HomeMy WebLinkAbout040-480-01340-48-
I BRUCE & MARTHA BER M'
Y 10 Laguna G ico. �. ,�♦�j0
f - PeLW 6=87E;P,E,11(LI ew Singe family) '(L
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40-48-13
JIM & DEBBIE GAILHARD h Q
Contr: Western Sierra -Const, urham
Permit#763-88B,P,E,M(new single family) r -'
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PERMIT NO. 763-88B, P, E, M
PERMIT EXPIRES
OWNER .TIM & DEBBIE GAILHARD
CONTR.. Western Sierra Const, Durham
ASSESSOR PARCEL 40-48-13
J LOCATION In U; guna Ct • Chico
1
Temp. Power Pole
t
Called PG&E
Temp. Elec. Service
R
Called PG&E /
t
em as Service
Called PG&E, ""
VA
JOB FINALED (Date) '
Signature
= OK
0 =Not OK
='Not Applicable
= Not Ready
MOBILE HOMES
- ''MISCELLANEOUS
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
Date
DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK exc®pt #'s
1. Zoning, Requirements -Setbacks -Easements
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
2. Footings; Soils-Siie-Depth-Spacing-Connectors-Steel
3. Sewer; Location -Test -Fall -C/O -Concrete
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; Location -Test -Easement Needed (Sketch)
4. Wood Awn.; Posts_Beams-Rftrs.-Connec.-
Shthg.-Rfg.-Bracing
. 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
6. Gas; Location -Test -Wrap: / /"L"ft.
/ /"Nat. or/ /"L"ft./ /"LPG
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Utility Clearance
7. Elea -
8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
Card -131
Date Card -131 Date
10. Roof; Shthg-Roofing
Card -131
Date Card -B1 Date
11. Ext.; Steps -Doors -Landings
Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
1: Zoning Requirements -Setbacks -Easements
Card -131
Date Card -81 Date
2. Footings; Size -Spacing -Marriage Line
Card -131
Date Card -131 Date
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
Date
POOLS (Plans) OK except#'s '
5. Drain; MH Test -Fall -Flex Connector ..
1. Setbacks -Easements
6. Water; MH Test -Regulator -Connector.
2. Soils; Compaction -Structure Stability
7. Water and Sewer Connected -C/O to Grade -HD Approval
3. Pool Structure; Steel -Connections -Thickness -
Dead Men -Lining
8. Gas and Electricity Tagged
9.. Exits; Insp.-Sketch'
4. Elec.; Receptacles and Lighting, Distances-GFI
10. Cert. of Occupancy
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
Card -81 Date Card -131 Date
Card -131
Date Card -131 Date
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Card -81
Date Card -81 Date
Card -131
Date Card -131 Date
s
= OIC
o Not OK. z
� = NtSt Applicable RESIDENTIAL (Single and Duplex)
' = Not Ready
Date ND RFLOOR (Plans) OK except WS
Date .� FRAMING (Continued)
oning requirements -Seth s- asements
. Hangers -Post Caps -Anchors -Connectors
t ., Main; Soils-Steel-Ele rnd.-/ P' Ftg. Depth
Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng.
25 Ftg., Garage; Soils -Steel-/ /" Ftg. Depth.
Fireplace Ties or Type A Flue -Fireplace Throat
4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth
. Attic Access; Size & Romex Protection -Draft Sto s_
mwalls, Main; Steel-Blockouts-Wrapped
drm. Windows or Exiting Doors -Sill Hgt. & Dimensions
temwalls, Garage; Steel- Blockouts-Wrapped
Garage Fire Protection Framing
VF Slab; Steel -Wrapped
89. Property Line Firewall & Openings .
iers - el
. Ext. Doors -One T -Check Garage -3rd story, 2 exits
W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test
tairs; Width -Headroom -Rise -Run -Landing -Fire Protection
10. Gas Pipe; Size -Anchors
. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
11. Water Pipe; Test -Anchors -Regulator -Service Test
54. Siding -Nailing V eer
12. Electric; Undergrourid
. Stucco Mesh -Drip. S ed -Fd. Vents-Underflr. Access
13. Plenums & Ducts; Clearance-Material-Supprt-Ins.
X56. Glazing, Area -Glass Protection -Skylights -Plastic
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Shear Walls; Nailing -Bolts
15. Insulation
nsulation-Walls-Clg.
filtration-Walls-Wndws
Card -131 ,SK Date `'( Card -81 Date
Card -131 Date I Card -B1 Date
Card -B1 rd -B1 Date
Card -131 t Card -B1 Date
Date PLUMBING (Permit) OK except #'s
Water Ht. Vent -Access -Combustion Air
Date FINA (Plans) OK except #'s
Water Pipe; Test & Anchors -Nail Protection
. Steps -Door & Sidelight Prote• ion -Landings
tk D.W.V.; Test-Fttngs & Anchors -Nail Protection
6 . S oke Detector
Shower Pan; Test, First Floor -Tub Accessurnace;
Vents -Clearance -Comb. Air -C ctor-
In Garage; Above Floor -Ducts -Mach. Protection
Test Tub & Shower, 2nd Floor -Tub Access
Gas Pipe; Size & Anchors
EgAedroo Exiting
F.I. Bath Fixtures & Tub Access -Spa
Card-B1,q,,1P,,7, Date o, /hard -61 Date
Card -61 Date Card -B1 Date
Date ELECTRICAL (Permit) OK except #'s
Afrim & Subpanel;. Breaker Sizes -Labels
& Rails
lace o ov learances-Hea
Outlets at Wood Panel; Int.'& Ext.
22. Fixture & Transformer Clearance -Ins. Protection fig. -fit- Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance
Elec. Receptacles Spacing -Lights & Switches at Doors 7 c. Outlets & Receptacles at Kit. Counter
Size Boxes & No. of Conductors -Stapled P - "Garage Fire Door; Swing -Landing -Closer
Romex Installed Close to Edge of Studs & C.J. 7.2--A.-C�-ct in Garage -Damper
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water J2Z03,AW11r. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
. 2 Appliance Circuits in Kitchen &Conductor Size ., Elec. &Mech. Equip. Listed for Location
8. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga.
Cu or Al le . Receptacles in Garage; (G.F.I.)-Ro x Protec.
mange Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. . nsytation-Foam-Looked in Attic 4,Yes
Insulated Neutral Yes No 7 . uard Rails & Deck Construction -Post Caps
Service -Riser Conductors & Ground -Main Disconnect7 . eennts & Crawl Hole Door -Drainage & Wood -Earth
31. Equip. Clearances Panels-Motors-Mech. Equip. C rance Looked under Floo ❑Yes
32. Clothes Closet Light -Shower Light -Spa Light 7 . ollowing instld.; Dr' es o No; Walks ffrYes o No;
PI tars 13Y__ No
ab-oucco; Brown -Finish
Card -81 Dat rd -B1 Date WA,C. Unit; Disconnect, Electrical, Plumbing
Card -B1 Date Card -B1 Date. ents Above Roof; Plbg.-Appliance-Firepl.-Clearance to
Openings.
