and returned to the plan review line-up when required items are received.
Date Received By
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................
❑ 9. Plot plan and business license approval from the City of Biggs ....................................
❑ 10. Letter of intent for non-residential buildings.........................................................
❑ 11. Detached Accessory Building Form filled out by the owner .....................................
❑ 12. Hazardous Material Form...............................................................................
❑ 13. Other •
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
❑ 14. Fees as shown on the attached Schedule of Fees Due Sheet .......................................
❑ 15.—Statement of Intent for Non -heated and A/C Buildings ................................... �...
Sanitation and plot plan approval from the Environmental Health Department inS�
❑ 17. City of Chico Plumbing permit........................................................................
❑ 18. California Department of Forestry plan approval ❑ paid. Sent by: ......................
❑ 19. Planning approval for (A) Use: Pel- _(B)Parking: (C) Parcel Check: a —'Z®—O 2
❑ 20. Contact Land Development about ❑ Improvements, ❑ Drainage ..............................
❑ 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 22. Pre -Inspection for required ................
❑ 23. Contractor's license information. (Number, Name Style, Classification) ......................
❑ 24. Worker's Compensation Carrier and Policy Number ..............:..............................
❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) .....................
❑ 26. Letter of Signature authorization....................................................................
❑ 27. Recorded copy of Agricultural Acknowledgment Statement ....................................
❑ 28. Manufactured home utility clearance:->%,;............................................................
❑ 29. Existing violations and/or expired permits14.......................................................
❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $
❑ 31. Other:
When issued Telephone and hold for pickup.
I have been informeoof the aboke it' a gd'recjgirdments for obtaining a building permit.
Applicant: � - Date:
1. Index permit application for the above items n{Gmbered:
2. al items required
esigner, owner, was advised of the above data by
Contractor, designer, owner, was advised of the above data by
Plans reviewed by: Date:
Structural reviewed by: Date:
Note transfer by: Date:
Yellow: Building Division
Plan Check Letter
P Mne, ❑ iail, ❑counter, by tr •y .Date:_ 0�
phone, El mail, ❑ co u er, b Date: ..
Plans approved by: Date:Z
_Structural approved by: Date:
M
N
N
N
�i
E.H. USE ONLY
Rat Plan Anacliod �—
Float Man Attachad
sent to G.D. '2.6
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location AP#
.Plan Approved for: Sewage Disposal Water Supply: Public Private Well
Clearance for dwelling. Other
Hold final for:
Final clearance O.K. for: .
NGTE:
Environmental Health Specialist
8/96
Date
1~ /DATE
j�
• � �/CSS '_CJ
e0000
------------
Io
PREPARED BY PAGE
NOTES
V
PERMIT NO.
RESIDENTIAL
'039-540-031 _ 01-2422.
DILBECK, BUD
9445 DWYER CT, DURHAM
CONT: JIM BLACK
DETACHED SHOP
II SPECIAL CONDITIONS 11
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
JOB FINALED (Da 7`
Signature
1
CHECKED
BY
,/ = OK
Sewer; Location -Test -Fall -C/O -Concrete
0 = Not OK
Water; Location -Test -Easement Needed (Sketch)
- = Not Applicable -n MOBILE HOMES
• = Not Ready
6.
Date '
MOBILE HOME UTILITIES (Plans) OK except f's
Well Clearance 8 Disconnect
1. Zoning Requirements -Setbacks -Easements
Utility Clearance
2. Soils; Special MH Support Sketch
3.
Sewer; Location -Test -Fall -C/O -Concrete
4.
Water; Location -Test -Easement Needed (Sketch)
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
6.
Gas; Location -Test -Wrap;-/ /" L'ft.
/ P Nat. or / /"L"ft./ PLPG
7.
Well Clearance 8 Disconnect
8.
Utility Clearance
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
t
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK except 11's
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Tie Downs -Type -Installation Cert.
10. Exits; Insp.-Sketch
11. Cert. of Occupancy
12. Permanent Foundation Only; License Decal
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
MISCELLANEOUS
Date
r
DECKS, COVEYS,
,J
CARPORTS GARAGES (Plans) OK except #'s
oning Requirements -Setbacks -Easements
(�
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3.
ecks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
Wood Awn.; Posts- Bea ms- Rftrs.-Con nectors
Shthg.-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
t
orfs; Windows -Doors
Iect
a
g.; Sills Anchors-Studs-Rftrs-Trusses
Sidi , ailing -Veneer -Stucco -Mesh
1
o ; Shthg-Roofing
Steps -Doors -Landings
12.
Braced Wall Panels
Date
-7-f//
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except q's
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5.
Elec.; Pool Lighting; 15 Volts -GF]
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
11.
Light Niche
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
V= OK
0 = Not OK
- = Not Applicable
= Not Ready
RESIDENTIAL (:
Date
FRAMING (Continued)
Underfloor (Plans) OK except #'s
46.
1.
Zoning -Setbacks -Easements -Flood -Slope
47.
2.
Fig., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
48.
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
49.
4.
Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
50.
5.
Stemwalls, Main; Steel-Blockouts-Wrapped
51.
6.
Stemwalls, Garage; Steel-Blockouts-Wrapped
52.
6a.
Hold Downs and Special Anchors
53.
7.
Slab, Steel -Wrapped
54.
8.
Piers -Fireplace Ftg.-Steel
55.
9.
D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test
56.
10.
UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
57.
11.
Water Pipe; Test -Anchors -Regulator -Service Test
58.
12.
Electric Underground
59.
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
60.
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
61.
15.
Access & Ventilation
62.
16.
Insulation
Date
Date
Card B-1 Date Card B-1
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
PLUMBING (Permit) OK except #'s
63.
17.
Water Htr.; Vent -Access -Combustion Air Baffle
64.
18.
Water Pipe; Test & Anchor -Nail Protection
65.
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
66.
20.
Shower Pan; Test, First Floor -Tub Access
67.
21.
Test Tub & Shower, Second Floor -Tub Access
68.
22.
Gas Pipe; Sixe & Anchors
69.
Stairs & Rails
Date
Fireplace or Stove, Clearance -Hearth
Card B-1 Date Card B-1
Date
Elec. Outlets at Wood Panel, Int. & Ext.
Card B-1 Date Card B-1
Date
Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance
ELECTRICAL (Permit) OK except #'s
73.
23.
Fixture & Transformer Clearance -Ins. Protection
74.
24.
Elec. Receptacles Spacing -Lights & Switches at Doors
75.
25.
Size Boxes & No. of Conductors Stapled
76.
26.
Romex Installed Close to Edge of Studs & C.J.
77.
27.
Equip. Ground made up w/Mach Fasteners -Bond Gas & Water
78.
28.
2 Appliance Circuits in Kitchen & Conductor Size GFI
79.
29.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or AI
80.
30.
Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or At
Insulated Neutral ID Yes C) No
81.
31.
Service -Riser Conductors & Ground Main Disconnect
32.
Equip. Clearances Panels-Motors-Mech. Equip.
82.
33.
Clothes Closet Light -Shower Light -Spa Light
83.
34.
Smoke Detector
84.
A.C. Unit Disconnect, Electrical -Plumbing
Date
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
Card B-1 Date Card B-1
Date
Water Well, Disconnect, Electrical, Plumbing
Card B-1 Date Card B-1
Date
Exterior Elec. Trim, G.F.I. Receptacle -Underground
MECHANICAL (Permit) OK except #'s
88.
35.
A.C. Ducts Insulation & Support
89.
36.
Vent Fan, Exhaust above insulation
90.
37.
Condensate Drain & Overflow, Size & Grade
91.
38.
Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet
92.
39.
Attic Access & Platform if Furnace in Attic
93.
Energy Compliance Certificate -Other Certificates
94.
Address Posted
Date
Card B-1 Date Card B-1
Date
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
FRAMING (Permit) OK except #'s
40.
Sits Proper Materials & Anchors
41.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
42.
Bearing Walls over Girders & Floor Nailing
43.
Draft Stop in Walls (rat proof)
44.
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
45.
Headers & Beams -Size & Bearing
Tingle & Duplex)
Date
FRAMING (Continued)
46.
Hangers -Post Caps -Anchors -Connectors
47.
Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rfng.
48.
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
49.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
50.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
51.
Garage Fire Protection Framing
52.
Property Line Firewall & Openings
53.
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
54.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
55.
Plywood on Roof Overhang -Attic Vents -Ratter Outriggers
56.
Siding -Nailing Veneer
57.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
58.
Glazing Area -Glass Protection -Skylights -Plastic
59.
Shear Walls; Nailing -Bolts
60.
Brace Interior/Exterior Wall Panels
61.
Insulation -Walls -Ceilings
62.
Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
63.
Ext. Steps -Door & Sidelight Protection -Landings
64.
Smoke Detector
65.
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor -Ducts -Mach. Protection
66.
Bedroom Exiting
67.
G.F.I. & Bath Fixtures & Tub Access -Spa
68.
Elec. Trim & Subpanel, Breaker Sizes & Labels
69.
Stairs & Rails
70.
Fireplace or Stove, Clearance -Hearth
71.
Elec. Outlets at Wood Panel, Int. & Ext.
72.
Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance
73.
Elec. Outlets & Receptacles at Kit. Counter
74.
Garage Fire Door; Swing -Landing -Closure
75.
A.C. Duct in Garage -Damper
76.
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
77.
Plb., Elec. & Mech. Equip. Listed for Location
78.
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
79.
Insulation -Foam -Looked in Attic
80.
Guard Rails & Deck Construction -Post Caps
81.
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor O Yes
82.
Following Instld./Drive 0 Yes ] NoMalks D Yes C.l NotPlanters ] Yes _ No
83.
Stucco Brown -Finish
84.
A.C. Unit Disconnect, Electrical -Plumbing
85.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
86.
Water Well, Disconnect, Electrical, Plumbing
87.
Exterior Elec. Trim, G.F.I. Receptacle -Underground
88.
Ventilation Throughout House
89.
Glass Protection
90.
Corrections from Previous Inspections
91.
Gas Test -Meters Tagged, Gas -Electric
92.
Water & Sewer Connected -C/O to Grade -HD Approval
93.
Energy Compliance Certificate -Other Certificates
94.
Address Posted
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card 6-1
Date
Card B-1 Date Card B-1
Comments at Final:
'y�.�r�(''Y.:'r� r. r.1 r'..�',.���.ct^�'C+--. �`' ., 7.r.•.i��ia%P�j-� _�.i�1_► (,E,i,t_2 R 1 R � Rs�'
a .
• ..�.� , ,`'; : ; ; :..: `.COUNTY OF BUTTE` r r t , r.r .•,r r,r ► M p 4 ! L .
�•, BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530)'538-7541
CORRECTION NOTICE
R PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
Date 1 D •� O• " ` Inspector
iC
REV 10/92
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530) 538-7541 '
CORRECTION NOTICE
OWNER — PERMIT NO. '
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above add -ss and should be corrected. Please notice this office when correction of work is Y
complet .If you have any questions pertaining to this matter, or need additional explanation,
pleas contact this office immediately.
I 1 G t`C� c-4
Date � f1 ; ►T/1() I Inspector
REV 10/92
�
2
_y
s,
'K.
.i
a
7
K
Date � f1 ; ►T/1() I Inspector
REV 10/92
^ COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUIL
DI DIVISION
- 7 County Center Drive • Oroville, California 95965 • Telephone (530) 5 8-7541 PERMIT No.
(Rev. 12/96) APPLICATION AND PERMIT o1-2422
ASSESSOR PARCEL NUMBER
039-540-031
ZONING
SR1
BUILDING PERMIT
OWNER BUD DILBECK
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
8,640
. OWNERS MAILING ADDRESS
9445 DWYER CT, DURHAM 95938
CONTRACTOR'S NAME
JIM BLACK
TELEPHONE
342-2169
CONTRACTORS MAILING ADDRESS
.PO BOX 636, DURHAM 95938
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $ 8,640
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ 108.00
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
Plan Checking Fee
$ 70.20
BUILDINGADDRESS
9445 DWYER CT DURHAM
Energy Plan Checking Fee
$
$
PERMIT FEE
$ 198.20
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Feel 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other SHOP
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 ❑X Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: DETACHED SHOP
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
Q2o.00
PERMIT FEE
$
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service z�o*.voa.ss
23.00
LICENSED CONTRACTOR'S DECLARATION
1 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 (� �l
OWNER -BUILDER LAATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A TO 1000A
46.00
NEW CONST. OWE3LNG OCCUP.
OR ADDNS. ( a Acc. BLDs.
SO
3.5¢FT. 14.00
T.
NON-RNEW ESID ULT'_CIRCUT
97.50
FOWER APPARATUS
8 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FIXTURES
20
e L @ .50
Ex. Occup..OUTFIXLE S(RRESID °En
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
$ 34.00
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is Issued.
L9%I 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�urance a ler and policy number are:
Carrier 5 � tic-
Policy Number Ip 11 fG/ —0 %
(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 ff I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
orthwith comply with those rovisions.
X C_ Date Z 5 _
Signature I Applicant - Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $232.20
HAZ.
_
I D. FEES I
D
I CDF
P EL
ISsu
This permit is hereby Issued under
of the Butte County Code and/or
indica a for which fees have
t
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date (D (. O
O I I b �2
0to
ReceiptNo. 3
1
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 -County Center Drive • Oroville, California 95965 •Telephone (530) 538-7541 PRM,MI NO.
(Rev. 12/66) APPLICATION AND PERMIT
ASSESSOR PARCEL NUM _ ,5�� 3 I
c) S9OWNE
)
BUILDING PERMIT
P [J ^
TIMPHONE
SO. Fr. OCC. BUILDING VALUATION
OWN ID NOs01,
COMM R'B
1-�
TELEPHONE
147--2-169
CONTRACTORS MALJNO ADDRESS
CONSrAuc,noN LENDER
FFireplace
LENDER'S MNUNG ADDRESS
w
Total Valuation $
ARCHRECT OR ENGINEER
LICENSE NO.
Flln Fee $
20.00
ARCWECT OR ENGNEERS MAIUNG ADDRESS
Permit Fee b
Plan Checking Fee $
euwow+o ADDRESS
U
Energy Plan Checking Fee $
_
$
PERMIT FEE1. $
..:.-Fiv. SUBDIVISION'S NAME
°ARCE"''�iP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTU
SF ❑ Duplex ❑ Mobilehome ❑
s
Each Trn
7.00
Solar or heat P-Ulblgwater heater
23.00
Water pi Ing
15.00
Each as water heater or van
15.00
TYPE OF WORK
New Addition ❑ Re ❑ litiees El' InstallsE3 Other ❑
Describe Work:
n
Gas piping stem 1 - 5 outlets
15.001
Buildingsewer
15.00
Mobile Home S G W
(920.00
PERMIT FEE f
ELECTRICAL PERMIT
Filing Fee 20.00
OR
Main Service z�oaL LESS
23.00
*PERMIT FEE PAIb
SRA w ;
SHERIFF #
OTHER s
A OVW RECEIVft 0 /J�
"RECEIPT "JOLI t
* TO BE PVT INTO CowmER
i
I
i
Main Service 200A To I000A 48.00
NEW CONST.OW ELLNO oq;uP.
OR ADDNS. 6 ACC. BLDs. For.
( 3.5¢s
NEW GONST
NON-RESID MULT40UnEr CGi7.50
POWER APPARATUS
6 SNCiLE OUn.ET q0.
Ex. Occup. ovn.Er OR FwuREs p ® 1.00
sAL @ .SO
Ex. Occup. oLmE,DAP o.) L 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE t
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE: s
Mobile Home Installation Fee S
Energy Inspection Fee $
occ
CONST. IyFt
TO AL FEE $ a
eS
'
FLAODj
COF
✓
PVEL
P•
R --
This permit is hereby Issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
Indicated above for which fees have been paid.
By Date
PERMIT EXPIRES ON
ro
�F.i.i^'.:t�yiY'•. �, fi`A�`.Z3}�,;_}„��.,5�. s.�� "s�M-'r,dh'•t=, r *,,c'ray..7Tziro7TMRn`"¢'�fs��}���i�►.:i�5'�i �7:Mz "��(i''}
COIINTY'DF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER --T 1 1 ASSESSOR PARC ER:
Proposed Building Use: Q Building Inspector: Date: � 2 �
At time of permit application, I was advised th following data must be su d prior to permit processing and/or issuance:
Date Received By
❑ 1. All items have been submitted ---------------------------------------------------------------------------------------
E12. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------
•❑ 3 . Complete plans, 3/4 sets, signed by the preparer of plans. -----------------------------------------------------
04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. --------
❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------
❑ 6. Energy Design Compliance and supporting documentation. ----------------------------------------------------
❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ---------------------------------------------------------
❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------
❑ 9. Manufactured Home data and installation instructions including Tie Down Specifications .------------------
❑ 10. Fees of $-------------------------------------------------------------------------------------
❑ 11. Impact fees as shown on the attached schedule. -----------------------------------------------------------------
❑ 12. California Department of Forestry plan approval/fees. ---------------------------------------------------------
❑ Flood elevation certificate. ----------------------------------------------------------------------------------------
i v 4 . Sanitation and plot plan approva� Health Department. -------------------------------------------
❑ 15. City of Chico plumbing permit. -----------------------------------------------------------------------------------
❑ 16. Plot plan and business license approval from the City of Biggs. ----------------------------------------------
❑ 17. Planning approval for (A) Use: 0 t< (B) Parking: -------------------------- 10-- 1-- Q .�
❑ 18. Contact Land Development about El Improvements, ❑ Drainaggal Parcel. ----------------------- `^
❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). ----------------------------
020. Pre -inspection for required Request to Building Inspector on (Date)
*—Workers'
. Contractor's license information. (Number, Name Style, Classification). ------------------------------------
Compensation carrier and policy number.-----------------------------------------------------------
❑23.Owner-Builder Verification (Given to owner ❑,Mailed to owner ❑).________
❑24. Letter of signature authorization. --------------------------------------------------------------------------------
❑25. ecorded copy of Agricultural Acknowledgment Statement. --------------------------------------------------
Letter of intent on building use. -- ��--- r -CSS--- �L------ _____________
027. Manufactured Home utility clearance. ------------------------------- -----------------------
E128. Existing violatio fired permits. -----------------------------
❑29. 0433 A, ❑ ant Dt�l JQ, vI. . Title, ❑ Check to H.C.D $ .---------------
030. Other: p*V -------
When you issu 0 p s ` follows I]Mail to owner il oto contractor.