Date MECHANICAL (Permit) OK except #'s
A.C. Ducts Insulation & Support
Vent Fan; Exhaust above insulation
\ Condensate Drain & Overflow; Size & Grade
Furnace -Vent; Access -Comb. Air -Return Air Vent -N5 outlet
3p. Attic Access & Platform if Furnace in Attic
Card- Date rd -B1 Date
Card -91 Date Card -61 Date
Date FRAMING (Plans) OK except #'s
Sills, Proper Material & Anchors
Walls;Studs-Nailing, Spacing & Bracing—Plates-Sound
Be ing Walls over Girders & Floor Nailing
raft Stop in Walls (rat proof)
Fire Stops; Furred Ceilings -Stairs -Chases -
Header & Beam -Size & Bearing
ter Well; Disconnect, Electrical, Plumbin
94-'EAqrior Elec. Trim; G.F.I. Receptacle -Underground
e tilation throughout House
ass Protection
or tions from Previous Inpe ons
a -Meters Tagged; -Electric S-,0
ter & Sewer Connected -C/O to Grade -HD Approval
Compliance Certificate -Other Certificates
Card -B —j,. Date Card -B1 Date
Card -B1 Da C =81 Date
Card -B1 . . Date -2Card-B1 Date
Comments at Final:
(NOTE: An entry must be made each time you visit job site)
COUNTY OF BUTTE
t' DEPARTMENT OF PUBLIC WORKS
r 196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
4 routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
Y !h
4v _
Inspector Date
e
i »
COUNTY OF BUTTE
r DEPARTMENT OF PUBLIC WORKS
M�
' 196 Memorial Way, Chico —Phone: 891-2751
7 County Center Drive, Oroville — Phone: 538-7541 j
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
OWNER 1 PERMIT NOS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notif tHis office
when co ction of work is completed. If you have any question, pertaining to this
matt , or need additional explanation, please contact this office immediately-
TSU � �// / i hiC. C� n. C � ✓1 � a
i�lDr o v e � C Jo v 5-4)1 , r� S�o, � 1tiT: � v`� ,, , u•1 � �{ �
of
Inspectora'_� Y/��`-� 1 �� Date /�
i`
�,: •- °° COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 53$-7541
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
110 W'F-jFj
Inspector Date
OWNER
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Orovi Ile — Phone: 538-7541
747 Elliott -Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
-2 6 3 _i
P IT 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.
Inspector
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Orovi Ile — Phone: 538-7541
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
OWNER
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.
e2�
00
Inspector 40 ei�
Date
L M A'.! I O N
ROOF
Material
Thickness (inches)
ENERGY C EIRTIF ICAT ION
DESCRIPTION OF INSULATION
EXTERIOR WALT.
Material Fiberglas ss (/
Thickness (inches�
)E—�`--�
Tly—
CEILING
Balt or B.innket Type_Fiberglass
Thickness(inches)
Loose Fill Type_ Fiberglass
Minimum Thickness(Inches)
Asea covered(ft. )
FLOOR, E!,"- A'lEb
Materia 1 Fiberglass
Thick-tr.ss (inches) _
FLOOR, S. AI.I __ ---^�
Material
Thickness (incites)
Width
FOIINDAPIrnN I4ALL
Mater1a'i
• '1'hi.r_krte��s(inches)
1/0 - "/'F —, �
A.P. No.
Brand Name_
Thermal Resistance (R Value)
Brand Name CertainTeed ,
Thermal Resistance(R Value).__/.:���
Brand Name CertainTeed
Thennal Resistance(R Value)_a
Brand Name CertainTeed
Number of Bags_ Wt. per bng 25 ib.
Thermal Resistance(R Value)
Brand Piame CertainTeed`
Thermal Ilesistance(R Value)
Brand Nana
Thennal Resistance(R Valu(%)
Brand Narne _
Thermal Resistnnce(R Valr.te)
I hereby c ortify that the above it 1-1 t1.011 was installed in the above -
in bui.ld'Lng
confnnnance with the State of California Jlneru Requirements.
Hawkins Insula -ion Co., Inc. 37840' _
l':iRi•I I`L1I.1E/UbiNI:R — S'I'A'1'I; COII'i'RAC'!()R'S * i.ICEIdSF. NO.
SIGNA�rwSTAI,IA'i'iON t1l'PI,ICA'I'Ult
DACE
I hereby certify the above insulrttiort and all requi.re(I items as shown on the
Building Deportment approved plans -and nttnchnrente hrtvo been installed as
required by the State of California Energy Requirements.
All equipment, (levices and materials are of the cluali.ty prescribed or are
Specifically approved by the State of Califor-kin.
Flial
(Please print)
'1'011 �F QI:NLICI.(, PIl'RAC'i'OI7()1.1---
S'T'ATE COU-MACTOR'S LICENSE PFO, —
DA'L'E
THIS CF'ft'I'IFI6A'1'E MST BE 014 FILE WITH THE BUILDING DEVARTMI'N1' PRIOR To FINAL
INSI'J3tTI-ON APPROVAL AND A COPY SItALL BE POSTED WITHIN THE BUILDING .
January 198/r
_. _. _...._ ..__.
...�.__,.. ---a-g•-•; , �,�,,.,�.• . ..,,,,,,r... _ ... ��;: - .. . _..._..._..____
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS ERMIT N0.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
A 5 OR PA'R EL NUMBER
--
Zo G
BUILDING RMIT
O M
d
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING A RESS42
S r f ✓'o ' /�
C/ N RAC OR'S NA ET
r tr 0 �'•
ONE
-
C R C OR'S AILING AD E S
Gr Cf�'1
Fireplace //
CONSTRUCTION LENDER
UNKNO�w/
V
Total Valuati n $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITE' T OR ENGINEER
one
LICENSE NO.
Plan Checking Fee
$ -
Energy Plan Checking Fee
$
ARC141TECT OR ENGINEER'S MAILING ADDRESS I
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
1
SUBDIVISION NAME
3OUTI* � iS IqCeC-
PARCEL MAP
ya ��
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF)Q Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home I S I G JW 1
10-00 ea
TYPE OF WORK
New"K NK Addition[:]Remodel❑ Utilities Installation❑ Other ❑
Describe work:
Permit Fee
$ 60.0F
Contractor
ELECTRICAL PERMIT
Filing Fee 10.001
Main service OOOV OR LESS
100 AMP OR LESS
00
10.6,
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I decl a under penalty of perjury (Check One):
`, '..
am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Cpde nd my license is in full f ce and effect.
License No. Classification
Flas 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)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
DWELLING OCC
NEW CONST. � ACC. SLOGS. �20sgft
OR ADDNS.TR
NEW CONSI.OUTLT
NO ..RES'..BRA CH CIRCE1 S 2,50 ea
POWER APPARATUS e\
SINGLE OUTLET CIR.
Ex. OCCUp�OUTLET3 OR FI%TURES zoveos
BAL95o
FIXED A
Ex. OCCup. OUTLETS P(RESID )REA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. �Yirin 15.00
9
Permit Fee $ 1K9 A
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
n 0.e 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 10.0C
Heating
Coolin g
7
Hood
3.00
Ventilation
Permit Fee
= x(0,0
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 a ,_indemnify and keep harmless the County of Butte against
all liabilitie ments, costs and expenses which may in any way accrue
against aid ury y in c nsequ ce of the granting of this pe i .
X -`/' ate �'
Signature of Applicant - Owner ❑ Contractor Agent ❑
An OSHA permit is required for excavations over 5'0" deep and de olition or cons ct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $ D,
TOTAL PE IT FEE $'. 1.
o cu P.
��
co TrPE
scNo L
P D
PARC
PD
ND 3%
This permit is. hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTO OF PUBLIC
By
PlEddlT EXPIRES Date
the applicable pro+i-
resolutions to Jo
fees have been paid.
WORKS
Date
r
�Receipt No.
SITE-D.P.W., YELLOW-ASSCSSOR. PINK -INSPECTOR OLDENROD-AP .CANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE� hr LIF OR�NIA 95965 - TELEPHONE: 916/538-7541 +�
PERMIT APPLICATION DATA SHEET --
Permit No. -
OWNER l C/ / 1� P. No.
Proposed Building Use Building Inspector �M'Date
At time of permit application, I was advised the following data must be submitted prior to permit processing
and:/or issuance: .L DATE RECEIVED APPROVED
1. All items.have been submitted. -.k. .
Plot plans in iee c signed by preparer of plans. .
3. Complete plans in , signed by preparer of plans.
4. Complete engineered plans and calcs, with wet signature on pians.
ePlans with ergy Design Compliance Statement.
. School District "Fees Paid" Stamp on Floor Plan.MA
Statement of Inten for Non -Heated and AC Buildings.
8. Fees of $ , /o , , , , , •,
9. Letter of signature authoriz )ipn. . . . . . . . .
0. Sanitation approval from �(� i C Health Dept.
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance. . . . . .
13. Contractor's License Information (no., name style, classif.)
14. Owner -Builder Verification (Given to owner0, Mail to ownerR)
_15. Improvements may be required. . . . . . . . , , , '
16. Mobilehome Installation Data. . . . . . . . . .
17. Pre -Inspection for RequiredPre -Inspect request to . Building Inspector (Date)
18r -Recorded copy of Agricultural Acknowledgment Statement.
19—Driveway Permit.
Plot plan approval from city of i ?
1 Engineered trusses': , duplicat (required prior to plan check).—
When
heck). When you issue the permit, process as follows: Mail tocaner, Mail to contractor.
Telephone �%S-G��g.S and hold for pickup az Mice, Deliver w/inspector.
Other
Applicant.z&/ Date :A? A//4�r�
Copy of plans sent Health Dept., Fire Dept., Other Date
The following data must be submitted pr' Dr it c (ems Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required: W an uw
, 4(t, .
oe"ntracto esigner, owner, was advised of above required data by J�phone---nail_counter bydate ,I,56LBy
Contractor, designer, owner, was advised of above required data by—phone—mail—count date
Plans checked by "Date 0" Plans approved by " nateoll-L 7(5r
Sets of plans on hoId-in File cabinet AP folder
Copy—DPW
S,
;TO: Building Department
FROM: Environmental Health, Chico
s !
SUBJECT: Sanitation Clearance
Owner Location' AP#
Plan.; approved for: sewage disposal j,. water supply
Hold final for: water supply
Final clearance O -A. for: water supply
Clearance for. -A bedroom mob' a ome., Other
Note***
Sanitarian Date
t .
RESIDENTIAL PLAN CHECKING GUIDE
(S.F.) DUPLEX & MISC. ONLY)
OWNER (; 41i --H ArD
Bldg. Permit # 7!
A.P. # 40 1K– / 3
GENERAL
oning requirements: (sideyards and number of permitted living units).
2. Valuation.
�i'/Plans signed by designer.
4. Energy Design and Compliance.
existing violations on property.
PLOT PLAN
I omplete parcel size and dimensions.
26O/Aetbacks, sideyards, easements, etc.
3! 9ther buildings or structures..
4. Gr ding, fills, drainage.
5. to d hazard.
6 onditions on creation map or compliance document.
7/85
FL00 LAN _
Complete to scale plan with dimensions.
,, equired windows for light 'and ventilation (Sec. 1205).
3 Re u' windows for second exit (Sec. 1204).
cylights (Chapter 34 & Sec. 5207).
5"uman impact glass (Sec. 5406).
6f/, Re uired room sizes, ceiling heights (Sec. 1207).
7�.C. .'s in baths, garage and exterior outlets (Article 210-8).
8 t fixtures, switches, receptacles, and exterior receptacles for maintenance of
mechanical equipment.
9�,ocations of water heater, heating and cooling equipment, other electrical or gas
_.Aq4Apment, and plumbing fixtures.
lr�/. ��rage firewall, door size, and closer (Sec. 503(d)(3)).
I i '3'0" exterior exit door (Sec. 3304(e)).
1A!N 1Z
ft 'ace and wood stove location.
1 Smoke detectors (Sec. 1210).
STRUCTURAL DETAILS
1 Foundation plan complete enough:to construct building. (OWMV-6 ft Svv Min
It—construction details complete enough:to construct building.
elevations and wall construction details complete enough to construct bui�ding.
4h/ Roof construction details complete enough to construct building. 779US41S
mace construction details and calcs if necessary.
Sufficient data and details to satisfy energy requirements (State Law) (Form 1).
MISCELLANEOUS ITEMS TO LOOK OUT FOR
Exposure I plywood on exposed locations and overhangs.
details: landings, rise and run, head clearance, handrails (Sec. 3306).
,grrlr_il details (Sec. 1711 & 3306(j)).
stone veneer (Chapter 30).
�rior plaster - weep screeds (Sec. 4706).'*
6/� Proper roof pitch for roof covering (Chapter 32).