7 Telephone C' j and hold for pickup at office. ❑ Deliver with Spector.
Applicant: Date:
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Departmen Air Pollution Date: By:
Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ O Date: By:
1. Index permit application for the above items numbered: k 7 ❑ Plan Check List
2. Additional items required:
ontracto , designer, owner, was advised of the above required data byfifp one, ❑ mail, ❑ding Divisio counter, by Date: W4
q
Con tor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Buildings ' ion counter, by Date:
Plans reviewed by: Date: Plans approved by: Date: 0
Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: /0//?— 1 a
f'.. ,
A
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
E.M. USE RNLY
Piot Pica Attached
Roar Ptaa AttachedLf�—
Seat to B.O.
-.sem -0 31, -
Owner L-q6ation AP#
Plan Approved for: Sewage Disposal Water Supply: Public Private Well
Clearance for dwelling. Other
Final clearance O.K. for:
NOTE:
Environ mental'Health Specialist
8/96 i
.....................
`
COUNTY OF BUTTE - DEPARTMENT.OF DEVELOPMENT SERVICES
OWNER'S STATEMENT OF USE - DETACHED ACCESSORY BUILDING
PN:� f
0 �
ONE: �
BUILDING PMT. #
OWNER:/LCL/ —
PHONE:
3 �5
^/I
MAIL ADDRESS: 9445 wV P�
�rh�►�m n�9 9�93�
SITE ADDRESS: jlgt l Iff
PROPOSED USE: WDAn (A kitiA 0Q
PLEASE ANSWER QUESTIONS 1-20. PLEASE EXPLAIN YES ANSWERS (2-18) IN THE SPACE PROVIDED ON THE REVERSE OF THIS FORM. (PLEASE
PRECEDE
EACH COMMENT WITH RELATED QUESTION #)
GENERAL INFORMATION:
1.
Is there a primary dwelling on the property?
Yes:
No:
2.
Is the structure already built, under construction, or under notice of code violation?
Yes:
No:
—X-
3.
Will items produced in this building be offered for sale?
Yes:
No:
X
4.
Will the public have access to this building?
Yes:
No:
x `
5.
Will any advertising, on or off site, be associated with the use of this building?
Yes:
No:
_
6.
Will this building be occupied at any time,as a sleeping quarters?
Yes:
No:
x
7.
Will this building be occupied at any time as an eating area?
Yes:
No:
x_
8.
Will this building be occupied at any time as a cooking area?
Yes:
No:
-_
9.
Will this building be occupied at any time as a living area?
Yes:
No:
X
I
SITE CONDITIONS:
10.
Is the structure foundation within 5' of septic tank or leach lines?
Yes:
No:
X
11.
Is any portion of the proposed structure located closer than 20' to your front property line?
Yes:
No:
x
12.
Do you plan to add a driveway or modify existing access to a county maintained road?
Yes:
No:
13.
Will the proposed structure encroach within any recorded easement?
Yes:
No:
CONSTRUCTION FEATURES:
14.
Will this building have insulated floor, walls, or ceiling?
Yes:
No:
15.
I
Will this building be heated or cooled?
Yes
No.
I 16
Will this building have a water closet/toilet?
Yes:
Nc:
11
Will this building have a sink?
Yes.
No:
t 8
Will this building have a water heater?
Yes
No:
i
19.
What type of floor covering will the building have? h1hoe - C�a3C�E-TE LAA
i�►�1Ly
20
What type of wall covering will the building have? SO te-r QV_X_ PktO ?16,
BOA2�
ADDITIONAL INFORMATION: 44LIQ
` _ (RJIIkJL Ach,leX
V
S�
Ati
l dl AJC1C1(` �C11�R .l)1�9 i� I�YAa .
I hearby affirm under penalty of perjury the above infromation is true and correct. I understand that any changes to the use, or character of use, of this building wiil
require permits from the per uthority. I understand that Real Estate Disclosure laws require disclosure of this information if or when offered for sale.
OWNER'S SIGNATURE DATE OWNER'S SIGNATURE DATE
FOR DEPARTMENTAL USE
REVIEWED BY:
COMMENTS:
DATE:
�r
R SIDENTIAL
039-540-031 PERMIT#95-1438
DILBECK, William
9445 Dwyer Ct., Durham
Cont; Jim Black
New Carport
JOB FINALED (Date f� _
Signature
J=OK
O = Not OK
No Readyable
= MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap: / /"L"ft.
/ /"Nat. or/ /" L"ft./ /"LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date
Card B-1 Date Card B-1
_
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLAINEOUS
Date DECKS, QOVER , CARPORTS, RAGES, (Plans)OK except #'s
1..Z ni5gRequire acks-Easements
2 :j 4 Z &,Pl5otings; Soils -Size -Depth -Spacing -Connectors -Steel
3. uecKs; L3naers ana/Or joists-ueCKing-tsracing-Atalrs-Maes
4. Wood Awn.; Posts -Bea ms-Rftrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Win ows-Doors
7. Elec
rmg; 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 -Panel boards -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
= Not Applicable
= Not Ready RESIDENTIAL (;
Date UNDERFLOOR (Plansj*OK except ff'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-Wra pped
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 N's
16. Water Htr.: Vent -Access -Combustion Air-Bafiie
----------- ----- -----------------------------
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/Mech. Fastners-Bond Gas & Water
-------------- ---------------------------------------- ----------------------------
27. 2 Appliance Circuts in Kitchen & Conductor SizerGFI
- -----------------------------------------------------
28. Subfeed Wire Sizer r ga. Cu or AI-A.C. Wire Size r / ga.
Cu or Al
--------------------------- - --------- -----------------------------------------------
29.
----------------- ---------------------------------------------------------------
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 a's
-------------- 34.--A.-C.-
Ducts Insulation & - Support- ---- ---- ------ ------ - --------------- ------ - - - --- - - - --- - ---
35. Vent Fan: Exhaust above insulation
36. Condensate Drain & Overflow: Size & Grade
------------------ ------ --. ------
37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet
-------- - - - --------------------------- I
Attic -Access-&. Platform if Furnance in Attic
----------------------------------------- ------------------------------------
Date Card B-1 Date Card -B-1
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
------------------------------
Headers & Beam -Size & Bearing
Wngle & Duplex)
Date FRAMING (Continued)
45. Hangers -Post Caps -Anchors -Connectors
46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng.
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
48. Attic Access; Size & Romex 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
Date Card B-1 Date
Card B-1
Card B-1
Date FINAL (Plans) OK except #'s
61. Ext. Steps -Door & Sidelight Protection -Landings
------------------------ --
62. Smoke Detector
------------------------- -----
63. Furnace: Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor -Ducts -Meeh. Protection
--------------
64. Bedroom Exiting
--------- -
65. G.F.I. & Bath Fixtures & Tub Access -Spa
66. Elec. Trim & Subpanel: Breaker Sizes & Labels
-------------
67. Stairs & Rails
68. Fireplace or Stove: Clearances -Hearth
------------ -- --------------------
69. Elec. Outlets at Wood Panel; Int. & Ext.
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 Gara a -Dam er
------- -----------------------------
74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage: Above Floor -Meth. 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 -Const ruct ion -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 ❑ 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
------..-------------------------------------- --
DCard B-1 Date Card B-1
--ate--------------- ----------------------------- --- -
Date Card -B-1 Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT 95
ASSESSOR PARCEL -NUMBER
039-540-031
ZONING
SRI
BUILDINGPERMIT
OWNER
WILLIAM DILBECK
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
199 5,096
OWNER'S MAILING ADDRESS
9445 DWYER CT, DURHAM 95938
CONTRACTOR'S NAME
JIM BLACK
TELEPHONE
342-2169
CONTRACTOR'S MAIUNG ADDRESS
PO BOX 636 DURHAM 95938
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee $ 20.00
LENDER'S MAIUNG ADDRESS
Permit Fee $ 81.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $ 52.65
Energy Plan Checking Fee $
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
Penalty $
BUILDING ADDRESS
9445 DWYER CT DURHAM
PERMITFEE $ 153.65
PLUMBING PERMIT Filing Fee 20.00
Each Trap 7.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Solar or heat pump water heater 23.00
Water piping 15.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each gas water heater or vent 15.00
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
TYPE OF WORK
New P) Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: CARPORT
Mobile HomeS G W 920.00
PERMITFEE g
Contractor
ELECTRICAL PERMIT Filinq Fee 20:00
Main Service EOOV OR LESS
( 2ooA OR LESS ) 23.00
Main Service ( 200A TO I000A ) 46.00
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 `Z, Lic. No. �ZC�C
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
NEW CONST. DWELLING OCCUR SOADO.
OR a ACC. BLOS. ) 3.Sa FT.
NEW CNS.
CONST. MULTI.OUTLET
NON-RESID. ( BRANCH CIRCUITS ) 97.50
( a POWER APPARATUS )
SINGLE OUTLET CIR.
Ex. Occup. (OUTLET OR FIXTURES BAL 0 I.50
Ex. Occup. ( OUTLETS (RE D.)EA) 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMITFEE s
Contractor
WORKERS' COMPENSATION DECLARATION
I 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.
,l I 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' cpennsa�fiion�uran carrier and policy number are:
Carrier A
MECHANICAL PERMIT Filing Fee 20.00
9
Heating
Cooling
Hood 6.50
Ventilation
PERMITFEE $
Contractor
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.)
❑ 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 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 complywith th se provisions.
�
X \�__ Date -���� _
Signature of Applicant - ❑ Owner III Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee Is
Energy Inspection Fee Is
Occ
CONST. TYPE
TOTAL FEE $ 153. 5
HA2. I D. FEES
IMP
✓
FLOGq
/
COF PARCEL
a-...
ISS
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
BY J D to
PERMITEXPIRESON &,/R�
(Date)
Receipt No. U�
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
II
COUNTY OF BUTTE -1- D.E A MENTOF ,EVELGIxMENTSERVICES -BUILDING DIVISION
7 COUNTYCENTER DRIVE - OROVIILF'GALIFORNIA95965 -TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA. SHEET -
-:OWNER Aa, +�!' P. No. C� 3 -S C�- 3�
be
- Proposed Building Use Building Inspector , Date ;2 s -
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.
California Department of Forestry plan approval/fees. ....................... .
13.
14.
Flood elevation letter (100 year floo by California Engineer . ................. .
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.
re.
Panswctlon mquest-
Pre -inspection for required. . to Building inspector (Date)
21.
Contractor's license information. (No., Name Style, Classification) . ..............
22.
Certificate of Wo�rkmans Compensation Insurance . ............................
r 23.
Owner -Builder Verification (Given to owner Mail to owner . ....... `
24.
1"
Recorded copy of Agricultural Acknowledgement Statement . ..............
^� 25.
Letter of signature authorization . ........................................ `
ti 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 . ..................... ; ..................
Documentation of 50% subdivision developed or (A) Road improvements completed
.30.
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 owner. Mail to contractor.
Telephone and hold for pickup at ! �; [�� office. Deliver with inspector.
Other
Parcel Creation ' C l CZ Date a7
Acreage Applicant
r
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 ounter 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 plans on hold in File cabinet AP folder
Copy = Department of Public Works
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
F.H. USE ONLY
Hot Plan Allached
ri,,(,r Han nuaclud
Sent u, is. u.
Owner Locati n AP#
Plan Approved for: Sewage Disposal Water Supply: Public Private Well
Clearance for bedroom mobile home. Other
Hold final for:
Final clearance O.K. for:
NOTE
En - onmental Health Specialist
8/92
Date
ocy
� I
O\ I
�T a
A setback ``` . from tho 1 `f
property lin^- ant! a ,-. +bark
of from ',!.Ie r(—.1 ?.
l00 r t�-S C
1etrudruworc pt
1 filer o� a Ll ease rn�'1�S�S ` N
�CollS
i
OpWaitR
AgALL URAL .. BE CLEAR OF ALL EASEMENTS.,
. AND EQUIPMENT INCLUDING
OVERHANGS SH
A SET BACK OF i FT. FROM THE SIDE AND
/O F1'. FROM THE REAR PROPERTY LINES AND t
FT. FROM THE ROAD CENTERLINE SHALL BE `
LEAR OF STRUCTURES AND EQUIPMENT EXCEPT D
FOR A 2 FT. EAVE OVERHANG.
ic�� �s
AE -941 NTIAL�
V'39-54-31 4235-90B
BLACK, Jim
9445 Dwyer Ct, Durham
(fire sprinklers/sf)
i
S PRwIt(AI Pe -SYS r-rA,\ PC�tw 2�ci riga-r
�&ST <�6 . 8C Y, rr �N� l �� T-He2JE_
C tit_
Nat- 'R9-ADy Foe F►n/A L_
I/V5pv-c,—(ov, R[- in/s,0gciI o^/ Fee
� Qv�cR�t1 fa rl vAt- GtZACE PelticA
<Z " , /.7;,.t.d.�-y✓a
Hq.6e /S ccYnp(-I9rlr Avl� o4fcHpiei5
Jt
O = Not OK
Not
= Not Readyable MOBILE HOMES ;
Date MOBILE HOME UTILITIES (Plans) OK except #'s y
S. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts- Bea ms- Rftrs.-Coonectors
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
M
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap: / f L" ft.
/ /"Nat. or/ /" L"ft./ /"LPG
7. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts- Bea ms- Rftrs.-Coonectors
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
M
J=OK
O = Not OK
- = Not Applicable RESIDENTIAL (Single
' =Not Ready
& ,Duplex)
i
Date
UNDERFLOOR (Plans) OK except #'s
Date FRAMING (Continued)
1. Zoning -Setbacks -Easements -flood -Slope
45. Hangers -Post Caps -Anchors -Connectors
2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Ring.
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
5. Stemwalls, Main; Steel- Bloc kouts-Wrapped
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped
50. Garage Fire Protection Framing
6a. Hold Downs and Special Anchors
51. Property Line Firewall & Openings
7. Slab; Steel -Wrapped
52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
8. Piers -Fireplace Ftg.-Steel
53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
10. Gas Pipe; Size -Anchors
55. Siding -Nailing Veneer
11. Water Pipe; Test -Anchor -Regulator -Service Test
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
12. Electric; Underground
57. Glazing Area -Glass Protection -Skylights -Plastic
13. Pienums & Ducts; Clearance -Material -Support -Ins.
58. Shear Walls; Nailing -Bolts
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
59. Insulation -Walls -Ceilings
15. Insulation
60. Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
Date Card B-1 Date Card B-1
16. Water Htr.; Vent -Access -Combustion Air -Baffle
Date FINAL (Plans) OK except #'s
17. Water Pipe; Test & Anchor -Nail Protection
61. Ext. Steps -Door & Sidelight Protection -Landings
18. D.W.V.; Test -Fittings & Anchor -Nail Protection
62. Smoke Detector
19. Shower Pan; Test, First Floor -Tub Access
63. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor -Ducts -Mach. Protection
20. Test Tub & Shower, Second Floor -Tub Access
21. Gas Pipe; Size & Anchors
64. Bedroom Exiting
65. G.F.I. & Bath Fixtures & Tub Access -Spa
Date
Card B-1 Date Card B-1
66. Elec. Trim & Subpanel; Breaker Sizes & Labels
Date
Card B-1 Date Card B-1
67. Stairs & Rails
Date
ELECTRICAL (Permit) OK except #'s
68. Fireplace or Stove; Clearances -Hearth
22. Fixture & Transformer Clearance -Ins. Protection
69. Elec. Outlets at Wood Panel; Int. & Ext.
23. Elec. Receptacles Spacing -Lights & Switches at Doors
70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
24. Size Boxes & No. of Conductors -Stapled
71. Elec. Outlets & Receptacles at Kit. Counter
25. Romex Installed Close to Edge of Studs & C.J.
72. Garage Fire Door; Swing -Landing -Closer
26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water
73. A.C. Duct in Garage -Damper
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage; Above Floor-Mech. Protection
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga.
Cu or Al
75. Plb., Elec. & Mech. Equip. Listed for Location
29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI.