7 Rafter ties or bearing ridge beam.
62A-1 1, 4NV..T�
RESIDENTIAL PLAN CHECKING GUIDE (CONT'D)
MI&ra�ae
EOUS ITEMS TO LOOK OUT FOR (CONT'D)
door or porch header sizes.
9! Adequate bracing.
1 iving area over garage - complete 1 -hour separation :required on garage side
inclu porting walls and posts, etc.
--exits on three-story dwellings (Sec. 3303 & see Mezannines 1716).
12. Attic access and ventilation (Sec. 3205).
19. floor access and ventilation (Sec. 2516).
lod stoves, clearances, alcoves & 1 -hour shafts.
IWO
1 Combustion air for fuel burning appliances.
l6 --Tftr±Bm requirements on duplexes.
17To-be soils - special foundation design.
18---1Mtairring walls requiring design.
19-.— hg e, siz r split evel house requiring lateral design.
t� l�
CCK, - $n .R - f -P, 1-6,wr a
7/85
54-3 cD
syr � x f C,4u E�D
. i ;'
RESIDENTIAL ENERGY PLAN CHECK/INSPECTION SUMMARY
Owner Climate Zone Permit No.
Floor Area 2_606
Compliance path: Package ❑ A ❑ B ❑ C ❑ Point System ❑ Budget ❑ Other
MIN R -VALUE DESCRIPTION
REQ'D
INSTALLED ITEMS (1) INSULATION:
Roof/Ceiling �• 34
Wall �• 13
❑ Slab Floor Perimeter
❑ Raised Floor
(2) INFILTRATION:
❑ (A) A vapor barrier is required in climate zones, 1, 14 & 16.
(B) All manufactured windows and sliding glass doors shall meet the
1972 ANSI Air Infiltration Standards and shall be certified and
labeled.
(C) All swinging doors and windows leading to unconditioned areas
shall be fully weatherstripped.
Tight - the above standard features plus:
❑- (D) Continuous infiltration barrier
❑ (E) Electrical outlet plate gasket
❑ (F) Air-to-air heat exchanger
(3) GLAZING:
(A) Location
Area Glazing %Floor Area Single Double Triple
Total Bldg / 79 1919
North D O --
East '75, 31 —
South 19 O.
West !65--
Skylights
s , z
® Skylights O O
(B) Shading
Shading
Coefficient Description
(� East .f% Dyr4 L C' [, 4 Z/ N4
South � �► t/
® West �� y
Skylights
(C) South Overhang
Length of projection , ft. Description �E4167_
❑
(D) Moveable
insulation:
Area
ft2 Description
(E) Thermal
mass
❑
Type
- Area
Ft.2
HC=
R=
MC=
Location
❑
Type
- Area
Ft.Z
HC=
R=
MC=
Location
❑
Type
- Area
Ft.2
HC=
R=
MC=
Location
❑
Type
- Area
Ft.Z
HC=
R=
MC=
Location
❑
Type
- Area
Ft.2
HC=
R=
MC=
Location
❑
Type
- Area
Ft.Z
HC=
R=
MC=
Location
7/83
�a.
C'
0
�R
(4) MASONRY AND FACTORY -BUILT FIREPLACES shall be equipped with tight
fitting closeable metal or,glass doors covering the entire opening
of the firebox; a combusion air intake equipped with a readily
accessible, openable, and tight fitting damper to draw air from the
outside of the building; and a tight fitting flue damper with a
readily accessible control.
*1(5) HEATING, V$NTILATING, AIR CONDITIONING SYSTEM
(A) Heating
Central Gas Furnace
(brand and model number)
Btu/hr
(heating capacity)
Heat Pump
(brand and model number)
Btu/hr
(heating capacity at 47°F)
Active Solar
type (liquid or air)
model number solar fraction
orientation
collector tilt
-7/ %
SE
ACOP
Collector brand and
ft2
collector area collector
rated y -intercept
rated slope
Other ope Smye-
(describe)
(B) Cooling
Electric Air Conditioner
(brand and model number)
Btu/hr
(cooling capacity at 95°F)
❑ Electric Heat Pump
(seasonal EER)
EER
Btu/hr
(cooling capacity at 95°F)
❑ Other _
(describe)
❑ (C) A TWO-STAGE THERMOSTAT, which controls the supplementary heat on
its second stage, shall be required for heat pumps.
(D) AN AUTOMATIC SETBACK shall be provided for all thermostats, except
those controlling heat pumps.
(E) AN INTERMITTENT IGNITION DEVICE shall be provided for all gas-fired
fan type central furnaces, gas-fired fan type wall furnaces and
gas cooking appliances.
(F) BACKDRAFT DAMPERS shall be provided for all fan systems exhausting
air to the outside.
(G) DUCT CONSTRUCTION & INSULATION. All transverse duct, plenum, and
fitting joints shall be sealed with pressure sensitive tape or
mastic to prevent air loss and shall be insulated to conform to
the provisions of Section 1005 of the UMC, 1976 Edition.
7/83 2
*1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing
charts (form #4) or other approved methods, section 2-5352(g), and fill out the
following:
Heating: Winter design temperature 27 °, elevation A.- Sdo ', heating load&.530C) BTU
elevation factor 06 x heating load = maximum outlet capacity gas furnace
bs-soo BTU
Cooling: Summer design temperature 102, °, cooling load BTU
2 (USE ONLY AS A SIZING GUIDE, COOLING MAY BE INADEQUATE)
* Submit T.I.P.S.E. chart or other approved system (form #5) to document sizing of
solar panels.
® DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of
Title 24, Part 2, Chapter 2-53 of the California Ad inistration Code.
7/83 SIGNATU OF BUILDI;G DESIGNER OR APPLICANT
91
F F"VR K 1
(6) DOMESTIC WATER SYSTEM
(A) Gas Only Gallons
(brand and model number) (tank size)
❑
Heat Pump w/Electric Backup
(brand and model number)
Gallons
(tank size)
❑ * 2
Active Solar
(collector brand and model number)
(rated y -intercept) (rated slope) (solar fraction)
ft
(backup heater type, brand and model number) (collector area)
(collector orientation) (collector tilt)
❑
Location of Solar Panels
❑
Other
(Describe)
(B) TANK INSULATION. Storage type water heaters and storage and
backup tanks for solar systems shall be externally wrapped with
R-12 insulation or greater.
Me
(C) PIPE INSULATION. The five feet of pipe closest to the water
heater and outside conditioned space shall be insulated with a
minimum of R-3. Steam and steam conditioned space shall be
insulated with a minimum of R-3. Steam and steam condensation
return piping and recirculating hot water piping outside the
building envelope shall be insulated in accordance with
T20 -1408(d).
(D) FLOW RESTRICTORS shall be provided for showerheads and faucets
as outlined in the new appliance efficiency standards and shall
be certified to the Energy Commission.
(7) LIGHTING
(A) Lamps used in luminaries for general lighting in kitchens and
bathrooms shall have an efficacy of not less than 25 lumens per
watt (usually florescent).
*1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing
charts (form #4) or other approved methods, section 2-5352(g), and fill out the
following:
Heating: Winter design temperature 27 °, elevation A.- Sdo ', heating load&.530C) BTU
elevation factor 06 x heating load = maximum outlet capacity gas furnace
bs-soo BTU
Cooling: Summer design temperature 102, °, cooling load BTU
2 (USE ONLY AS A SIZING GUIDE, COOLING MAY BE INADEQUATE)
* Submit T.I.P.S.E. chart or other approved system (form #5) to document sizing of
solar panels.
® DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of
Title 24, Part 2, Chapter 2-53 of the California Ad inistration Code.
7/83 SIGNATU OF BUILDI;G DESIGNER OR APPLICANT
91
ZONE it
OWNER POINTS
_ _
PERMIT NO. ASSIGNED ACTUAL
1 SLAB - INSULATION
10. SHADING (Exclude Overhang)
EAST - .66 ► t`P6
SOUTH - .19-.42
WEST - .13-.36
SKYLIGHT - .37-.57
11. HORIZONTAL SOUTH OVERHANG 2' y
12. MOVABLE INSULATION - NONE
13. INFILTRATION (Standard=0)(Tight=+12)
14. THERMAL MASS SF
15. GAS.'FUPNACE (SE) 71-76%
16. HEAT PIRIP (EER) 7.5-7.9%
17.DUAL PACK (SE, SEER) 8.0-8.3/71-76% a•� 7�
WOOD STOVEF5
6.1:5 WATER -NEATER
ATTIC ? 90 %
OTHER _
TOTAL POINTS =
Table 3-1. Slab Floor Points
1 Tn-.tIa- I R -Value of Insulation I
I tiun I I
19erth,
I Inches 1 0-2 13-4 ! 5-6 I 7+ 1
I 1 I I I I
1 0- 11 1 -5 ! -5 I -5 I -5 I
I 12 - 15 I -5 1 -3 1 -2 1 -1 I
i 15 - 19 I -5 1 -2 I -1 l 0 1
120 + ( -5 I -1 I ' 0 I +1 I
I 11 I I 1
7/7/83
Table 3-3a. Ceiling Insulation
Points
I R -Value of Insulation I Points I
I
I
O II
4-4 I
- 2
Table 3-4a. Wall Insulation Points
I R -Value of Insulation I Points
-i-z
Table 3-2. Raised Floor Points
I R -Value of I I
I Insulation 1 Points I
I I 1
I below 3 I -12 I
I 3-4 I -8 I
I 5 - 7 ( -6 1
i e - 12 I -4 I
I 13 - 18 I T2 1
I -19+ I . 0 I
19 I -4
22 I -2
30 ( 0
38 I +2
49 I +4
11 1 -7
19 I 0
24 1 +2
30 I +3
Table 3-5. 7orth-Fac1n Glazing Pts
Glazing Type 1
I Total I 1
I Z of ST, , Db!. Trpl,
I Floor I U- I U- I U- I
Azea 10.66 10.42- 10.41 I
I 11.10 1 0.65 I down I
o + 4 �_� +4
I 0.1- 1.2 1 +4 ! +4 I +4 I
f 1.3- 2.3 ( +1 I +2 I +2 I
I 2.4- 3.6 I -2 I 0 1 +1 1
I 3.7- 4.8 I -4 I -2 I -1 I
I 4.9- 6.1 1 -7 I -4 1 -3 1
1 6.2- 7.3 I -9 I -6 1 -5 I
I 7.4- 8.2 I -12 f -8 I -7 1
I 8.3- 9.7 I -14 1 -10 I -8 I
I 9.8-10.8 I -17 I -12 I =10 I
110.9-12.0 I -19 I -14 I -12 I
112.1-13.2 I -22 I -16 1 -13 I
113.3-14.5 I -24 I -18 1 -15 I
114.6-15.3 I -2; I -20 1 -17 I
Table 3-6. Last-Facln¢ GlazinR Pts.
I I Glazing Type 1
--I Total I I
I Z of 1 Sngl, I Dbl, I Trpl,
I Floor I (U - I (U - I (U - I
1 Area 11.10) 1 0.65).1 0.41)1
Ipc+!nts (points I ointsl
T o I � +� M
1 up to 1.3 1 +3 I +4 1 +4 1
I 1.4- 2.4 I +1 I +2 I +2 1
I 2.5- 3.6 I -2 I 0 1 0 1
1 3.7- 4.6 I -5 1 --=2-1 -1 1
1 4.7- 5.5 I -8 I -4 I -3 1
I 5.7- 6.7 I -10 I -6 I -5 I
1 6.8- 7.7 I -13 I -8 1 -7 I
I 7.8- 8.7 1 -15 I -10 1 -8 I
1 8.8- 9.7 I -1.7 I -12 I -10
I 9.8-11.2 I -21 I -15 I -13 ;
111.3-12.7 1 -25 I -18 -15 I
112.8-14.0 I -23 1 -21 1 -18 1
114.1-15.3 I -32 f -24 1 -20 I
Table 3-7. Sou---h-r=c1n Glazin Pts Tabir a 3-10. ShadingCoefficient Pot -is
I Glazing :?pe I I SC by I
I Total I I f Orien- 1 1 Floor Area
1 2 of I Smgl, I Dbl, Tr -;-"7 I tetfon I
I Floor I (t - I" (U - I ('; -' I I
I Area 1 1-10) 10.65) 1 0.41)1 1 1 1 i
I I a'-rts I mints 1 ointsl I Last 1 1 3.2 1
O }! +3 + 3 I 1 0-3.1 1 to I 6.4 ap
up to 1.5 1 +2 1 +2 .I +2 1 I I I 6.3 I
I 1.6- 3.6 I -1 I 0 I 0 1"
I 1.7•- 5.2 I --4 I -2 I -2 1 1 T-
I 5.3- 6.5 I -6 I -4 I -3 1 1 0 -.19 I 0 i +1 I +2
I 6.6- 7.7 I -9 I -6 I -5 1 1 .20-.36 I 0 I 0 I ♦1
1 7.8- 8.9 I -:1 1 -8 I -7 I I .37-.66 I 0 I 0 1 0
I 9.0-10.0 I -23 I -10 .I -9 I I .67-.82 I 0 I 0 -1
110.1-11.5 I =17 I -13 I -11 I( .83 up I 0 I -1 I -2
111.6-13.0 I -21 I =16 I -14 I I I ( I
f 13.1-14.5 I _5 I -19 1 -16 I i I
114.6-16.0 1 --^S I -22 I -19 1 1 South 1 0 1 3.2 1 6.4 1 9.0 ( 9.•
I I I 1 1 1 I to I to F to I to ! up
I 1 3.1 16.3 17.9 19.5 1
Table 3-8. West -facing Glazing Pts. I 7-----7-
I I blazing type 1 1 0 -.18 1 0 1 +1 1 +2 1 +2 1 +3
I .19-.42 1 0 1 0 1 0 1 0 1 0
I Total f I I 43-.66I o� -1 I -2 1 -2 1
I I of I Smsl, Dbl, Trpl, I ,67 up 1- 0 1 -2 I -4 1 -4 1 -6
I Floor I (U - I (U - I (U - I
Area 11..D) 10.65) 10.41)1 1 .1 1 1.6 1 3.2 1 6.4 1 3.0
I I oir s l oint9•6 I o+ b intsl pest I to I to I to I to I :p
o + b 1 1 1 1
I up to 1.3 I -5 I +6 I +6 I 1.5 3.1 6.3 7.9 1I I I I I
I 1.4- 2.2 I =3 I +4 I +5 1
1 2.1- 2. I 1 +2 I +3 I -.12 0 +1 +3 +6 +7
I 1 I I !