Insulated Neutral ❑ Yes ❑ No
76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection
77. Insulation -Foam -Looked in Attic ❑ Yes
30. Service -Riser Conductors & Ground -Main Disconnect
78. Guard Rails & Deck Construction -Post Caps
31. Equip. Clearances Panels-Motors-Mech. Equip.
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
32. Clothes Closet Light -Shower Light -Spa Light
33. Smoke Detector
80. Following instld.; Drive ❑ Yes O No; Walks O Yes ❑ No;
Planters ❑ Yes ❑ No
Date
Card B-1 Date Card B-1
81. Stucco; Brown -Finish
Date
Card B-1 Date Card B-1
82. A.C. Unit; Disconnect, Electrical, Plumbing
Date
MECHANICAL (Permit) OK except #'s
83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to
Openings
34. A.C. Ducts Insulation & Support
84. Water Well; Disconnect, Electrical, Plumbing
35. Vent Fan; Exhaust above insulation
85. Exterior Elec. Trim; G.F.I. Receptacle -Underground
36. Condensate Drain & Overflow; Size & Grade
86. Ventilation Throughout House
37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet
87. Glass Protection
38. Attic Access & Platform if Furnance in Attic
88. Corrections from Previous Inspections
89. Gas Test -Meters Tagged; Gas -Electric
90. Water & Sewer Connected -C/O to Grade -HD Approval
Date
Card B-1 Date Card B-1
91. Energy Compliance Certificate -Other Certificates
Date
Card B-1 Date Card B-1
Date
FRAMING (Plans) OK except #'s
Date Card B-1 Date Card B-1
39. Sils, Proper Material & Anchors
Date Card B-1 Date Card B-1
40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
Date Card B-1 Date Card B-1
41. Bearing Walls over Girders & Floor Nailing
Comments at Final:
42. Draft Stop in Walls (rat proof)
43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearing
each time you visit job site)
(NOTE: An entry must be made
J
J
s
Jr COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
J
— — 1
ZONING
Q1?T
BUILDING PERMIT
o
Jim Black
TEL PH
342-21ONe9
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS -
P.O. box 636, Durham, CA 95938
CONTRACTOR'S NAME
Owner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
None
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 11g. 90
ARCHITECT OR ENGINEER
None
LICENSE NO.
Plan Checking Fee
$ 19-29
Energy ecg
Ener Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
9445 Dwyer Ct., Durham
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
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
USE OF STRUCTURE
SF n Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G W
10.00e
TYPE OF WORK
New❑ Addition❑ Remodel❑ Utilities❑ Installation❑ Other
Describe work: fire sprinklers _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 AMP OR1 OR LESS10.00
Main service EA. ADD'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 an�j ase is in f f rte and eff ct.
lassification '��
License No. 400 as
❑ I, as the owner, or my em oyees with wages as their sole compen-
n
sation, will do the work,athe 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 OCCUP.&
OR ACDNS. ACC. BLDGS.
qft
/z2sea
NEW CONSTRES'., RANCH TLETCIRCUITS)
NO N.R ESID BRANCH CIRC ITS
2,50 ea
POWER APPARATUS .&)
SINGLE OUTLET CIR.
Ex. Occu o
p( UTLETS OR FIXTURES
20®s0C
.AL930
FIXED APLNS.
Ex. Occup. OUTLETS (RESID IR EA.1
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. bVirin 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 10.00
Heating
Cooling
g
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, a d expenses which may in any way accrue
again t said County in consequent f the granting of this permit.
X Date `Z`�a�4�
Sig , ctor�j Agent ❑
An OSHA permit is required For excavations over 5'0" deep and demolition or construct-
n of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $
67.75
HAz
CUA
PARK
SCHL
FLD
PAR
PD
HD
I U
Th;s permit is nereby issued under
sions of the Butte County Code and/or
work indicated ab o for which fees
DI C R OUBLI
By
EXPIRES toHITED.
the applicable provi-
resolutions to do
have been paid.
WORKS
D toPERMIT
eceipt No. 84675
rR
P. W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
N� .. -r a z'• c rY ..Z +, a�iR.: �,�� „ .. i., •rte e.� _ �,�. .�' ' � . _ ..
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE,, OROVILLE, CA`L'IFORNIA 95965 - TELEPHONE: 916/538-7541
r /
i� PERMIT APPLICATION.DATA SHEET - --
-� Permit No.-.,—,.
ICec
OWNER N� �'�� I r ' A. P No —�
Proposed Building Use ✓`er_1____ 5 -Bu�lding Inspector Date
�711
mit application, I was advised the following data m st be submitted prior to permit processing and/or issuance:
:;1.110
✓ DATE RECEIVED APPROVED
items have been submitted . ..............: .................
2. Plot plans in duplicate/triplicate, signed by prepparer of plans........
3. Complete plans in duplicate/triplicate, signed by, preparer of plans ..
4. Complete engineered plans and calcs, with wet "signature on plans ..
5. Hazardous Material Form I .................... ....................
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineereditruss details andl layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions............
10. Fees of $ I
11. Chico Urban Area fees plid..r.....................................
12. Park fees paid .........
13. chool-District-fees paid ..............
4. Sanitation approval from C- n Health Department
15. City of Chico plumbing permit. V
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements may be requ red. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for N required Pre-Inspec. request to
" Building Inspector (Date)
21. Contractor's license infora io—n (No:, Name Stle, Classification) ...
22. Certificate of Workmans Eompensation Insurance ..................
23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
24. Recorded copy of Agricultural Acknowledgment Statement .........
*21_ett e of s'gnat a auth iza n ./.
12
7.
When you issue the pe t, process as follows: Mail to owner. Mail to contractor.
Telephone%and hold for ickup at office. Deliver w/inspector.
Other/4
Applicant -'1-1Date /Q SCI l0
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 prigr to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer owner, as advised of above required data by phone_—mail counter b date_
Contractor, designer, er, was advised of above required data by_phone_mall_c by date.
Plans checked by Date' Plans apprayed by Date
Sets of plans on hold in File cabinet AP folder
Copy—DPW
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
AS SOR
, PARCEL U BER
S - J
OWNER--'—. __.. .. _
Z°I
BUILDING PERMIT
.0 _.
_ _
�m 1CCG `
TELEPHONE
E `ON
SO. FT. OCC. BUILDIN VALUATION
OW -R'S MAI
/+ r"!
)r
CO TRACTOR• NAME LEPHONNE
n Y'
C NTRACTOR'S MAILING ADDRESS
Fireplace
CON T UCTIION LENDER
67 t,ln'
UNKNOWN
Total Valuation $
LEN ER'S MAILING ADDRESS
Filing Fee
$ 10.00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS
s er
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
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
USE OF STRUCTURE
SFDuplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home Is
10.00e
TYPE OF WORK TTTccc���
New ❑ Addition ❑ Remodel ❑ Utilities 9 instaiiationEll Other
Describe work: r
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service io°o AMP ORV OR LESS
10,00
CONTRACTORS LICENSE LAW
I declare underenalt of perjury
p y p l y (Check One):
❑I am licensed under p
provisions Of Cha t. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
El 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)
ElI, 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 EA. ADD•L 100 AMP
2.50
NEW CONST. DWELLING OCCUPM
OR ADONS. ( ACC. BLDGS.
, /20sgit
NEW CONSTR ULT I -OUTLET
NON.RESID BRANCH CIRC ITS
2.50 ea
- (POWER APPARATUS e)
SINGLE OUTLET CIR,
Ex. OCCup(OUTLETS OR FIXTURES
20050t
e AL030t
Ex. OCCUp. OUTLETS FIXED P(RESID,)REA.)
2.00
Temporary service
10.00
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 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
against said County in consequence of the granting of this permit.
XThis
Date
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $ ,
HA2
CUA
PARK
SCHL
FLD
1 PAR
PO
Ho
IssuE
permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
Date
Receipt No. S�NTIT—By
WNITC-D.P.W.. YELLOW-ASSE330R, PINK -INSPECTOR. GOLDENROD -APPLICANT
4: ui
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R
RESIDENTIAL FIRE SPRINKLER, FLUSH PENDENT
MODEL F991 AQUARIUS T": 4.2 K -FACTOR
GENERAL DESCRIPTION
The 4.2 K -factor Model F991 Aqua.
rius Pendent Residential Fire Sprink-
lers (Ref. Figure A) are automatic
sprinklers of the fusible solder type.
They. are low profile, flush sprinklers
which are intended to be used in
*wet pipe residential fire sprinkler
systems for one. and two-family
dwellings and mobile homes per
NFPA 13D, and
•wet pipe fire sprinkler systems for
the residential portions of any,
occupancy per NFPA 13.
Small in size and attractive in appear-
ance, the F991 Aquarius Sprinklers
blend in with their surroundings. The
F991 Sprinklers produce a hemispher-
ical water discharge pattern below the
deflector.
Both a Push -on Escutcheon Plate as
illustrated in Figure A and a Clamp -on
Escutcheon Plate as described in Tech-
nical Data Sheet TD810 are available
for use with the Aquarius Sprinkler
Unit. The Push -on Escutcheon Plate
is intended for use with steel pipe or
copper tubing and the Clamp -on
Escutcheon Plate was designed for use
with plastic piping.
The F991 Sprinklers have been de-
signed to operate with a particular
fusible element temperature rating
and heat sensitivity characteristic,
as well as to discharge water in a
specific pattern 'and . quantity per
square foot relationship. The com-
bination of the performance charac-
teristics which are associated with
the F991 Sprinklers have been proven
to help 'in the control of residential
type fires and, therefore, to improve
the chance for occupants to escape
or be evacuated.
Fire sprinkler systems are not a sub-
stitute for intelligent fire safety
awareness or construction materials
and 'practices required by building
codes.
APPROVALS AND.STANDARDS
The Model F991 Aquarius Pendent
Printed in U.S.A. 9-87
1- The Sprinkler Unit consists of Components 2 thru 14.
2. The Fusible Element Assembly consists of Components 6 thru 14.
1 -Push -on Components:
10 -Loading Screw
Escutcheon
Plate 11 -Solder Element
6 -Retaining 8 -Inner Loading 12 -Disc Spring
2 -Dust Cap Ring Plate 13 -insulating
3 -Arms 7 -Heat 9 -Outer Loading washer
4 -Body Collectors Plate 14 -Tamper
Button-
5•Resistant
Button- Plug
Deflector FIGURE A
MODEL F991 AQUARIUS PENDENT RESIDENTIAL FIRE SPRINKLER
Residential Fire Sprinklers are listed
by Underwriters Laboratories Inc. and
Underwriters' Laboratories of Canada.
The listings only apply to the service
conditions and installation/usage cri-
teria indicated in the Technical Data
section.
The Model F991 Aquarius Pendent .
Residential Fire Sprinklers are ap-
proved by the New York City Board
of Standards and Appeals under Cal-
endar Number 334-79—SA.
Any questions concerning an interpre-
TD586
//oosE 3759- IrD
1r->61Z,V17-�
"AeXIMUM
MINIMUM REQUIRED FLOW
COVERAGE
(MINIMUM RESIDUAL PRESSURE)
AREA
F .. x?, x
ONE SPRINKLER
MULTIPLE SPRINKLERS
FLOWING,GPM
FLOWING, GPM*
14 x 14
18 ( 18.4)
13 (9.6)
16 x 16
22 (27.4)
16 (14.5)
3
&Z6
r Z
91-� y�
All
7.
AP 235:0 2y,,q
AMelyr
4-1 Aft OV
iI
s Z 1°SI
V-5-19
12,4-
Z, v
-
Z,v
�y
R �f.zI
37.7%
A�, y7
t 13'D-10 INSTALLATION OF SPRINKLER SYSTEMS IN ONE- AND TWO-FAMILY DWELLINGS AND MOBILE HOMES "
Table 4-4.3 (b) Pressure Losses (psi/ft) Copper Tubing - Types K, L & M. C = 150
Flow Rate - GPM
Tubing Type
Size in.
10
12 14 16 18 20 25 30
35 40
45
5o
3A M
0.08
0.12 0.16 0.20. 0.25 0.30 0.46 0.64
0.85 -
-
-
L
0.10
0.14 0.18 0.23 0.29 0.35 0.53 0.75
1.00 -
-
K
0.13
0.18 0.24 0.30 0.38 0.46 0.69 0.97
1.28 -
-
-
" 1 M
0.02
0.03 0.04 0.06 0.07 0.08 0.13 0.18
0.24 0.30
0.38
0.46
L
0.03
0.04 0.05 0.06 0.08 0.lo 0.15 0.20
0.27 0.35
0.43
0.53
K
0.03
0.04 om 0.07 0.09 0.11 0.17 0.24
0.31 0.40
0.50
0.61
.l y M
0.01
0.01 0.02 0.02 0.03 0.03 0.05 0.07
0.09 0.11
0.14
0.17
L
0.01
0.01 0.02 0.02 0.03 0.03 0.05 0.07
0.10 0.12
0.16
• 0.19
K
0.01
0.01 0.0E 0.02 0.03 0.04 0.06 0.08
0.11 0.13
0.17
0.20
14 M
-
0.01 0.01 0.01 0.01 0.01 0.02 0.03
0.04 0.05
0.06
0.08
L
-
0.01 0.01 0.01 0.01 0.01 0.02 0.03
0.04 0.05
0.07
0.08
K.
-
0:01 0.01 0.01 0.01 0.02 0.02 0.03
6.05, 0.06
0.07
0.09
E M
-
- - - - - 0.01 0.01
0.01 0.01
0.0E
0.0E
L
-
- - - - ••- 0.01 0.01
0.01 0.01
0.02
0.02
K
-
- - - - - 0.01 0.01
0.01 0.01
0.02
0.0E
For SI Units: I gal. = 3.785 L: 1 psi - 0.0689 bar; I ft 0.3048 m.
Table 4-4.3 (c)
Equivalent Length of Pipe in Feet for Steel and Copper
Fittings and Valves
Tees
Valves
.Fitting/Valve
Elbows Flow Flow
Globe
Diameter
45
90 Long Thru Thru
In.
Degrees Degrees Radius Branch Run Gate Angle Globe Pattern
Cock Check
144
1
2 1 4 1 1 10 21
11
3
3
1
1
3 2 5 2 1 12 28
15
4
4
1Y4
2
3 2 6 2 2 15 35
18
5
5
1 l
2
4 3 8 3 2 18 43
22
6
6
2
3
5 3 10 3 2 24 57
28
7
8
Based on Crane Technical Paper No. 410.
For SI Units: 1 ft = 0.3048 in.
Table 4-4.3 (d)
Pressure Losses in Water Meters
Pressure Loss (psi)
Meter Flow (gpm)
(Inches) 18 23 26 31 39 52
5/8 9 14 18 26
3/4 4 8 9 13 '
1 2 3 3 4 6 10
1.1/2 '• 1 2 2 4 7
2 •' •' •• 1 2 3
NOTE: Lower pressure losses may be used when supporting
data is provided by the meter manufacturer.
• Above maximum rated flow of commonly available meters.
' • Less than 1 psi.
For SI Units: I gpm = 3.785L/min; 1 in. = 25.4 mm
4-4.4 To size piping for systems with an elevated tank,
pump or pump -tank combination, determine the
pressure at the water supply outlet and proceed through
steps (c), (e), (g), (h), (i), 0) and (k) of 4-4.3.
4-5 Piping Configurations. Piping configurations
may be looped, gridded, straight run, or combinations
thereof.
4-6 Location of Sprinklers. Sprinklers shall be in-
stalled in all areas.
Exception No. 1: Sprinklers may be omitted from
bathrooms not exceeding SS sq ft (5.1 m2) with noncom-
bustible plumbing fixtures.
Exception No. 2: Sprinklers may be omitted from small
closets where the least dimension does not exceed 3 ft (0.9
m) and the area does not exceed 24 sq ft (2.2 mE) and the
walls .and ceiling are surfaced with noncombustible
materials.
Exception No. 3: Sprinklers may be omitted from open
attached porches, garages, carports and similar struc-
tures.
Exception No. 4: Sprinklers may be omitted from attics
and crawl spaces which are not used or intended for lirnng
Purposes or storage.
RESIDENTIAL FIRE SPRINKLER, FLUSH PENDENT.
MODEL F991 AQUARIUST"; 4.2 K -FACTOR
GENERAL DESCRIPTION
The 4.2 K -factor Model F991 Aqua-
rius Pendent Residential Fire Sprink-
lers (Ref. Figure A) are automatic
sprinklers of the fusible solder type.
They are low profile, flush sprinklers
which are intended to be used in
*wet pipe residential fire sprinkler
systems for one- and two-family
dwellings and mobile homes per
NFPA 13D, and
*wet pipe fire sprinkler systems for
the residential portions of any
occupancy per NFPA 13.
Small in size and attractive in appear-
ance, the F991 Aquarius Sprinklers
blend in with their surroundings. The
F991 Sprinklers produce a hemispher-
ical water discharge pattern below the
deflector.
Both a Push -on Escutcheon Plate as
illustrated in Figure A and a Clamp -on
Escutcheon Plate as described in Tech-
nical Data Sheet TD810 are available
for use with the Aquarius Sprinkler
Unit. The Push -on Escutcheon Plate
is intended for use with steel pipe or
copper tubing and the Clamp -on
Escutcheon Plate was designed for use
with plastic piping.