I 2.9- 3.66 I -33 0
I 1 +1 I -.36 0 I 1 0 1 0 0 0
1 1
I 3.7- 4.2 I -5 I -22 .13
I l .37-.57 I 0 1 -1 1 -3 I -6 1
I 4.3- 5.0 I -8 I -4 I -22 I
I 5.1- 5.6 I -10 t -6 f -4 .83 I -2 I -4 1 -8 I
up -16 I -20
I
5.7- 6.2 I -.3 1 -s I -6 I I I I I I
I 6.3- 6.9 I -t5 I -10 1 -7 I
1 7.0- 7.6 1 -'_8 1 -12 I -y I
1I 7.7- 8.2 -_D -14 -11 Skylight ht �I1 .1 -
8 1.6 3.2
8.3- 8.8 -16 -13 to to to to
8.9- 9.5 -5 -18 -15 .7
9.6-10.i -=I1I +5t
�.
�
I -20 I -16 I •`
1 10.2-11.0 1 -Z'S 1 -23 1 -17 ( 0-.12 1 0 1 +1 I +3 ( +6 1 -7
1 11.1-11.8 I -2 I -26 I -21 I .13-.36 1 0 1 0 1 0 1 0 1 0
111.9-12.7 I -'B 1 -29 I -24. 1 .37-.57 1 0 1 -1 I -3 I -5 ! --
12.8-13.5 I -&2 I -32 I -27 I .58-.82 1 -1 1 -3 1 -6 1 -12 1-
113.5-14.3 I -4T 1 -35 1 -29 I .83 up 1 -2 I -4 I -8 1 -16 f
1 14.4-15.2 I -S 1 -38 I -32 I 1 I I 1 1
I I 1 I 1 Table 3-11. Horizontal South
Table 3-9. SkyliTht Points
I I Gaazing Type I
I Total I I
I Z of Srgf, I Dbl, ITrpl,
I Floor I U- I U- I U- I
I Area 10.66•- 1 0.42- 10.41 I
t 1 1.IC 10.65 I down I
I up to 1.3 I 0 1 01
I 1.6- 2.2 I -i I -2 I -1 I
1 2.3- 2.8 1 I -4 t -3 I
I 2.9- 3.6 I -? 1 -6 1 -5 I
I 3.7- 4.2 I -1: 1 -8 I -6 I
4.3- 5.0 I -14 I ' -10 I -8 1
I 5.1- 5.6 I -li I -12 I -10 1
5.7- 6.2 I -19 1 -14 I -12 1
I 6.3- 6.9 I -2= I -16 I -13 I
I 7.0- 7.6 I -2: f -13 I -15 I
I 7.7- 8.2 I -2T I -20 I -17 I
8.3- 8.8 I -,3 1 -22 I -19 1
I 8.9- 9.5 I -3i 1 -24 I -21 1
1 9.6-10.1 I -33 1 -26 I -22 1
I --L- --- -L.- - !
Overha^.o. Pointy
Scuh Glaring
I Length Out 1 Area, I of Floor I
I from Wall I I
I ft r
I 10-6.3 I 6.4 up I
I I I I
0 - 0.5 1 -2 1-
10.6 - 1.0 1 -2 I -3 I
( 1.1 - 1.9 t -1 I -2 I
I 2.0 up I 0 I 0 1
I I I I
Table 3-12. Movable Insulation
Points
I Y.aveable Insulation] 1
I Area, Z of Floor I Points t
I I I
I 0- 5.5 I 0 I
I 5.6 - 11.5 I +2 I
I 11.6 - 17.5 I +4 1
I 17.6 - 23.5 1 +6 I
I X23.6+ I +8
2.
P4ISED FLOOR -
R-19
3.
CEILING - R-30
4.
WALL - .R-19
17-13
LE 5.
NORTH GLAZING
2.4-3.6%
d
6.
EAST GLAZING
-7
2.5-3.6%
3.7
7.
SOUTH GLAZING
& -
1.6-3.6%
OSE
3,
GLAZING-
WEST GL
-
2.9-3.6%
/
"►1Z
9.