The F991 Sprinklers have been de-
signed to operate with a particular
fusible element temperature rating
and heat sensitivity characteristic,
as well as to discharge water in a
specific pattern and quantity per
square foot relationship. The com-
bination of the performance charac-
teristics which are associated with
the F991 Sprinklers have been proven
to help in the control of residential
type fires and, therefore, to improve
the chance for occupants to escape
or be evacuated.
Fire sprinkler systems are not a sub-
stitute for intelligent fire safety
awareness or construction materials
and practices required by building
codes.
APPROVALS AND STANDARDS
The Model F991 Aquarius Pendent
Printed in U.S.A. 9-87
E (DIA.)
F (DIA.)
7/16� (I I A mm)
MAKE -IN —
11-/ 'L10 `14
Dim. Inches MM
A—
2.1/4
57.2
B—
2-1/2
63.5
C—Min.
5/8
15.9
C—Nom.
3/4
19.1
C—Max.
7/8
22.2
D—Nom.
1-1/16
27.0
E—
2
50.8
F—
1-1/2
38.1
I
J
TWO MRENCH
LUGS (SHOWN
90. OUT OF
POSITION )
MODEL NO.,
TEMPERATURE
RATING, 8
YEAR OF
MANUFACTURE
NOTES: B (DIA.) —
1. The Sprinkler Unit consists of Components 2 thru 14.
2. The Fusible Element Assembly consists of Components 6 thru 14.
1 -Push -on Components:
Escutcheon
10 -Loading Screw
Plate
2 -Dust Cap
6 -Retaining
8 -Inner Loading
11 -Solder Element
3 -Arms
Ring
Plate
12 -Disc Spring
4 -Body
7 -Heat
9.Outer Loading
13 -Insulating
Washer
5-Gasketed
Collectors
Plate
14 -Tamper
Button-
Resistant
Deflector
FIGURE A
Plug
MODEL F991 AQUARIUS PENDENT RESIDENTIAL
FIRE SPRINKLER
Residential Fire Sprinklers are listed
by Underwriters Laboratories Inc. and
Underwriters' Laboratories of Canada.
The listings only apply to the service
conditions and installation/usage cri-
teria indicated in the Technical Data
section.
The Model F991 Aquarius Pendent
Residential Fire Sprinklers are ap-
proved by the New York City Board
of Standards and Appeals under Cal-
endar Number 334-79—SA.
Any questions concerning an interpre-
TD586
tation of NFPA 13 or 13D sprinkler
system design/installation standards, as
well as requests for system/design in-
stallation standards not presently
covered by NFPA 13 or 13D, should
be addressed to the:
Secretary, Standards Council
National Fire Protection Association
Batterymarch Park
Quincy, MA 02269
WARNINGS
The Model F991 Aquarius Pendent
Residential Fire Sprinklers described
herein must be installed and maintain-
ed in compliance with this document,
as well as with the applicable stan-
dards of the National Fire Protection
Association, in addition to the stan-
dards of any other authorities having
jurisdiction. Failure to do so may
impair the integrity of these devices.
Because of the above cited stipulations
and the varied nature of residential
type architecture, there will be some
compartment designs which cannot be
fully sprinklered in accordance with
the recommendations of NFPA 13 or
13D. In the event of this condition,
consult the authorities having jurisdic-
tion for guidance.
It is the responsibility of an installing
contractor to provide a copy of this
document to the owner or his repre-
sentative and, in turn, it is the obliga-
tion of the owner to provide a copy of
this document to a succeeding owner.
The owner is responsible for maintain-
ing his fire protection system and
devices in proper operating condition.
The installing contractor or sprinkler
manufacturer should be contacted
relative to any questions.
TECHNICAL DATA
The Model F991 Aquarius Pendent
Residential Fire Sprinklers have a
160F/71C temperature rating and are
rated for use at a maximum service
pressure of 175 psi.
The F991 Aquarius Sprinklers are
ordered in two parts; the Push -on
Escutcheon Plate which is Compo-
nent 1 in Figure A, and the Sprinkler
Unit which consists of Components
2 thru 14 in Figure A.
The F991 Sprinkler Unit is available
with a chrome plated finish as "stan-
dard order" and a bright brass finish
can be provided on a "special order"
basis. A painted finish for the F991
Sprinkler Unit is not available.
The Push -on Escutcheon Plate is
available with either a chrome plated
or white painted finish on a "standard
order" basis. A bright brass finish and
DISCHARGE IN U.S. GALLONS PER MINUTE IGPMI
._.......
14 I*aqJ
0000......
00.C..
.../...
....■.....0000./.■■/■
0000 0000 .........
C00.000000.00........"w■
■.00.00 . 0000.......00...1■■
0000... C.C.............
'■0000.. 0000.0000..00....■..r■■■
0000/// .///.////.....r1■■■
/00...........00.■. ��■■■■
..0000..0000../00.00.■ u.•
././.■////////0000 � ���
WillMEN
'
• ........ 0000... rI Mw■
.............
.....■..000000.. r1 . w■■
..■..00...00.00■ ■■■■
0000000000.00 .0000 r
■......� .■■ ■in■■
.......0 0000 ■ ■■■
0000..... 0000 i ■Owns
• ...0000.00000000 ■■■■■■
.......00..00
••■•.•.••.•.CC—. 'I ■■■■iw ■n■.411111 GOOEOw■
ON
.....�. .
........
LO
?.5 .�
S
Z.0 a
a
50 75 loo
DISCHARGE IN LITERS PER MINUTE
FIGURE B
NOMINAL DISCHARGE CURVE
painted finishes, other than white, can
be provided for the Push -on Escutch-
eon Plate on a "special order" basis.
The Push -on Escutcheon Plate, which
provides 1/4 inch of adjustment, is in-
stalled by simply slipping it over the
Body. Four prongs located around the
inside diameter of the Plate hold it
against the Body.
The F991 Sprinkler Unit is shipped
with a plastic Protective Cap covering
the outside of the Fusible Element and
the lower portion of the Body. The
Protective Cap can be left in position
while the Sprinkler Unit is being
installed and then it is slid off once the
ceiling installation is complete and the
sprinkler system is ready to be put
into service.
The nominal discharge curve for the
F991 is plotted in Figure B and it re-
presents the flow "Q" in U.S. gallons
per minute (GPM) as determined by
the formula: Q = K%Fp where the nom-
inal sprinkler discharge coefficient is
"K" and "p" = pressure in pounds per
square inch (psi). Listing standards
permit the actual value of K to vary
from 4.0 to 4.4.
Referring to Figure A, a Solder Ele-
ment (11) is compression loaded be-
tween the Loading Screw (10) and
Heat Collectors (7). When the Heat
Collectors are exposed to a tempera-
ture sufficient to melt the solder, the
contracting force exerted by the Re-
taining Ring (6) separates the Inner
and Outer Loading Plates (8, 9), with
the Outer Loading Plate squeezing the
solder out from between the Loading
Screw and the lower Heat Collector.
Once the Retaining Ring has collapsed,
the Fusible Element Assembly (con-
sists of Components 6 thru 14) falls
out of the Body, and simultaneously,
—2—
the Gasketed Button -Deflector (5) is
forced down by system pressure into
its operated position. The two Arms
(3) guide and stop the Gasketed But-
ton -Deflector.
The Push -on Escutcheon Plate is
installed by simply slipping it over
the Body. Four prongs located around
the inside diameter of the Plate hold
it against the Body.
NOTES
The Push -on Escutcheon Plate can
NOT be used to hold the F991 Sprink-
ler Unit in position. When using the
Push -on Escutcheon Plate, the Sprink-
ler Unit must be secured in position by
firmly fastening the sprinkler system
piping to the dwelling structure.
If the Sprinkler Unit is not properly
secured in position, reaction forces
resulting from sprinkler operation
could alter its orientation and water
distribution pattern.
Refer to Technical Data Sheet TD810
for information on the Camp -on Es-
cutcheon Plate which is suitable for
use with plastic piping.
The Body is bronze per.ASTM 8584
(C83600 or C84400) and the Dust
Cap is polyolefin. The Heat Collectors
are copper per ASTM B152(C11000)
and the Inner and Outer Loading
Plates are brass per ASTM B16
(C36000) or ASTM B140(C31400 or
C31600). The Loading Screw and two
Arms are Type 302 stainless steel per
ASTM A276 or Type 303 per ASTM
A582. The Disc Spring is a chrome
plated high strength carbon steel
and the Retaining Ring is titanium per
ASTM 8348 (Grade 5). The Gas-
keted Button -Deflector consists of
a sintered brass button -deflector per
MPIF CZP-0220-T and the gasket is
Teflonf. . The Push -on Escutcheon
Plate is formed from a low carbon
sheet steel.
The Model F991 Aquarius Pendent
Residential Fire Sprinklers must only
be installed and utilized in accordance
with the following described criteria
which are provided by the manufac-
turer.
These restrictions relate to
•the general service conditions neces-
sary to sprinkler performance and
integrity,
•the minimum amount of water which
must be discharged from an opera-
ting sprinkler,
•the maximum area which can be
covered by the spray from an opera-
ting sprinkler,
• installation requirements necessary
!DuPont Registered Trademark
C
C
to the proper operational sensitivity
of the sprinklers,
• preventing the wetting (i.e., cold
soldering) of the Fusible Element
Assembly of a non -operated sprink-
ler, which is adjacent to one which
has operated, and
• preventing the weakening followed
by the possible release of a sprink-
ler's Fusible Element Assembly, due
to exposure to heat sources other
than abnormal fire.
NOTES
I. Residential Fire Sprinkler Systems
should only be designed and in-
stalled by those competent and
completely familiar with automatic
sprinkler system design, installation
procedures, and techniques.
2. Several criteria may apply to the
installation and usage of each
sprinkler. Consequently, it is rec-
ommended that the sprinkler sys-
tem designer review and develop
a working understanding of the
complete list of criteria, prior to
initiating the design: of the sprinkler
system.
3. Questions concerning sprinkler in-
stallation and usage criteria, which
are not covered by the following
instructions, should be mailed to
the attention of the Technical
Data Department. Include sketches
and technical details, as appro-
priate.
4. In some instances, the requirements
of this document concern specifica-
tions which are more stringent than
those specified in NFPA 13 or 13D
and, which take precedence over
those specified in NFPA 13 or 13D.
General Service Conditions
The F991 Sprinklers must only be util-
ized
1. in wet pipe automatic sprinkler sys-
tems,
2. within residential portions of any
occupancy (per NFPA 13) or with-
in residential "Dwelling Units" (per
NFPA 13D),
3. at a maximum service pressure of
175 psi,
4. at a maximum temperature of
115F/46C (including the combined
effects of ambient temperature and
solar radiation),
5. with all interconnecting system pip-
ing, as well as sprinklers maintained
at a minimum temperature of 40F/
4C, and
6. with water supplies which are sub-
stantially free of contaminants and
particles of a size greater than 1/8
inch.
MAXIMUM
COVERAGE
AREA'
FT. x FT.
MINIMUM REQUIRED FLOW
(MINIMUM RESIDUAL PRESSURE)
ONE SPRINKLER
F.LOWING,GPM
MULTIPLE SPRINKLERS
FLOWING, GPM*
14 x 14
18 ( 18.4)
13 (9.6)
16 x 16
22_ ( 27.4)
16 (14.5)
Refer to different Hydraulic Design Criteria for wet pipe fire sprinkler systems in the
residential portions of any occupancy per NFPA 13 and, one- and two-family dwellings
and mobile homes per NFPA 13D.
TABLE A
HYDRAULIC DESIGN CRITERIA FOR
4.2 K -FACTOR MODEL F991 SPRINKLERS
Hydraulic Design Criteria
NOTES
In order to be treated as individual
compartments, spaces such as hall-
ways, rooms, dinettes, stairwells, and
landings must be separated by soffits,
beams, or lintels having a height of 8
or more inches.
The number of sprinklers within each
compartment mist be as few as possi-
ble. Do NOT use more sprinklers than
necessary to cover a particular space.
Model F991 Sprinklers utilized in wet
pipe automatic sprinkler systems that
are installed in dwellings or mobile
homes per NFPA 13D, must be hy-
draulically designed to provide a dis-
charge from any single sprinkler and
any two adjacent sprinklers within
the same compartment which is not
less than the minimum flow rates
specified in Table A.
Model F991 Sprinklers utilized in wet
pipe automatic sprinkler systems that
are installed within dwelling units of
any occupancy per NFPA 13, must be
hydraulically designed to provide. a
discharge from the most hydrauli-
cally demanding single sprinkler and
a discharge from each of any four
sprinklers covering adjacent areas
within the same compartment Jvhich
is not less than the minimum flow
rates specified in Table A. When a
compartment contains less than four
sprinklers, the hydraulic design area
must include all -sprinklers within
that compartment plus the sprinklers
in adjoining compartments, hallways,
or stairwells, up to a maximum of four
sprinklers. In all cases, the design area
must include the four most hydraulic-
ally demanding sprinklers.
Spray Coverage Criteria
The nominal wetting patterns for
the F991 Sprinklers, at the mini-
mum required flow conditions (Ref.
—3—
Table A), are illustrated in Figure C.
The following are the F991 Sprinkler
installation criteria necessary to as-
suring that they will provide their
design distribution of water spray.
1. The maximum area to be covered
by a single F991 is not to exceed
the maximum coverage area de-
fined in 'the preceding subsection
on Hydraulic Design Criteria and
any 900 quadrant is limited to 25
percent of the maximum total
coverage area (i.e., 49 sq. ft. for 14
ft. x 14 ft. and 64 sq. ft. for 16 ft.
x 16 ft.).
2. The maximum permitted distance
from an F991 Sprinkler to a wall
or partition is 7 ft. for the 14 ft.
x 14 ft. coverage area and 8 ft. for
the 16 ft. x 16 ft. coverage area
(Ref. Dimension "a" in Figure D).
3. The maximum permitted distance
between adjacent F991 Sprinklers
within the same compartment is
14 ft. for the 14 ft. x 14 ft. cover-
age area and 16 ft. for the 16 ft.
x 16 ft. coverage area, (Ref. Dimen-
sion "b" in Figure D).
4. An F991 Sprinkler must be located
at least 4 inches beyond the outside
corner of an alcove wall or parti-
tion, as shown by dimension "d" in
Figure D.
5. F991 Sprinklers located on pitched
ceilings and/or overhangs must be
positioned in accordance with the
criteria illustrated in Figure E.
6. The maximum permitted distance
between the mounting surface of an
F991 Sprinkler and the bottom of
ceiling mounted obstructions such
as overhangs and light fixtures is
as shown in Figure F.
7. An F991 Sprinkler that is located
on a level ceiling must be position-
ed away from an intersecting pitch-
ed ceiling in accordance with the
minimum requirement given in
Figure G.
8. An F991 Sprinkler that is located
on a pitched ceiling must be posi-
tioned away from an intersecting
level ceiling in accordance with the
o'
z'
4'
6'
8'
14' COVERAGE AREA
16'X 16' COVERAGE AREA
FIGURE C
NOMINAL WETTING PATTERNS AT MINIMUM REQUIRED FLOW CONDITIONS*
'See Technical Data and Warranty Sections.
minimum requirement given in
Figure H.
NOTE
77re spray from the F991 is distributed
radially outward and downward from
the sprinkler deflector. Consequent-
ly, the sprinklers must be located such
that there will not be any blind spaces
shielded from spray by partitions,
room dividers, overhangs or other
parts of the dwelling structure.
Operational Sensitivity Criteria
The F991 Sprinklers must be in-
stalled
1. beneath solid ceilings having a
smooth or textured surface.
2. with a bottom of Heat Collector
(Ref. Fig. A) to ceiling distance
of between 5/8 and 4 inches.
3. at least 4 inches away from a verti-
cal wall surface (Ref. Dimension
"d" in Figures D and E), and
4. not more than 3 feet vertically
down from the peak of a pitched
ceiling, except that the horizontal
distance from the sprinkler to the
peak is not to be less than 2 feet
(Ref. Dimensions "e" and "f" in
Figure E).
The F991 Sprinklers must NOT be
used
a. beneath soffits or beams having a
depth of more than 3-1/8 inches,
b, above or below open-gridded type
suspended ceilings, and
c. with beams, joists, or ducts having
a height of more than 3 inches lo-
cated within the sprinkler coverage
areas.
NOTE
Beams having a height of more than
3 inches may be located with their
centerlines along the boundries
separating adjacent sprinkler cover-
age areas.
It is recommended that as part of the
sprinkler system design, the designer
review the dwelling plans and, where
appropriate, advise the owner or his
representative as to the following.
—4—
I. Lintels of at least 3 inches in height
and preferably 8 inches should be
used over all passageways from one
space to another, in order to reduce
the possibility of sprinkler opera-
tions outside the fire area.
II. Beams of at least 3 inches in height
should be used to border each of
5 or more adjoining areas of F991
Sprinkler coverage (within the same
compartment), in order to decrease
the time to first sprinkler operation
as well as to reduce the possibility
of multiple sprinkler operations.
Cold Soldering Criteria
1. With reference to Figures D and E,
the minimum required distance be-
tween adjacent F991 Sprinklers is
8 feet, except as noted.
2. When F991 Sprinklers must be lo-
cated on intersecting pitched ceil-
ings, they must be located as shown
in Figure E-1 with a partition or
90° (TYP.) (a)
Fig.D-1
(a) (a)�
--= (a)
Fig. D-3
(b)(c)
(a)
(0)4--�Fin_n-2
(b)(c)
(a)
(a) (b)(c)
(b)(c)— �(a)
(d) (a) (d)
1I II
--(a)—'� (d) (d)� (d)
Fig. D-7 Fig. D-8 Fig. D-9
LEGEND
♦ SPRINKLER
INTERIOR WALL SURFACE
(a) 7 FEET IS THE MAXIMUM PERMITTED FOR THE 14' X 14' COVERAGE AND 8
FEET IS THE MAXIMUM PERMITTED FOR THE 16'X 16' COVERAGE.
(b) 14 FEET IS THE MAXIMUM PERMITTED FOR THE 14'X 14' COVERAGE'AND 16
FEET IS THE MAXIMUM PERMITTED FOR THE 16'X 16' COVERAGE.
(c) 8 FEET IS THE MINIMUM REQUIRED.
(d) 4 INCHES IS THE MINIMUM REQUIRED.
FIGURE D
PLAN VIEW ILLUSTRATIONS OF
SPRINKLER -TO -WALL AND SPRINKLER=TO-SPRINKLER
POSITIONING CRITERIA
—5—
�(aJ
(e)
opal o)(09
i
(f) (f) ,
Fig. E-1
Fig. E—z -1
(d) r(d) —(f Fig. E -3-(f) Fig. E-4
LEGEND
SPRINKLER
INTERIOR SURFACE
(a) 7 FEET IS THE MAXIMUM PERMITTED FOR THE 14' X (d) 4 INCHES IS THE MINIMUM REQUIRED.
14' COVERAGE AND 8 FEET IS THE MAXIMUM PERMIT-
TED FOR THE 16'X 16' COVERAGE. (e) MAXIMUM OF 3 FEET EXCEPT THAT M MUST BE AT
LEAST 2 FEET.
(b) 14 FEET IS THE MAXIMUM PERMITTED FOR THE 14' X (f) 2 FEET IS THE MINIMUM REQUIRED.
14' COVERAGE AND 16 FEET IS THE MAXIMUM PER-
MITTED FOR THE 16' X 16' COVERAGE. (g) SEE COLD SOLDERING CRITERIA NO. 2.
(c) 8 FEET IS THE MINIMUM REQUIRED. (h) SEE COLD SOLDERING CRITERIA NO. 3.
FIGURE E
ELEVATION VIEW ILLUSTRATIONS OF
POSITIONING CRITERIA FOR SPRINKLERS LOCATED ON PITCHED CEILINGS AND/OR OVERHANGS
24
Ln 18
2
U
OZ
FwF—
�w
U
w
IL Q 12
N
J —
♦ � t7
X _j
Qa
V(MAX.)
cc
w
> 6
F
H -
` V
( MAX.)
0
0 1 2 3 4 5 6 7
FIGURE F DISTANCE TO OBSTRUCTION WOR 'S', FEET
MAXIMUM PERMITTED VERTICAL DISTANCE BETWEEN THE SPRINKLER MOUNTING SURFACE AND
THE BOTTOM OF CEILING MOUNTED OBSTRUCTIONS SUCH AS BEAMS, OVERHANGS AND LIGHT FIXTURES
8
beam extending down from the
peak to at least one inch below the
centerline of the sprinkler mount-
ing surface.
NOTE
Use of a partition or beam ex-
tending down from the peak will
also tend to decrease the time to
first sprinkler operation.
3. When F991 Sprinklers must be lo-
cated at different elevations on a
pitched ceiling, they are to be lo-
cated as .shown in Figure E-4. Al-
so, a baffle may be required mid-
way between the sprinklers. Refer
to Figure I for the baffle installa-
tion requirements.
4. When adjacent F991 Sprinklers
must be located on intersecting
level and pitched ceilings, the
sprinklers must be spaced apart in
accordance with the criteria given
in Figures J and K.
Heat Source Criteria
The F991 Sprinklers must NOT be
located
1. where the temperature of the Fus-
ible Element Assembly will ex-
ceed a temperature of 115F/46C
(including the combined effects of
ambient temperature and solar
radiation),
2, where they will be exposed to the
rays of the sun passing thru glass
or plastic skylights,
3. in an unventilated compartment
containing a furnace or water
heater,
4. in an unventilated attic or in an
unventilated -concealed compart-
ment under an uninsulated roof,
5. in a ventilated compartment
where the temperature of the Fus-
ible Element Assembly will ex-
ceed 115F/46C,
6. within the following distances of
exposed light fixtures:
Wattage Minimum
Range Distance
Less than 250 6 inches
250.499 1 foot
500-999 2 feet
1,000 and more 3 feet
7. within 2 feet of the outside edge
of a ceiling mounted, downward
discharging heating diffuser,
8. within 2 feet of the left or right
edges of a horizontal discharging
heat diffuser or within 3 feet of
the front of a horizontal discharg-
ing heat diffuser,
9. within 18 inches of the side of an
uninsulated heating duct,
10. within 1 foot of an uninsulated
hot water pipe,
ui
W
LL
Lu _
w -
¢w
Bu
oz
wa
2 N_
J
�Q
z~
_Z
�o
N
cc
O
X
...........11 ...............:.
H
(MIN.)
0
0 5 10 15 20 25 30 35 40 45 50 55 60
CEILING ANGLE'A', DEGREES
FIGURE G
MINIMUM REQUIRED HORIZONTAL DISTANCE BETWEEN
A SPRINKLER LOCATED ON A LEVEL CEILING
AND AN INTERSECTING PITCHED CEILING
5
LU 4
pw
Lu LL
a 3
LU u
�z
�H
ON 2
zZ
�z
a
N 1
S
(MIN,)
0 5 10 15 20 25 30 35 40 45 50 55 60
CEILING ANGLE'A', DEGREES
FIGURE H
MINIMUM REQUIRED SLANT DISTANCE BETWEEN
A LEVEL CEILING AND A SPRINKLER
LOCATED ON AN INTERSECTING PITCHED CEILING
—7-
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operation could alter its orienta-
tion: and water distribution pattern.
3. Use only a non -hardening type of
Teflont based pipe joint sealant
and apply it sparingly to the male
threads only.
4. Hand tighten the Sprinkler with
the attached Protective Cap (as
shipped), into the sprinkler fitting.
5. Using the Model F871 Aquarius
Sprinkler Wrench shown in Fig-
ure Q, tighten the Sprinkler into
the fitting. Align the Wrench
Lugs of all Sprinklers within a
compartment to be parallel to one
of the compartment walls.
NOTE
If the compartment has one or
more corners in which the intersect-
ing walls are riot perpendicular to
each other, then check with the
sprinkler system designer to see
which wall the Wrench Lugs should
be made parallel to.
The Wrench is slipped over the
Protective Cap and can be mounted
to a 1/2 inch socket drive rachet. A
radial force of 10 to 18 lbs. applied
to a typical 9 inch long rachet
handle will exert the 7 to 14 ft.lbs.
of torque required for a leak tight
sprinkler joint.
NOTE
A maximum of 21 ft.lbs. of torque
is to be used to install the sprinkler.
Higher levels of torque may distort
the sprinkler orifice seat with
consequent leakage.
6. Do not remove the Protective Cap
at this time. The Protective Cap is
intended to protect the sprinkler
until the ceiling installation is com-
plete and the sprinkler system is
ready to be put into service.
NOTE
Failure to use the Protective Cap,
while the ceiling installation is
being completed, can result in the
accidental damage or painting of a
sprinkler. Damaged or painted
sprinklers must be replaced.
7. After the ceiling installation is com-
plete or the sprinkler system is
ready to be put into service, slide
off the Protective Cap.
NOTE
Failure to remove the Protective
Cap will prevent proper operation
of the sprinkler.
8. Align the two slots on the inside
edge of the Push -on Escutcheon
Plate with the Wrench Lugs on
the sprinkler Body and then push
12
1.- 11
W
UJ
LL
W 10
2 W
5u
OZ
W<
�N s
20
Z) J
�Q
zz a
20
N_
O
x
6
S*
(MIN) / A
*THE MINIMUM REQUIRED VALUE OF
'H' IS ESSENTIALLY INDEPENDENT OF
ANGLE'A'.
tREFER TO FIGURE H FOR MINIMUM
REQUIRED SLANT DISTANCE.
0
SLANT DISTANCE 'S', FEET
FIGURE K
MINIMUM HORIZONTAL SPACING CRITERIA FOR
ADJACENT SPRINKLERS LOCATED ON
INTERSECTING LEVEL AND PITCHED CEILINGS
ENGAGE SLOTS WITH SPRINKLER
WRENCH LUGS
:AT IS
.RPENDICULAR
) PLANE OF
WRENCH LUGS
eFT nP111C
FIGURE Q
MODEL F871 AQUARIUS
SPRINKLER WRENCH
the Escutcheon Plate up over the
Body of the sprinkler until its out-
side edge comes in contact with
the mounting surface.
NOTE
Do not attempt to make-up for in-
sufficient adjustment in an Escut-
cheon Plate by under- or over -tight-
ening the Sprinkler. Readjust the
position of the sprinkler fitting to
suit.
—9-
tDuPont Registered Trademark
NOTE: SPRINKLERS MUST BE LOCATED OUTSIDE OF SHADED AREAS SHOWN IN FIGURES L THRU P.
f
i-6'
ITYP)
FIGURE L
POSITIONING CRITERIA FOR SPRINKLERS
TO BE LOCATED NEAR A RANGE OR WALL OVEN
S F'
FRONT EC
OF FIREPI
(m
FIGURE M
POSITIONING CRITERIA FOR SPRINKLERS TO BE
LOCATED NEAR A RECESSED HEARTH FIREPLACE
s FT.(TYR)
'ceccccecccc
FIGURE N
POSITIONING CRITERIA FOR SPRINKLERS
TO BE LOCATED NEAR AN OPEN HEARTH FIREPLACE
ATJ•
SFl
FIGURE O
POSITIONING CRITERIA FOR SPRINKLERS
TO BE LOCATED NEAR A COAL
OR WOOD BURNING STOVE
161N. (TYP. TO FLUES)
�b'iu'Uc."evSV9b�
6o e o
6IN. IT YPJ
G IN.(ALL AROUND)
O
FIGURE P
POSITIONING CRITERIA FOR SPRINKLERS
TO BE LOCATED NEAR A FURNACE
OR WATER HEATER
.CARE AND MAINTENANCE
The F991 Sprinklers must never be
shipped, stored, or used where their
temperature will exceed 115F/46C-
and
15F/46C-and they must never be painted,
plated, coated or otherwise altered
after leaving the factory. Modified or
over -heated sprinklers must be
replaced.
NOTE
Particular care to prevent over -heating
must be exercised when storing sprink-
lers in cars, trucks, trains, or other
vehicles on warm, bright sunny days.
Care must be exercised to avoid dam-
age to the F991 Sprinklers — both be-
fore and after installation. Sprinklers
damaged by dropping, striking, wrench
twist/slippage, or the like, must be
replaced.
NOTES
Absence of an Escutcheon Plate may
delay the time to sprinkler operation
in a fire situation.
Before closing a fire protection system
main control valve for maintenance
work on the fire protection system
which it controls, permission to shut
down the affected fire protection sys-
tem must be obtained from the proper
authorities and all personnel who may
be affected by this action must be
notified.
The F991 Sprinkler must only be re-
placed with pendent units which are
listed for residential fire protection
service and which have the same nom.
inal K -factor, the same coverage area,
the same or lower flow ratings (as in-
dicated under "Hydraulic Design
Criteria"), and the same or higher
temperature rating.
NOTES
It is recommended that residential fire
sprinkler systems be inspected quarter-
ly and maintained in accordance with
the advice and suggestions given in
NFPA 13A and NFPA 13D.
Wet pipe sprinkler systems must be
maintained at a minimum temperature
of 40F/4C. Exposure to freezing tem-
peratures can result in bursting of the
pipe and/or sprinkler.
Do NOT enclose sprinklers within
drapes, curtains, or valances.
Do NOT hang anything from the
sprinklers.
Automatic sprinklers are NOT to be
tested with a heat source. Weakening
or operation of the Fusible Element
Assembly can result.
Do NOT cleanse the sprinklers with
soap and water, detergents, ammonia,
cleaning fluids, or other chemicals.
Remove dust, At, cobwebs, cocoons,
insects, and larvae by gently brushing
with- a feather,, duster or gently vac-
uuming with a soft bristle (i.e., dust-
ing) brush attachment. .
The minimum vertical clearance be-
tween the tops of free standing parti-
tions, room dividers, cabinets, storage
racks, stock piles, etc., and the mount-
ing surface of each adjacent overhead
sprinkler is NOT to be less than the
clearance given below.
Horizontal Distance Minimum
from Sprinkler Vertical
to Item, Ft. Clearance, In.
More then 6 ............ 24
From 3to6............ 19
Between 2 and 3 ......... 16
From I to 2 ............ 13
Less than 1 ............. 10
Exercise suitable safety precautions in
the use and storage of highly flamma-
ble and potentially explosive materials.
The rapid rate of fire development and
spread which can be caused by such
materials may reduce the ability of the
sprinkler system to aid in the control
of a fire in which they are involved.
REMODELING
When remodeling such as by adding
false beams or light fixtures or chang-
ing the location of compartment walls,
first verify that the new construction
will not violate the installation require-
ments stated under WARNINGS. Alter
the new construction and/or the
sprinkler system to suit the require-
ments of this document.
WARRANTY
The data provided in Figure C is not
intended for use as a minimum wetting
pattern specification.
For details on Limited Warranty, see
back page.
ORDERING PROCEDURE
Orders for Model F991 Aquarius
Pendent Residential Fire Sprinklers,
Push -on Escutcheon Plates, and the
Aquarius Sprinkler Wrench must
include the description and Product
Symbol Number (PSN) where ap-
plicable.
Sprinkler Unit:
Specify: Model F991 Aquarius Pen.
dent Residential Sprinkler Unit with
(specify type) finish, PSN (specify).
Chrome Plated Finish
160F/71C . .. . .. PSN 58-991-9-160
Bright Brass Plated Finish
160F/71 C .. . . . .. PSN 58-991-2-160
—11—
NOTES
The Push -on Escutcheon Plate for the
F991 Sprinkler Unit and the Sprinkler
Wrench must be ordered separately.
The Push -on Escutcheon Plate, which
is described below, is intended for use
with steel pipe or copper tubing. Re-
fer to TD810 for information on the
Clamp -on Escutcheon Plate which is
suitable for use with plastic piping.
Push -on Escutcheon Plates:
Specify: (Specify Type) finish Push -
on Escutcheon Plate for Aquarius
Sprinkler Unit, PSN (Specify).
White painted finish . PSN 56-991-0-001
Chrome plated finish . PSN 56-991-9-001
Bright brass plated finish. .
..........
. ...... ... ... PSN 56-991-2-001
Product Symbol Numbers are not
specified when ordering Push -on Es-
cutcheon Plates with special painted
finishes. It is suggested that a color
chip be provided when ordering spe-
cial painted finishes. Otherwise, re-
sponsibility for duplication of the
desired finish cannot be accepted.
Sprinkler Wrench:
Specify: Model F871 Aquarius Sprink-
ler Wrench, PSN 56-871-1-001.
Orders for NFPA publications should
be addressed to the:
Publication Sales Department
NFPA
Battermarch Park
Quincy, MA 02269
PATENTS
The following patents are applicable
to the Model F991 Aquarius Pendent
Residential Fire Sprnklers:
COUNTRY PATENT NO.
U.S.A. . . . . . . . . . . . . . . . . 4,618,002
United Kingdom ... .. .. .. .2,155,328
CONVERSION FACTORS
Parenthetical metric conversions cited here-
in are approximate.
1 inch
= 25.400 mm
1 foot
= 0.3048m
1 pound
= 0.4536 kg
1 ft.lb.
= 1.356 Nm
1 psi
= 6.895 kPa
= 0.0689 bar*
0.0703 kgcm2'
1 U.S. gallon
= 3.785 dm
= 3.785 liters*
*Not recognised International System units.
WEIGHT
The nominal weight of the Model
F991 Aquarius Pendent Residential
Fire Sprinkler Unit (with Protective
Cap) is 4 ounces and the weight of
the Push -on Escutcheon Plate is 0.4
ounces.
P
lid c
-ko
I )D N T I A L
39-54-2-�WT
7)-Sj
00 k(3=759-90B,i,ER,M�-
31
BLACK, Jim
9445 Dwyer Ct, Durham
(new sf)
G4
117"
OFFICE Copy
c
Address 19S SL4YE(?
GAS
Meter By Date
ELECTRIC
Meter By
----------- Date
I
JOB FINALED (Date) — P-9
'Signature loozl�\A�IL
J=aK ,
O Not OK
NApplic
ot
Readyable MOBILE HOMES
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch.
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap: / /" L" ft.