SKYLIGHT
-
0-1.3%
O
10. SHADING (Exclude Overhang)
EAST - .66 ► t`P6
SOUTH - .19-.42
WEST - .13-.36
SKYLIGHT - .37-.57
11. HORIZONTAL SOUTH OVERHANG 2' y
12. MOVABLE INSULATION - NONE
13. INFILTRATION (Standard=0)(Tight=+12)
14. THERMAL MASS SF
15. GAS.'FUPNACE (SE) 71-76%
16. HEAT PIRIP (EER) 7.5-7.9%
17.DUAL PACK (SE, SEER) 8.0-8.3/71-76% a•� 7�
WOOD STOVEF5
6.1:5 WATER -NEATER
ATTIC ? 90 %
OTHER _
TOTAL POINTS =
Table 3-1. Slab Floor Points
1 Tn-.tIa- I R -Value of Insulation I
I tiun I I
19erth,
I Inches 1 0-2 13-4 ! 5-6 I 7+ 1
I 1 I I I I
1 0- 11 1 -5 ! -5 I -5 I -5 I
I 12 - 15 I -5 1 -3 1 -2 1 -1 I
i 15 - 19 I -5 1 -2 I -1 l 0 1
120 + ( -5 I -1 I ' 0 I +1 I
I 11 I I 1
7/7/83
Table 3-3a. Ceiling Insulation
Points
I R -Value of Insulation I Points I
I
I
O II
4-4 I
- 2
Table 3-4a. Wall Insulation Points
I R -Value of Insulation I Points
-i-z
Table 3-2. Raised Floor Points
I R -Value of I I
I Insulation 1 Points I
I I 1
I below 3 I -12 I
I 3-4 I -8 I
I 5 - 7 ( -6 1
i e - 12 I -4 I
I 13 - 18 I T2 1
I -19+ I . 0 I
19 I -4
22 I -2
30 ( 0
38 I +2
49 I +4
11 1 -7
19 I 0
24 1 +2
30 I +3
Table 3-5. 7orth-Fac1n Glazing Pts
Glazing Type 1
I Total I 1
I Z of ST, , Db!. Trpl,
I Floor I U- I U- I U- I
Azea 10.66 10.42- 10.41 I
I 11.10 1 0.65 I down I
o + 4 �_� +4
I 0.1- 1.2 1 +4 ! +4 I +4 I
f 1.3- 2.3 ( +1 I +2 I +2 I
I 2.4- 3.6 I -2 I 0 1 +1 1
I 3.7- 4.8 I -4 I -2 I -1 I
I 4.9- 6.1 1 -7 I -4 1 -3 1
1 6.2- 7.3 I -9 I -6 1 -5 I
I 7.4- 8.2 I -12 f -8 I -7 1
I 8.3- 9.7 I -14 1 -10 I -8 I
I 9.8-10.8 I -17 I -12 I =10 I
110.9-12.0 I -19 I -14 I -12 I
112.1-13.2 I -22 I -16 1 -13 I
113.3-14.5 I -24 I -18 1 -15 I
114.6-15.3 I -2; I -20 1 -17 I
Table 3-6. Last-Facln¢ GlazinR Pts.
I I Glazing Type 1
--I Total I I
I Z of 1 Sngl, I Dbl, I Trpl,
I Floor I (U - I (U - I (U - I
1 Area 11.10) 1 0.65).1 0.41)1
Ipc+!nts (points I ointsl
T o I � +� M
1 up to 1.3 1 +3 I +4 1 +4 1
I 1.4- 2.4 I +1 I +2 I +2 1
I 2.5- 3.6 I -2 I 0 1 0 1
1 3.7- 4.6 I -5 1 --=2-1 -1 1
1 4.7- 5.5 I -8 I -4 I -3 1
I 5.7- 6.7 I -10 I -6 I -5 I
1 6.8- 7.7 I -13 I -8 1 -7 I
I 7.8- 8.7 1 -15 I -10 1 -8 I
1 8.8- 9.7 I -1.7 I -12 I -10
I 9.8-11.2 I -21 I -15 I -13 ;
111.3-12.7 1 -25 I -18 -15 I
112.8-14.0 I -23 1 -21 1 -18 1
114.1-15.3 I -32 f -24 1 -20 I
Table 3-7. Sou---h-r=c1n Glazin Pts Tabir a 3-10. ShadingCoefficient Pot -is
I Glazing :?pe I I SC by I
I Total I I f Orien- 1 1 Floor Area
1 2 of I Smgl, I Dbl, Tr -;-"7 I tetfon I
I Floor I (t - I" (U - I ('; -' I I
I Area 1 1-10) 10.65) 1 0.41)1 1 1 1 i
I I a'-rts I mints 1 ointsl I Last 1 1 3.2 1
O }! +3 + 3 I 1 0-3.1 1 to I 6.4 ap
up to 1.5 1 +2 1 +2 .I +2 1 I I I 6.3 I
I 1.6- 3.6 I -1 I 0 I 0 1"
I 1.7•- 5.2 I --4 I -2 I -2 1 1 T-
I 5.3- 6.5 I -6 I -4 I -3 1 1 0 -.19 I 0 i +1 I +2
I 6.6- 7.7 I -9 I -6 I -5 1 1 .20-.36 I 0 I 0 I ♦1
1 7.8- 8.9 I -:1 1 -8 I -7 I I .37-.66 I 0 I 0 1 0
I 9.0-10.0 I -23 I -10 .I -9 I I .67-.82 I 0 I 0 -1
110.1-11.5 I =17 I -13 I -11 I( .83 up I 0 I -1 I -2
111.6-13.0 I -21 I =16 I -14 I I I ( I
f 13.1-14.5 I _5 I -19 1 -16 I i I
114.6-16.0 1 --^S I -22 I -19 1 1 South 1 0 1 3.2 1 6.4 1 9.0 ( 9.•
I I I 1 1 1 I to I to F to I to ! up
I 1 3.1 16.3 17.9 19.5 1
Table 3-8. West -facing Glazing Pts. I 7-----7-
I I blazing type 1 1 0 -.18 1 0 1 +1 1 +2 1 +2 1 +3
I .19-.42 1 0 1 0 1 0 1 0 1 0
I Total f I I 43-.66I o� -1 I -2 1 -2 1
I I of I Smsl, Dbl, Trpl, I ,67 up 1- 0 1 -2 I -4 1 -4 1 -6
I Floor I (U - I (U - I (U - I
Area 11..D) 10.65) 10.41)1 1 .1 1 1.6 1 3.2 1 6.4 1 3.0
I I oir s l oint9•6 I o+ b intsl pest I to I to I to I to I :p
o + b 1 1 1 1
I up to 1.3 I -5 I +6 I +6 I 1.5 3.1 6.3 7.9 1I I I I I
I 1.4- 2.2 I =3 I +4 I +5 1
1 2.1- 2. I 1 +2 I +3 I -.12 0 +1 +3 +6 +7
I 1 I I !
I 2.9- 3.66 I -33 0
I 1 +1 I -.36 0 I 1 0 1 0 0 0
1 1
I 3.7- 4.2 I -5 I -22 .13
I l .37-.57 I 0 1 -1 1 -3 I -6 1
I 4.3- 5.0 I -8 I -4 I -22 I
I 5.1- 5.6 I -10 t -6 f -4 .83 I -2 I -4 1 -8 I
up -16 I -20
I
5.7- 6.2 I -.3 1 -s I -6 I I I I I I
I 6.3- 6.9 I -t5 I -10 1 -7 I
1 7.0- 7.6 1 -'_8 1 -12 I -y I
1I 7.7- 8.2 -_D -14 -11 Skylight ht �I1 .1 -
8 1.6 3.2
8.3- 8.8 -16 -13 to to to to
8.9- 9.5 -5 -18 -15 .7
9.6-10.i -=I1I +5t
�.