/ /"Nat. or/ /" L"ft./ /"LPG
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-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-PaneIboa rds-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
7. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements = '
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-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-PaneIboa rds-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
4=OK NO=V
O = Not OK , hC :I,0. 0
=Not NotAeadyable ,�UO3�AJJ3CRESIDENTIAL (Single & Duplex) t,?Oj-� �IjI C)rAlsioaRaA?r.M
.. _
,Date . z'_IW"UNDERFLOOR' Plans 'OK exc t N"s., .8n3V0: .�OHO of :7 ki-Date_.". , FRAMING'(Continued) 2_31T!_JIlU 3fEUK 231iuf:• _ ntx
-Se cks-Easeme s=Fieed•SI e� QninoS i i
�2.1Ftg.1,:Main; Soils=Elec-'G :/0U.!.Ftg<Depthd"uo-�a .S
zli6F' Ftg.;'Garage;•Soils-Steel Elec::6ead�/e/'.Ftg`.Depth j
4. Ftg., Porches &'Decks-, Soils-Steel-/'1/Ftg:•Depth V .4 1
---5.-Stemwalls, Main; Steel-Blockouts=Wrapped`�F•"!itic -- _
----`=6".Stemwalls;'Gara4e;Steel-Blockouts'-Wrapped �ol,.r. __
.6a..Hold_powns and Special Arichor"sv .,,ar
-----•-,7
Steel -Wrapped
PP /'/y CI /
-------•-. - 8. -Piers -Fireplace Ftg.`-Steel ,"'_' - K„c ;gm Y, xJ _
_ D.W.V.; F40 ritting'T -2-Way."C%O Sewer.Test"-O:b
__10. Gas Pipe; Size -Anchors
11. Water Pipe; .Test -Anchor -Regulator ServiceTe'sY '_fir
_ 12. -Electric; Underground__.-_
_13. Pienums & Ducts; Clea ran ce- Material -Support- Ins.
14.'-Girders-Sills-Anchor'Boits-Joists-Vents=Cripples.
Date j-$-VJ(--Card 8--1�{y_. _Date'."�' s= '.Card B=1_ _
Date _ -Card B-1 t" __DatC"na,7ugel,v CaidB=1._-_"._
Date PLU GING' Permit OK ene t
Water.Htr.; Vent -Access- om stion ' Batfle-=---
` ater Pipe; &Anchor -Nail Protection._ _ - --
JZ'D.W.V.; Test -Fittings &-Anchor-Nail Protection -- -- -
Show Pan; T ; First Floor -Tub Access --
20. Test Tub & Shower, -Second Floor -Tub Access�=-�- --- -;
as Pi , Size 'Anchors "=
Date �j (=��--Card'B-1 �-� -Date , e�;c� j Card B;i�—
Date "l,- (A' -A (-Card`Date Card B=1- - -----
Date ELECTRICAL (Permit)' OK except q's -- ---- -
22.'Fixture'&Transformer Clearance -Ins -Protection - ^- --- -�
23/Elec. Receptacles'Spacing-Lights& Switches at Doors -•----L
2 .,Size;Boxes'&'No. of Con ductors-Stapled
=-=--�---- -= =
— ztr rtomex,insranea uiose io toge or atuas a
quip. GrDund made up w/Mech. Fastners-Bonji Gas &ter
2 Appliance Circuts in Kitchen & Conductor Size/GFI
2rSubfeed Wire Size / / ga. Cu or AI-A.C. Wire Size /gip/ ga. '
Cu o1q
9. Range Circ. /6/ ga. Cu o <A__lLOven Circ. 161 ga. Cu oZ9
Insulate Neutral 0 Yes A No
e - ise Conductors & Ground -Main Disconnect
3X -Equip. Clearances Panels-Motors-Mech. Equip.
Clothes Closet Light -Shower Light -Spa Light
3 . Smoke Detector
Date 3 ��n_�t Card B-1Date Card B-1
Date -h 1 Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except p's
6*-A.C. Ducts Insulation & Support
�Went Fan; Exhaust above insulation
Jfa. ondensate Drain & Overflow; Size & Grade
Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet
cces lata rm 'f Furnance in Attic
Date 3-6-ci1 Card B-1 C C, Date Card B-1
Date -E)I Card B-1 CC Date Card B-1
Date FRAMING (Plans) OK except If's
�3_Sils, Proper Material & Anchors
WWalls Studs -Nailing, Spacing & Bracing -Plates -Sound
W. Bearing Walls over Girders & Floor Nailing
021 graft Stop in Walls (rat pr of)
Fire Stops; Furre ei' Stairs -Chases -Tub
44' -Headers & Beam -Size & Bearing
_ e,(WCing. Joist Rftr.,ties= Puri in -roof: BracGT.rus$>`BpIU' Rfng.
Al.-Pireplace•Ties'or.Type A Flue-Fireplace.Throatclearance
481-Attic'Access, Siie!&'Romex Protection -Draft Stop -Ins. Baffles
r"�' drm:°Wind'ows'or.Exiting!Doors-Sill.Hgt;.& Dimensions
Garage Fire Protectio r . m' f •n0oa,)0i ;_ .v 0
— - -•- --54,�Foperty- Line .Firev ali & Openings_-
- - - •--- 59!`�rxt. Doors -One T -Check Garage'3rd Story' Y2 Exits _,.
----•- - 39-Stafrs; Width -Headroom -Rise -Run -Landing -Fire Protection.--_-- -_-
---- - - plywood on Roof Overhang-Attic.Vents-R after, Outrigge rs
--- -- r{!�,Siding-Nailing Veneer-_.
s: •-t
-- - -----3ttilCco Mesh -Drip Screed-Fd...Vents-Underflr.,Access___�_
laiing-Area-Glass Protection-Skylightsy Plastic —,........-,ruo:..,...
A•. _1 JYt c GTti SMC; ►a �1.iictC,:m> 81..L,
- aIle; n Bolts.�.................,...,,.,,r......,,.....-,,,,._,..�_.
-- __.�...�$ - S 8 •_n_W I. e, inRs
•o_r,:tw uanut.r.+r �na:p.� _
66, Infiration- alts-Wi doves''_` .`gG apn,lu°'_' �-
,v:J - ✓- n �v u , , r =..1 nt4 ,84t) L
—! rim 11ro 1:1D:J p
Date -2-/: -4r,-Card B -1 -jam(,''" `Date`.3='!z{="i/'.Card 8-1,GC._
]V I 1Jl J -:GJI f4rV1 ;1,.
-Date 2 .�, P.L�-Card -B-1 �.(„"'_ ._.Date' _--.._ _Card B-1.
n7"—"U .vw.br.,,"" 79Tn1'd Y
•-Date-�INAL' lane -OK exce t #'s_-__._
--61, x Steps -Door.& Sidelight Protection Landings _`__.____
--•- -- -6 ke Detector-.----_ ' Yvr��yzn� :r.9,z� v
-- - - ,--63efurnacents-Clearance-Comb.;AiV-Connector
I r_a e; Above Floor-Ducts-Mech. Protection
6 dr m Exiting
I. Bath_ Fixtures & Tub Access(9-1,<110 10 sfau
!6alec..Trim & Subpanel; Breaker Sizes &'Labels s'rq
•rs & Rails
8. Fireplace or Stove; Clearances -Hearth
6t-Etec. Outlets at Wood Panel; Int. & Ext.
Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
lec. Outlets & Receptacles at Kit. Counter
Garage Fire Door; Swing -Landing -Closer
UgQyU,,tr Vents leatd- - omb. Air-Connector-P.R.V.
In arage; Above' oor-Mech. Protection
7&.-Tgb., Elec. & Mech. Equip. Listed for Locatic�--
WB lec. Receptacles in Garage; (G.F.I.)-Romex Protection
"'� . Insulation -Foam -Looked in Attic 0 Yes
7& -ward Rails & Deck Construction -Post Caps '
79r41dh. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor 0 Yes
Following. instid.; Drive 0 Yes 0 No; Walks 0 Yes O No;
Planters 0 Yes 0 No
84-Stueco; Brown -Finish
A2"A.C. Unit; Disconnect, Electrical, Plumbing
88"'Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to
Openings
e4r-Wster Well; Disconnect, Electrical, Plumbing
861'txterior Elec. Trim; G.F.I. Receptacle -Underground
_. Ventilation Throughout House
8 . ass Protection
Corrections from Previous Inspections
�8 Gas Tit -Meters Tagg'ed; Gas -Electric
W Water & Sewer Connected -C/O to Grade -HD Approval
Energy Compliance Certificate -Other Certificates
Date or. Card B-1 Cj< Date Card B -1 -
Date q-,'Z•Q Card 13-1 K4 Date Card B-1
Datej,?CI8-1 C Date Card B-1
o,Z Card
Comments at Final:
(NOTE: An entry must be made each time you visit job site)
COUNTY OF BUTTE'
3
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroyi Ile — Phone: 538-7541'
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
3
�� Actt 375g -ter �
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
whencorrection o ork is completed. If you have any question pertaining to this
ratter, or nee additional explanation, please contact this office immediately.
M ,�� � �b O S An1b Ml� , � �� FfLo•+lJr' t �A(' IL .
v
Date Cl - Inspector J-1�vl.aT,"�
- .. - 1 :%-...i'_, -'f i•;.•r;�. � - � - --- s."s:c'�r"-.�.-.A�. w„•'�i'r'IiFG;� i
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
• 7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
I L-A ck- � -7 s9-$0
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter_or need additional explanation, please contact this office immediately.
ZVA
A She ria.a/ Z -Z Pte. z/3 C,r- ow 2/1 iniG 1V0;
a?iff
Date Inspector_
LOCATION
ROOF
ENERGY CERTIFICATION
CL
A. P. NO.
Material_.—
Brand Name
_
Thickness_.
'.Thermal Resistance (R Value)—__
EXTERIOR WALL
Material FIBERGLASS
Brand Name CERTAINTEED_
Thickness (Inches)_T �_ Thermal Resistance (R Value)
CEILING
Batt or Blanket Type FIBERGLASS
Brand Name CERTAINTEED
Thickness (Inches) /�Z-
Thermal Resistance (R Value)
Loose Fill Type FIgFRGLASS_
Brand Name CERTAINTEED_
Minimum Thickness (Inches )
_
No. of BagS__V Weight/Baq_25_lbs
Area Covered (Sq. �`t. )x/31 Thermal Resistance (R-Value)"--21?�'
FLOOR,ELEVATED
Material_._FI_BERGLASS _
— r___
Brand Name CERTAINTEED
Thickness Inches)
Thermal Resistance (R Value)___
FLOOR, SLAB
-
Material_ —
Brand Name_
_
Thickness (Inches)
Thermal Resistance (R Value)
FOUNDATION WALL
Material_
Brand Name
Thickness (Inches)
Thermal Resistance (R Value)
I HEREBY CERTIFY THAT THE ABOVE INSULATION WAS INSTALLED IN THE
ABOVE BUILDING IN CONFORMANCE WITH THE -STATE OF CALIFORNIA ENERGY
REQUIREMENTS.
HAWK IN.S_Z.NRUST�,S INC _ __ r'
379407 _
Firm Name/Owner -State Contractos Li _ __cense No.
Signature Date
I HEREBY CERTIFY THE ABOVE INSULATION AND ALL REQUIRED ITEMS AS
SHOWN ON THE BUILDING DEPARTMENT APPROVED PLANS AND ATTACHMENTS
HAVE BEEN INSTALLED AS REQUIRED BY THE STATE'OF CALIFORKIA'ENERGY
REQUIREMENTS.
Firm Name/Owner
Signature Gen. Contractor/Owner
Datea ----.._.------
Datee
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
AA
ASSESSOR PARCEL NUMBER
ZONING
SR -1
BUILDING PERMIT
OWNER
Jim Black
TELEPHONE
342-2169
SQ. FT. OCC. BUILDING VALUATION
2136 R 85 440.00
OWNER'S MAILING ADDRESS
P.O. Box 636, Durham 9 38
952 M 13 328.00
CONTRACTOR'S NAME
Owner
TELEPHONE
57/, 5
'i l� J 'i
IS ,7/.0.00
CONTRACTOR'S MAILING ADDRESS
Owner
Fireplace A 1,000.00
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $ 105 508.00
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 448.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
224.00
Energy Plan Checking Fee
A$
$ 15.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit tee
$ 697.00
PLUMBING PERMIT
Filing Fee 10.00
9445 Dwyer Ct. Durham
Each Trap
131 2.00 26.00
Solar or heat pump water heater
20.00
LOT NO.
4
SUBDIVISION NAME /
!L `' J
PARCEL MAP
Water piping
5.00 5.00
Each qas water heater or vent
1 5.00
r�--�yf USE OF STRUCTURE
SF t Duplex❑ Mobilehome❑ Other
1=
SPECIFY
Gas piping system 1 - 5 outlets
5.00 5.00
Building sewer
5.00
Mobile Home JSFG W
10.00e
TYPE OF WORK
New[J Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: 3 Bedroom _
Permit Fee
$56.00
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 1VOR AMR OR 00LESS
1 10.00 10.00
Main service EA. ADD'L 100 AMP
1 2.50 2,50
CONTRACTORS LICENSE LAW
1 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 4�force and effect.
License No. °3476`�� 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)
ElI, as the owner, am exclusively contracting with licensed contract -Mobile
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.E
OR ACDNS. (ACC. BLDGS.
X /z¢sgft 77.20
NEWCONST R. ULT%.OUTLET
N ON•R ESID BRANCH CIRC ITS
2.50 ea
/ POWER APPARATUS 61
%SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
eA 030
FIXED ARLNS.
Ex. OCCUp. OUTLETS PIRESID IKEA.)
2.00
Temporary service
10.00
Home Facilities
15.00
Misc. Wiring
g
15.00
Permit Fee
$ 99.70
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
1 have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
Heating
116.00 6.00
Split
lin
Cooling 4 Ton
1 .1 .00 11.00
Hood
1 3.00 3.00
Ventilation
permit Fee
$ 30,Q�
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 otcops
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 Wpenses which may in any way accrue
again t said County in conse Uence of Jtpe granting of this permit.
/) �� rgQt�
X ` Date- J ri/
Signature of Applicant - Owner Contractor Agent ❑
An OSHA permit is required for tions o er 0 ' d p a d d molition or construct-
ion of structures over 3 stori ino ht. '
Mobile Home Installation Fee $
Rpergy Inspection Fee $ 30.00
PE
V
j
TOTAL FEE 12.70
HAZ
^`
CUA
-
PARK
._
SCHL
F
PAR
PD
HO ISSUE
Th's permit is nereby issued under
sions or the Butte Count Code and/or
work indicated above for which fees
IR CTO OF PUBLIC
By
n y ^/'//�(�'
PERMIT EXPIRES ate
the appiicab a provi-
resolutions to do
have been paid.
WORKS
Date 2
I/
73995
Receipt No.
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK-INSPEC O . GOLDENROD -APPLICANT
1
COUNTY OF BUTTE' - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 Nil
PERMIT APPLICATION DATA, SHEET ,
A , I "' k V, Permit No.
UWNEK I V I j-/ L— / I E__ A. P D.
Proposed Building Use Building Inspector Date
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED APPROVED
1. All items have been submitted . ....................................
2. Plot plans in duplicate/triplicate, signed by preparer of plans........
3. Complete plans in duplicate/triplicate, signed by preparer of plans ..
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form ..........................................
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
�•Engineered truss details and layout in duplicate (required prior to plan check)
. Mobilehome installation data including manufacturer's installation
instructions. ...
. Fees of $ �� e! ..
11. Chico Urban Area fees paid .......................................
12. Park fees paid ...............................................
13. �f✓S School District fees paid .............. 1(971019U
14. Sanitation approval from ��T� Health Department
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
1 Improvements may be required. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy) 1/7-
20. Pre -Inspection for required ... Pre-Inspec. request to
Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
4-'(,;f4" Recorded copy of Agricultural Acknowledgment Statement .. /-- / 3— 9e,!
25. Letter of signature authorization ...................................
26.
When you issue the permit, process as follows: Mail to owner.
Telephone and hold for pickup at office
Mail to contractor.
Deliver w/inspector.
Copy of plans sent Health Dept., Fire Dept., —Other—Date
The following data must be submitted prior to permit i su ncl le new item,,not the ed above .
1. Index permit for above items No.
2. Additional items required:
Contrac ,designer, owner, was advised of above required data by _phone_rnail—counter b .date
Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date
Plans checked by Date Plans approved by Date
Sets of plans on hold in . File cabinet AP folder
Copy—DPW
;. Huildinq Department
s -
Environmental Health
�i 41
,EJECT: 'Sanitation Clearance
``/ .a r"(4 -
Owner
// IbA)
Owner Location AP#
Plan Approved for: Sewage Disposal Water Supple
Hold final for: Water Supply
'Final clearance O.K. for: Water Supply
Clearance for —2=r bedroom mob**w home. Other
NOTE ***
.J
Sanitarian Date
X�7�r.'- �r f .+'f�,•
l l(Iitinn;il Ir"nf inn field will he required if ezperienee'showv it tcibe 6ecessary: No part of the system mav''
3.< -
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
�' - 2 7 Pd„ APPLICATION AND PERMIT
i
PERMIT NO.
ASSES -9P CEL R
20N� )
BUILDING PERMIT
OWNER
I dl n 6 � A _ /� fe
tNvG, �'T c.J�
TELEPHONE
a� 6
`
SO.FT. OC BUILDING VALUATION
!/
OWNER'S IIpI DF�ESS
(//OR'!
E/Jr`
CONT ACT
TEL P ONE
CONTRACTOR'S MAILING ADDRESS
Fireplace10049
CONSTRUCTION LENDER
UNKNOWN
Total Valuation 1 $
LENDER'S MAILING ADDRESS
Filing Fee $
10.00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
i1 0
Energy Plan Checking Fee$
Q
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDINGA RESS
Permit fee $
7.
1414" 9 , , _�� �v�
tN
PLUMBING PERMIT Filing Fee
10.00
Each Trap
r O�
Solar or heat um water heater
pump 20.00
LOSUBDIVISION
NAME
PA C L 'M-A-01""Water
piping 5.00
~�00
Each qas water heater or vent 5.00
0 Q
USE OF STRUCTURE
S.F�< Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00
Q
Building sewer 5.00
Q
Mobile Home S I G I W 0.00e
TYPE OF WORK
Ne Addition❑ Remo el tilities❑ Installation ❑ Other ❑
Descri work:i�
'
Permit Fee $,
Contractor
ELECTRICAL PERMIT Filing Fee
10.00
Main service 100 SS
AMP O1 OR R LESS 10.00
Main service EA. ADD'L 100 AMP 2.50
,
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
® I am licensed under provisions of Chapt. 9, Div. 3 of the Bushes$
and Professions Code and my license Is In full force and effect.
License No. `�1 �o S1 Classification S1BALe
❑ 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 OCCUP.&
OR ADDNS. ( ACC. BLDGS. /20Sgft 77 2
NEW CONSTR. ULTI.OUT LET
NON.RESIO BRANCH CIRC ITS 2.50 ea
(POWER APPARATUS 8)
SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 209500
30
Ex. Occup. OUTLETS FIXED P(RESID )REA.) 1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00Misc.
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.
Tem I have placed on file with the County of Butte Building Department
Ll� a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ 1 shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C: provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT Filing Fee
10.00
Heating
Coolin g
,
Hood 3,00
Ventilation
pit F
Permit Fee $ Rf49100
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
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 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee g,
occ
CONST TYPE
TOTAL FEE $
HAZ
I CUA I
PARK
I SCHL
I FLD
I PAR
I PD
I HD
ISSUE
This permit is nereby issued under the applicable
sions of the Butte County Code and/or resolutions
work indicated above for which fees have
DIRECTOR OF PUBLIC WORKS
By Date
PERMIT EXPIRES Date
provi-
to do
been paid.
Receipt No. !
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT
d
Recording requested by
Mid Valley Title
Escrow No. 116614 DMP
Return to DPW
g0-47082
90=047062 ; R e c F e e
Check
Recorded
Official Records ;
County of
Butte
,:Candace J. Gr.ubbs_ ;.
Recorder
8: 00am • 2 -Nov_' -90
AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8.1 of the Butte County Code requires this acknowledgement
be recorded prior to issuance of a building permit.
ti
7.00
7.00
• E4�
J J" 2
The property described herein is adjacent to land or included
within an area zoned for agricultural purposes, and residents of this
property may be subject to inconveniences or discomfort arising from
the use of agricultural chemicals, including, but not limited to herbicides, pesticides,
and fertilizers; and from the pursuit of agricultural operations including, but not limited
to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural zones which have as a
priority use for productive agricultural purposes, and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or disconform from normal,
necessary farm operations.
All that real property situate in the. County of Butte, State of California, described
as follows:
e
Date: ) D— 1 D
SEE ATTACHED LEGAL DESCRIPTION
PRO, RTY OWNERS:
JAMES R. BLACK
a
State of California ) On this the 12th day of October , 19 90 , before
) SS. me, the undersigned Notary Public, personally appeared
County of Butte )
JAMES R. BLACK
OFFICIAL
Personally known to me. �/ Proved to me on the basis
in=n • of satisfactory evidence.
rwa.•c 1�.•;�`� Y
a, q ddF PALMER to be theerson s whose name s is subscribed to
NOTARY PUBLIC . CALIFORNIA p ( ) C )
BUTTE COUNTY the within instrument and acknowledged that he
q(IFUPN� My Comm. Expires April 26. 1994 executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set• and and official seal.
v G� DEE PALMER
Notary Public
-a`� -
Present A.P. No. 0 -0 -go
DESCRIPTION:
g0s4 T: Z w
ORDER NO. BU -116614 DMP
ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE STATE OF
CALIFORNIA, COUNTY OF BUTTE, DESCRIBED AS FOLLOWS:
PARCEL I•
LOT 4, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "TURNER'S 3RD
SUBDIVISION'!, WHICH MAP WAS RECORDED IN THE OFFICE OF THE
.RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JULY 25,
1990, IN BOOK 118 OF MAPS, AT PAGE(S) 57, 58 AND 59.
RESERVING THEREFROM A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC
UTILITY PURPOSES OVER DWYER COURT, AS SHOWN ON THE ABOVE MAP.
SUBJECT TO COVENANTS, CONDITIONS AND RESTRICTIONS, RECORDED JULY.
25, 1990, UNDER BUTTE COUNTY. RECORDER'S SERIAL NO. 90-31406.
PARCEL II:
A NON-EXCLUSIVE EASEMENT FOR ROAD. AND PUBLIC UTILITY ,PURPOSES
OVER DWYER COURT, AS SHOWN ON THAT CERTAIN MAP ENTITLED,
"TURNER'S 3RD SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE
OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON
JULY 25, 1990, IN BOOK 118 OF MAPS, AT PAGES) 57, 58 AND 59.
EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF
PARCEL I, DESCRIBED HEREIN.
END OF DOCUMENT
5/89
RESIDENTIAL PLAN CHECKING GUIDE {
.(S.F., DUPLEX & MISC. ONLY)
..Bldg. -Permit #
OWNER"' A. P. # 3s - 3
GENERAL
Zoning requirements: (sideyards and number of permitted living units).
Valuation.
Plans signed by designer.
Energy Design and Compliance.
Existing violations on property.
Items on data sheet. -
PLOT PLAN
Complete parcel size and dimensions.
Setbacks, sideyards, easements, etc..
Other buildings or structures.
Grading, fills, drainage.
•' Flood hazard:
Special conditions on creation map or compliance document.
FAU & FAS road setback.
LIT Or)D DT A M
Complete to scale plan with dimensions.
equired windows for light and.ventilation (Sec. 1205).
equired windows for second exit (Sec. 1204).
V.Human
kylights (Chapter 34 & Sec. 5207).
impact glass (Sec. 5406)..
equired room sizes, ceiling heights (Sec. 1207).
FCIs in baths, garage, and exterior outlets (Article 210-8).
ight fixtures, switches, receptacles, and exterior receptacles for maintenance
of mechanical equipment.
' Locations of water heater, heating and cooling equipment, other electrical or
gas equipment, and plumbing fixtures.
jGarage firewall, door size, and closer (Sec. 503(d)(3)).
1 -3'0" exterior exit door (Sec. 3304(e)).
Fireplace and wood stove location, alcoves, and clearance.
Smoke detectors (Sec. 1210).
DETAILS
Foundation plan complete enough to construct building.
Floor construction details complete enough to construct building.
evations and wall construction details complete enough to construct building.
Roof construction details complete enough to construct building.
Fireplace construction details and calcs if necessary.
MISCELLANEOUS.ITEMS TO LOOK OUT FOR
Stairway details: landings, rise and run, head clearance, handrails (Sec. 3306).
Guardrail details (Sec. 1711 & 3306(j)).
`Brit"i:... ((Chapter. 30) . -
C.-
CE
R
R
RESIDENTIAL PLAN CHECKING GUIDE
f
MIS LLANEOUS ITEMS TO LOOK OUT FOR (CONY D)
terior plaster - weep screeds (Sec. 4706).
roper roof pitch for roof covering (Chapter 32).
Roof covering type - (fire hazard).
Rafter ties or bearing ridge beam.
Garage door or porch header sizes.
Adequate bracing.
ving area over garage - complete 1 -hour separation required on garage side
cluding supporting walls and posts, etc.
o exits on three-story dwellings (Sec. 3303 & see Mezannines - 1716).
tic access and ventilation (Sec. 3205).
derfloor access and ventilation (Sec. 2516).
mbustion air for fuel burning appliances.
ise requirements on duplexes.
obe soils - special foundation designtaining walls requiring design.
usual shape, size, or split level house requiring lateral design.
ashing at all exterior openings.
jj
j 71_g
5/89
CAPREALIAN ENGINEERING
P.O. Box 341
'Chico, CA 95927
(916) 891-6886
STRUCTURAL CALCULATIONS FOR:
2136 SO. FT. HOUSE
STRUCTURAL CRITERIA:
Seismic Zone 3
Basic Wind Speed -m.p.h.
(Example B, Method j--,:
Concrete fc - ),600 p.s.i.
Reinforcing Steel - Grade ejo
Masonry: Grade Solid Grouted yes/no
Structural Steel: Grade Yield: k.e.1.
REFERENCES:
-1986 if.
- Western Woods Ilse Book Second Editinn
- A.P.A. Construction Guide. PUB E 30E
- Manual of Steel Construction 8Lh Edition
- Concrete'Masonry Design Manual 5th Edition
- Structural Engineering Handbook. Gaylord & Gaylord,
DEC - 5 1990
LIP @ATE: 12-31•.9 3
ABBREVIATIONS:
O.T. - Overturning
O.T.M. - O.T. Moment
S.F. - Safety Factor
ALT. - Alternate
C.F. - Good For
N -S - North-South
E -W - East-West
E.N. - Each Way
TR1B. - Tributary
PRO,,VE
2nd Edition
CAPREALIAN ENGINEERING
P. 0. Box 341
CHICO. CALIFORNIA 95927
(916) 891-6886
SHEET NO. -
CALCULATED BY
CHECKED BY
SCALE ':
nF
DATE
DATE
ASSUMPTIONS AND
DESIGN DATA
Type of Structure Gee o d Fwa ^1 e Roof Pitch -5 Z
Loads in ///ft2.
Dead
Load
Total
D.L. Live Load TOTAL
Roof: Shy
3,
?„sr
t 1.a /6 18
74 Ll
S-Alst
DEC - 5 1-
Floor:
2nd Floor:
` cm, EV �
Balconies/9
Decks:
OF CO
Walls:
Other:
Wind Zone 7r m.p.h. Max. Ht.-ZL—ft. Ce= 0.7 Cg*= /.3-- qs= /S
I= / Wind Pressure (example B, method 2)= /3.7 P.s.f.
Earthquake Loading= ZgjLjJ= Q. /'Y Where Z= • 3 _ I=
Rw �i C ." W=Weight of building causing force in member
Basic Soil Pressure 1A60 #/ft2 + /00 O ft2/ft depth below l'
beneath original groun or finish grafi.
Passive lateral earth pressure= p.s.f./ft of depth
Active lateral earth pressure .s.f:/ft of depth.
Equivalent fluid density= Oft (Min. Density = 30 #/ft2)
Skin friction= (but not more than .5 x D.L.)
emomil ces/W i.... 83411
JOB
CAPREALIAN ENGINEERING
SHEET NO.
P. O. Box 341
CHICO, CALIFORNIA 95927 CALCULATED BY
OF
DATE Mc �-
(916) 891.6886
CHECKED BY
DATE
SCALE
i
i / i
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...... .........
DEC.p.�..�.....-...... 1990......:.............
...............:................::.... ....:....
..... ............. :.............
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va
DR
--5 1990
mewt ALA
CAMUA
101,
Or C. m:"%:,
F I V
15
J
JOB
' CAPREALIAN ENGINEERING SHEET NO. OF
P. 0. Box 341
CHICO, CALIFORNIA 95927 CALCULATED eY 'ACG../ • DATE DE C -4 1990
(916) 891.6886
CHECKED BY DATE
SCALE
l
f BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
(One'.Form per Building)
A.P. Number�1 Building' Department No.
School District City D County �, Jurisdiction
Property Owner C. �
Project Location/Address C?444a < DW �'1 4 1-t
Subdivision 7"0JzNgg- 30 S"V$ Lot Number
Residential Development:�/
Sq. Footage
# of Living MHI Addition. (Group R)
Units
OSq. Footage
Addition (Including 'Exterior
Roofed Areas)
Date`
Commercial/Industrial:
New
uildrYng Department Representative
(Floor Plans reviewed by School District Personnel)
tPA .
District Id No.
c oC School District certifies that
(Applicant Name)
� *��.5- ./��.�i.✓ CST
(Street"Address)
* .) r
(City)
L,
has complied with the requires
u
by the payment of . $
I
,. (Phone Numbe
9ss--/-3d'
�kystate) '-,( Zip Code)
rni s of Resolution No. g% :,
f presenting. 1i3(, square feet.
chool- istrict Representative Date
PAID BY C�Ecx NO.
B -A -MK NO /
PAID BY CASH
REMARKS:
white -applicant, yellow -building department., pink -school district
SCHOOL.FEE (8/88)
3. Raised Floor Insulation
" 1. Ceiling Insulation
-70
Insulation in.Floor
0.50
-120
Number of stories
38
R -value
R value
One
Two
Three
-5
R-0
-103
-49
•32 '
0 0
R-19
-8
-4
-2
U -value
R-30 -
-2
.1
.1
i
r
R38:
0
0
0
1;
U -value
0
0.02
4
2-
0.50
-176
-84
-S4
] s
0.30
-102
-49
32 "
.
1
0.10
-26
-13
-8
R-0
- 0.08
-18
-9
-6.. .
-4
0.06
-11
-5
-4
-2
0.04
-4
-2
-1
"•.I
0.02 ._..
-42
- -
1
Number of Stories
0.00
11
-"5
3
Three
' R-0
0
0
0
R-5
2. Wall Insulation
5
2
R-7
8
Single-
Single
F2 factor
-40
-11
Family
Family
Muld-
3
R-value
Detached
Attached
Family
0
R-0
38
-51
34
0.60
R-11
0
0
0
9
R-13
2
2
1
8
4
19
-29
-4
1
U -value
11
16
18
.-26.
0.80 _,...-:.:. � 153 .r. -._.-114'.-....»_
.-76
7
0.50 ..::�
-91 '
-68 - ..
-46
-1
0.30
-47
36
.-24
16
.-0.10
0
0
0
13
0.08
4
3
2
6
O.C6
.9 .
7
5
-14
0.04
14
11
7
18
0.02
19
.14
10
11
0.00
24
18
12
6
9
12
15
19
3. Raised Floor Insulation
-144
-70
Insulation in.Floor
0.50
-120
Number of stories
38
R -value
One Two
Three
R-0
•17 -8
-5
R-11
3 -2
1
R-19'
0 0
0
R-30
3
-8
U -value
0.08
-11
-0.60 •
-144
-70
-46
0.50
-120
-58 -
38
0.40 :
.-95
. -46
VMM
0.30
-69
-34
-22-
0.20
-13
-21
.-14
0.10
-17.
-8
-5
0.08
-11
-6
-4
0.06
•-6
3
-2
0.04
.1
6
0
0.02
4
2-
1
0.00
10
5
3
Controlled Ventilation Crawlspace
.13
-4
Number of stories
12
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
•1. Slab Edge Insulation
26
- -
-15
Number of Stories
.1
R -value
One
Two
Three
' R-0
0
0
0
R-5
8
5
2
R-7
8
6
3
F2 factor
-40
-11
-4
0.90
-4
3
-1
0.80
-1
-1
0
0.70
2
2
1
0.60
6
4
2
0.50
9
6
3
0.40
12
8
4
5. Infiltration (Air Leakage)
Spedficetion Points
Standard 0
6. Glass Heat Loss
Total
4
1
na
2
U -value
1
Percent
2
5
.51 to
At 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
-61
-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
3
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..Sheding (Shade Open)
Erfective Percent Class
(parent glass x SC)
Effective '
%Glass North
18 .5
16 4
14 4
12 3
11 3
10 2
9 2
8 2
7 1
6 1
5 1
4 0
3 0
2 0
1 -1
0 .1
na = not allowed
East South :.West Skylight
1 .
4
1
na
2
5
1
na
2
5
1
na
3
5
2
na
3
5
2
:na
3
5
2
1
3
5
2
2
3
5.
2
2
3
4
2
2
3
4
.2
3
2
4
2
3
2
3
1
3
1
2
1
3
0'
1
0
3
-1
-1
-1
2
-2
-4
-2
0
�. Shading (Shade Closed)
Exterior
Slab Floor
Effective Pes eestt Clasa
Mass
Mass
(percent g4w x SCS
0.00
Effective
Stories
3 2 1
1CFA
One
Two
%Gless
Nom
East
South-
West
Skyfght
18
14
48
-69
64
na
16
-12
-42
-59
-55
na
14
-10
-35
-50
-46
na
12-
-8
-29
-40
37
na
11
-7
-26
36
-33
na
10
-6
-23
31
-29
.74
9
,5
-20
-27
-25
-65
8
-5
-17
-23
-21.
-56
7
-4
-14
-19
-18
-47
6
3
-11
-15
-14
-38
5
-2
-9
-11
•10
-30
4
-1
-6
-8
-7
-23
3
0
-4
-5
-4
-16
2
1
.1
•2
-1
-9
1
1
1
1 .. ,.
1.
-4
01'
2
3
4.,
3
0
4.5
3
7
8
•10 -
11
9. Interior Thermal Mass
Interior
Exterior
Slab Floor
Raised Floor
Mass
Mass
styes
0.00
0 .. 0 0
Stories
3 2 1
1CFA
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
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
Z5
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
Single- .: Single -
Wall
Family Family Multi
Mass
Detached Attached Family
0.00
0 .. 0 0
0.20
3 2 1
0.40
5 4 3
0.60
8 6 4
0.80
10 8 5
1.00
13 10 7
1.20
13 12 8
1.40
12 13 9
1.60
10 13 11....:: ._
1.80
10 12
200
-- 12 I
10 11 13
11. Heating System
+5
SE or HSPF
more
(assumes ducts In attic) .. •
-14
Sum of 1.6
3
-25 or -24 to -14 to -4to +610 16 or
SE HSPF
less -15 -5 +5 +15 more
0.72
0 0 0 0 0 0
•6.60
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
0.95 8.71
20 18 15 13 11 8.
-4
Effective SE or HSPF
(SE or HSPF x duct eMclency)
Effective -25
or -24 to •14 in -4 to +610 16 or
SE HSPF
less -15 -5 +5 +15 more
0.30 275
-73 -64 -56 -47 -38 -30
na 3.41
-45 -39 -34 -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' 3 3 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 1.9 15
Zonal Control Adjustment
System Type
Resistance 10 9 7 6 4 3
Other 6 5 4 3 '. ' 2 2
12. Cooling
I
Systm
-Point Scores
a.0 X
& 4=
O
One
SEER
-4
-4
3 -2
-2
(assumes ducts
In attic)
3
:, 2
2 2
Stin of 7.10
or
-
AREA38
R-value(19)
-25 or
-2410 1410
-410
+6 to
16 or
SEER
less
-15 -6
+5
+15
more
8.0
-14
-12 -10
3
•b
-4
. 8.5
-9
.7 -6
.5.
-4
3
' •i 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 i
.; 10.5
7
6 5
4
3
2
11.0
10'
9 7
6
4
3;
-x•-120
15
13 11
9
7
5 '
13,0
20
17 4 14
12
9
6I
-
-9 . ' -7
EQedive SEER
0.8
WSB.
-25
(SEER xduct efllclency)
.12 •10'
-8
ZI
Smot7-10
-18
__12
-9 -7
Effective -25 or
.24 to -1410
-410
+61*
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
7.0
0
0 0
0.
0
0
8.0
9
8 6
5
4
3
9.0
16
14 12
9
7
5 ,
10.0
22
19 16
13
10
7 '
11.0
26
23 19
15
12
8
120
30
26 22
18
14
9
13.0
33
29 24
20
15
10
Zonal Control Adjustment
10 8 7 6 4 3
No Cooling System Installed
- _Stories
SC
-Point Scores
a.0 X
& 4=
O
One
-5
-4
-4
3 -2
-2
Two +
3
3
:, 2
2 2
1
or
-
AREA38
R-value(19)
t. nn r Mss
Single
-Family Detached and Attached
Exterior Wall Mass
R -value [0]
F2factor [0.77]
1: Unit Size (sQ
Standard
Water
p
1199 11Xy
1700 2200
2700
Heater
Credit
or
• 1. to
to to
. or .
'more
Type.
Type
Ass
1699
2199 2699
Type
SG
None
0'
I 0
A. 0
0
or
Solar
12
' 1. 8
6 5
4 '
HP -
-HWR
8
'5
4 3
3
WSB
5
3
3 2
2
5%
POU
8
5
4 3
3
SE
None
37
-24
-18 -15
-12
70%
Solar
-1
-1
-1 0
0
100% 105y. 110% 115% 120%.125-
20%125-0%
HWR
-18
-12
-9 . ' -7
.6
0.8
WSB.
-25
-16
.12 •10'
-8
ZI
POU
-18
__12
-9 -7
-6
IG
None
-5
-3
-2 -2
-2
4.6.
Solar
7
5
4 3
2
0.4
POU
3
2
1 1
1
IE
None
-28
-19
-14 -11
.9
2.9
Solar
8
5
4 3 -
3
4.2
POU
-10
-6
-5 -4
3
5.4
Muld-Famliy (Individual units)
0.3
0.6
0.8
1
Unit Size (so
1.4
Water
1.6
699
700
1200 1700
2200
Heater
Credit
or
b
to 10
or
Type
Type
less
1199
1699 2199
more
SG
None
0
0,,
0 '0 '
0•
or
Solar
14
7'
't5', , 4
3
HP
HWR
9
5
3' '" 2"0
2
17
WSB
9
4
3 2'
2
4.9
POU
9
5
3 2
2
SE'
None
-45
-2315`'
-11
-9
1.9
Solar
2
1
'11: � '0
0
3.2
HWR
.-23
-12
-8` :;.a3
. 5
4.5
WSB
. -25
-13
.8 -6
-5 -,
- eQU .
_23
__:-12
-8___6
-5
n
None
-8
-4
-3 -2
; '2
-
Solar
6'
3
2 1
1
18
POU
1.___0
4.4
0 0
0
IE
None
-30
-15
-10 -8
-s _
SS%
Solar
18
9
6 4
4
2
POU
-8
-4
•3 -2
-2
Y
-
SC
-Point Scores
a.0 X
& 4=
O
or
R -value [38]
r
or
Interior Mass/CFA
S�lr
R -value [11] -
U -value [0.098]
p
or
-
AREA38
R-value(19)
t. nn r Mss
or
AREA 8
Exterior Wall Mass
R -value [0]
F2factor [0.77]
SP
X
Standard
p
Duct Efficiency [0.78]
Effective SE or
(0.72/6.6]
Type [double]
U -value [0.65]
90 Total Glass (16] Sum 1.6
... �
-
SEER [9.5]
Duct Efficiency (0.74]
Effective SEER [7.03]
Type
Credit [none]
(t.7•V11S-t'7r
tc-pat.d
tTYPE 1'PASS
WIMC 4.2.
Let exposed
'
0%
5%
10%
15%
20%
.2S%..30%
35%
40% 457'.
50%
55%
60%
6Sx
70%
75%
80%
85%
90%
95%
100% 105y. 110% 115% 120%.125-
20%125-0%
0%
0
0.2
0.4
0.6
0.8
1.1
1.3
1.S
1.7
1.9
ZI
Z3
Z5
2.7
Z9
32
3.4
3.6
3.8
4
4.2
4.4-
4.6.
4.8
5
5.3
M
0.2
0.4
0.6
0.6
1
1.2
1.4
1.6
1.9
21
Z3
ZS
Z7
2.9
3.1
13
3.5
3.7
4
4.2
4.4
4.6
4.6
5
5.2
5.4
20%
0.3
0.6
0.8
1
1.2
1.4
1.6
1.6
2
2.2
Z4
ZI
Z9
3.1
3.3
15
17
3.9
4.1
4.3
4.5
4.8
5
52
5.4
56
30%
0.5
0.7
0.9
1.1
1.4
1.6
1.8
2
2.2
Z4
16
Z8
3
3.2
3.5
17
19
4.1
4.3
4.S
4.7
4.9
5.1
5.3
5.6
58
401/.
0.7
0.9
1.1
1.3
1.5
1.7
1.9
Z2
Z4
Z6
2.8
3
3.2
3.4
3.6
18
4
4.3
4.5
4.7
4.9
5.1
5.3
SS
5.7.
5.9
.S0%
0.9
1.1
1.3
iS
1.7
1.9
Z1
Z3
25
Z7
3
32
U
3.5
18
4
42
4.4
4.6
4.8
5.1
5.3
5.5
5.7
5.9.
6.1
SS%
0.9
1.1
1.4
1.6
1.8
2
2.2
Z4
2.6
Z6
3
32
3.5
3.7
3.9
4.1
4.3
4.5
4.7
4.9
5.1
5.3
5.6
5.8
6
6.2
60%
11.2
1.4
1.7
1.9
M
2.3
Z5
2.7
Z9
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
Z4
Z8
2.8
3
3.2
3.4
3.6
3.8
4
4.3
4.5
4.7
4.9
5.1
5.3
55
5.7
5.9
6.1
6.4
70%
1.2
1.4
1.6
1.8
2
Z2
Z5
Z7
2.9
11
13
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
13
1.7
.1.9
2.1
Z3
Z5
Z7
3
12
3A
16
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
BOY.
1.4
1.6
1.8
2
Z2•
2.4
16
2.8
3
3.3
1S
3.7
3.9
4.1
4.3
4.S
4.7
4.9
5.1
5.4
5.6
5.8
6
6.2
64
66
85%
1.4
1.7
1.9
2.1
2.3
Z5
2.7
2.9
3.1
3.3
3.5
3.8
4
4.2
4.4
4.6
4.6
5
S2
54
5.6
5.9
6.1
63
6S
67
807:"
1.5
1.7
2
2.2
24
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.
95%
1.8
1.8
2
2.2
Z5
Z7
2.9
3.1
33
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
100%
1.7
1.9
21
2.3
Z5
Z6
3
12
3.4
3.0
18
4
4.2
4.4
4.6
4.9
5.1
5.3
53
5.7
5.9
6.1
6.3
6.5
6.1
7
105%
1.8
2
Z2
2.4
2.6
Z8
3
3.3
3.S
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
So
7
110%
1.9
Z1
2.3
2.5
2.1
Z9
11
3.3
3.6
3.8
4
4.2
4.4
4.5
4.8
S
5.2
5.4
5.7
5.9
6.1
6.3
6.5
6.7
69
7.1
115%
2
2.2
24
26
2.83
3.2
3.4
3.8
3.8
4.1
4.3
4.S
4.7
4.9
5.1
5.3
5.5
5.7
5.9
6.2
6.4
6.8
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
5.4
S.6
58
6
6.2
6.5
6.7
6.9
7.1 •'
7.3
125%
21
23
Z5
2.8
3
3.2
3.4
3.6
3.8
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
7
7.2
7.4'
Foint system summary: Climate Zone 11 .
SCORE CARD
1. Ceiling Insulation
2. Wall Insulation
3. Raised Floor Insulation
4. Slab Edge Insulation
S. Infiltration
6. Glass Heat Loss
7. Shading (Shade Open)
a. North
b. East
c. South
d. West
e. Skylight
8. Shading (Shade Closed)
a. North
b. East
c. South
d. West
e. Skylight
9. Interior Thermal Mass
10. Exterior Wall Mass
11: Heating System
-Zonal Control? ( Y / N )
,,12.,C olingSystem
Zonal Control? ( Y / N )
13. Water Heating
Measures
SC
-Point Scores
a.0 X
& 4=
O
or
R -value [38]
U -value (0.0301
or
-•
S�lr
R -value [11] -
U -value [0.098]
p
or
TYPE 1 MASS
AREA38
R-value(19)
U -value [0.037]
or
AREA 8
Exterior Wall Mass
R -value [0]
F2factor [0.77]
SP
X
Standard
p
Duct Efficiency [0.78]
Effective SE or
(0.72/6.6]
Type [double]
U -value [0.65]
90 Total Glass (16] Sum 1.6
% Glass SC Eff. %Glass
.0
X 71
r �5
�o� •(moo x =
-- X =
%O Glass
SC
Eff. % Glass
a.0 X
& 4=
3
D, L3 X_
�P Q X
-•
S�lr
O X
22=
p
TYPE 1 MASS
AREA38
interiorWiss/CFA
COND.' FLOOR AREA
TYPE 2 MASS
AREA 8
Exterior Wall Mass
ND. L OR
AREA
SP
X
SE or HSPF
Duct Efficiency [0.78]
Effective SE or
(0.72/6.6]
HSPF [0.5615.15]
..X:
... �
-
SEER [9.5]
Duct Efficiency (0.74]
Effective SEER [7.03]
Type
Credit [none]
Sum 7.10
f3
'-H
i
�.ci ua.�;a�c �. r.�ru�..aut c: nC�uaCciUdl t -arcate Gone i -L
Project Title
fj I M B�"t,
Address
31'r.
3 X59-�0
Building Permit
,or— 5
a;Wed By/ Date
Enlomement Agency Use Only
BUILDING DATA
Duct
North
Glass Area
`t /
% Glass
112.0
Location
C ditioned Floor Area aZ �3 Number of Stories ;^
Output Manufacturer / Model #
East
_ /
3
(Btuh) (or approved equal)
a sed Floor Number of -Units f
�LtL L
South
/a, g
0-6
! Ingle Family Detached (SFD) [ ] Addidon.Alone
10
West
1� .
G • 9
] Single Family Attached (SFA) [ ] Existing Building
Skylight
O
e
[ ] Multi -Family (NM [ ] Existing -Plus -Addition
Total
3.3T
/5„P
BUILDING SHELL INSULATION.
Component. _. Insulation Locanorr/Comments •
Type R -Value (antic. -to garage, rmd. etc)
wall .............. 4,_f�G� //J5 • f%
-Wall ..............
Roof .....:.......
Roof .............
Floor .............
Floor ............. ,.
Slab Edge.....
GLAZING... - Shading Devices
• Glazing : ' -:= Area Glass Type Interior Exterior
Overhang
Framing Type
Orientation ' "'- -'- (sf) (single, double) (Tolle: blind. enc.) (shadescreett. etc.)
(yes/no)
(me!!ood)
North d/ dwhljg-
North ( )
East ( ) T—
East ( )
South
South ( )
West
West ( )
Skylight....... 0
THERMAL MASS
Type/Covering Area Thickness
ILYA&im2
HVAC SYSTEMS Minimum
Duct
Type (furnace, air Efficiency
Location
Duct
Output Manufacturer / Model #
conditioner, heat pump) (SE, SEER,HSPF)
(atptic,,�etc..)
R --Value
(Btuh) (or approved equal)
.
�LtL L
...Lo�L
L�V
��7
10
Maximum Furnace Heating Output: Btuh `A or HOT WATER SYSTEMS Tank Manufacturer/Model #v�QPR
Q�
System Tvoe (storaee eas, etc.) Capacity (or approved eaual) Soecial FeawitaG tr1
Mandatory Measures Checklist: Residential MF -111
NOTE. Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance
approach used Ivens marked with an asterisk (•) may be superseded by more stringent compliance requt ementslisted
on the Certificate of Compliance. When this checklist is incorporated into the permit doeurroats, the featutres notadshalt
be considered by all parties as binding minimum component perfomsance speaficatioru for the mandatory mtcasur s
whether they am shown elsewhere in the documents or on this checklist only.
DESCRIPTION DESIGNER ENFORCEMENT'
Buildirig Envelope Memures -
12.5352(a): Minimum ceiling insulation R-19 weighted avenge.
§2.5332(b): Loose fru insulation manufactures labeled R -Value_
12.5352(e): Minimum wall insulation in framed walls R-1 1 weighted average (does not apply to
exterior mass walls). ' •I .
§2-5352Wk Slab edge insulation - water absorption rate no greater than 03%. water vapor
transmission rate no greater than 2.0 permlutch.
§2-5311: Insulation specified or installed mats California Energy Commission (CEC) quality
standards. Indicate type and form.
12.5352(Ir vapor barriers mandatory in Climate Zones 14 and 16 only.
§2.5317: InfiltratioNEafrltration Controls
L Doors and windows between conditioned and unconditioned spaces designed to limit air
leakage.
b. Doors and windows certified,
c Doors and windows weathersrripped: all 'pinus and penetrations caulked and sealed
§2-5352(e): Special infiltration barrier installed to comply with 12.5351 moots CEC quality
standards.
§2.5352(dr Installation of Fireplaces
1. Masonry and factory -built fireplaces have:
L Tight fining, closeable metal or glass door
b. Outside air intake with damper and coned
c Flue damper and control
2. No continuous burning gas pilots all rwed.
HVAC and Plumbing System Measures
§2-5352(8) and 2-5303: Space co"tioning equipment sizing: attach calculations. ,
§2-5352(h) and 2-5315: Setback thermostat on all applicable heating systems.
§2-5316(a): Ducts constructed. installed and insulated per Chapter 10. 1976 UMC.
§2-5316(b}. Exhaust systems have damper controls.
§2.5314(c): Gas-fued space beating equipment has intermittent ignition device.
62-5314: HVAC equipment• water heaters• sh owerheads and faucets certified by the CEC.
§2-5352(i): Water heater insulation blanket (R-12 or greater) or combined interiorkaterior
insulation (R-16 or greater): fust 5 feet of pipes closest o tank insulated (R-3 or greater).
12.5312(Eaception 1): Pipe insulation on steam and steam condensate retum & recirculating
piping.
§2.5318(d): Swimming Pool Heating
I. System har.
a. On/off switch on heater,
b. Weatherproof instn ction plate on heater:
c. Plumbed to allow for solar.
2. 75 percent thermal efficiency.
3. Pool cover.
4. Time clock.
5. Directional water inlet
Lighting and Appliance Measures
t
12-53526Y Lighting - 25 lumcnstwatt or greater for general lighting in kitchens and bathrooms.
12-5314(c): Gas fired appliances equipped with intermittent ignition devices.
§2.5314(x): Refrigerators• refrigerator-freezen. frazers and fluorescent lamp ballasts certified
by the CE.C. Indicate make and model number.
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, Chapur 2, Subchapter 4. Article I of the California Administrative code. This
certificate has been signed by the individual with overall design responsibility and the budding owner. who shall
retain a copy of it and transmit the certificate to any subsequent purchaser of the building.
Designer
Name:
Addre :
Tekpione
signature) (date)
Building Owner
Name
Titk�rtrL
Address:
Telephone
(signature) (da(e)
Documentation Author Enforcement Agency
I Name:
SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) rName:
twt tern Aeency: .
_ Address: Telephone
- - --- — _
o
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