�
I -20 I -16 I •`
1 10.2-11.0 1 -Z'S 1 -23 1 -17 ( 0-.12 1 0 1 +1 I +3 ( +6 1 -7
1 11.1-11.8 I -2 I -26 I -21 I .13-.36 1 0 1 0 1 0 1 0 1 0
111.9-12.7 I -'B 1 -29 I -24. 1 .37-.57 1 0 1 -1 I -3 I -5 ! --
12.8-13.5 I -&2 I -32 I -27 I .58-.82 1 -1 1 -3 1 -6 1 -12 1-
113.5-14.3 I -4T 1 -35 1 -29 I .83 up 1 -2 I -4 I -8 1 -16 f
1 14.4-15.2 I -S 1 -38 I -32 I 1 I I 1 1
I I 1 I 1 Table 3-11. Horizontal South
Table 3-9. SkyliTht Points
I I Gaazing Type I
I Total I I
I Z of Srgf, I Dbl, ITrpl,
I Floor I U- I U- I U- I
I Area 10.66•- 1 0.42- 10.41 I
t 1 1.IC 10.65 I down I
I up to 1.3 I 0 1 01
I 1.6- 2.2 I -i I -2 I -1 I
1 2.3- 2.8 1 I -4 t -3 I
I 2.9- 3.6 I -? 1 -6 1 -5 I
I 3.7- 4.2 I -1: 1 -8 I -6 I
4.3- 5.0 I -14 I ' -10 I -8 1
I 5.1- 5.6 I -li I -12 I -10 1
5.7- 6.2 I -19 1 -14 I -12 1
I 6.3- 6.9 I -2= I -16 I -13 I
I 7.0- 7.6 I -2: f -13 I -15 I
I 7.7- 8.2 I -2T I -20 I -17 I
8.3- 8.8 I -,3 1 -22 I -19 1
I 8.9- 9.5 I -3i 1 -24 I -21 1
1 9.6-10.1 I -33 1 -26 I -22 1
I --L- --- -L.- - !
Overha^.o. Pointy
Scuh Glaring
I Length Out 1 Area, I of Floor I
I from Wall I I
I ft r
I 10-6.3 I 6.4 up I
I I I I
0 - 0.5 1 -2 1-
10.6 - 1.0 1 -2 I -3 I
( 1.1 - 1.9 t -1 I -2 I
I 2.0 up I 0 I 0 1
I I I I
Table 3-12. Movable Insulation
Points
I Y.aveable Insulation] 1
I Area, Z of Floor I Points t
I I I
I 0- 5.5 I 0 I
I 5.6 - 11.5 I +2 I
I 11.6 - 17.5 I +4 1
I 17.6 - 23.5 1 +6 I
I X23.6+ I +8
Table 3-13. Irtf•lttation Control
Fee.tvres Points
1 I
! Coac:ol Features I Points I
I Standard I 0 I
I I
^..9 air changes per hr ( I
1 I i
.t_
I Tight i +12 I
I I i
I ,).6 air changes per hr I I
i I I
Table 3-15. Cas F.r•%Rce Withouc
Reir!cer:t!on Ceol!nq Points
_
i 1
!
Seasonal Efficlenty I Points I
I (SE), t I I
I I I
i 71 - 76
1 0 1
! 77 - 82
i +2 I
1 83 - 38
I +4 j
I 89 - 94
I a6 1
I 95 up
I
+8 1
I I
Table 3-'C-. Neat P•i_o points
T
Energy Efflc!ency I Ports I
I Ratio (EER) I
1 1 1
1 7.5 - 7.9 1 +3 i
I S.0 - 8.3 I +6 I
I 8.4 - 3.7 1 +9 I
I 8.8 - 9.1 I +12 I
I 9.2 - 9.6 I +13 I
I 9.7 - 10.2 I +18 I
I. 10,3 - 10.8 I +21 I
I 10.9 - 11.5 i +24 I
i 11.5 - 12.3 I +27 I
I 12.4 - 13.2 I +30 I
I I
Table 3-17. Cas Furnace With
Refrigeration Coollne Points
!3efrleeracionl Cas Furnace I
Coaling I SE ! I
I171 -177-i63-189-195
i 1 761 821 831 9.:1 u I
1
! 6.0 - 8.3 I 01 +21 +4j +61 +8 1
1 8.4 - 8.7 1 +21 +,4! +51 +31+10 1
!
8.3 - 9.2 I +4i +:l +;1+101+12 1
I 9.? - 9.7 I +61 +°i+101`121+14 1
9.8 - 10.3 I +d1+l':I+121+141+16 1
i !C.4 - 10.9 I+1G:+L 21.1:1+;5;+!9 1
i 11.0 - 11.5 I+121+1=1+1514'131420 1
717/83
TALE 3-14 (ADAPTED)
PASS
DWELLINS AREA SQUARE FOOT
LUNE 11
INTERIOR THERMAL MASS POINTS
AREA
St!. FT,
I 1,000
lr A 3 C D A
10
1,500
8 C
D
A
2,000
6 C
D
A
Z. Soo
B C
0
A
3,000
B
C
D
I
I A
3,500
S C
i
4,000
0
1
(
Solar vith Electric I
1
I
I Resistanc. Backup I
E.0
'.J7.
ISO
200
253
31l0
353
403
53)
603
707
1)0
903
1,0.0 130
1,; OU
1,200
1,3O0
1,400 134
1. i0o i
2,001 I
2.500
J-
3,500
•1,070
4, SOD
1 2 2 2 2 2
I 4 4 4 2 2
6 6 6 t 4
8 8 6 4 6
1010 8 6 6
12 12 10 6 1 8
14 14 12 a 10
14 14 )2 8 IJ
18 18 16 10 12
22 20 18 12 14
; 24 24 20 14 18
:6 14 22 16 70
IS 28 T4 16 I22
30 75 18 '2
.32 32 28 z0 I24
34 12 30 22 X26
34 74 32 22 28
34 32 24 28
36 34 34 24 30
34
I
2
2
4
6
6
8
1G
10
12
14
16
16
20
20
24
26
26
28
30
34
2
2
4
4
6
6
8
8
10
12
lit
16
18
•20
22
22
24
26
26
32
0 1
2
2
2
4
4
6
6
6
8
10 114
10
12
14
14
16
16
18
18
22
2
2
2
4
6
6
6
8
10
12
14
16
18
20
22
22
24
24
30
34
2
2
•2
4
6
6
6
8
10
12
14
14
15
16
2G
20
22
24
24
30
34
2
2
2
4
4
6
6
6
8
10
12
12
1.1
16
18
18
20
20
22
26
30
0
2
2
2
2
4
4
4
6
6
3
8
10
10
10
it
12
14
14 I22
18
22 I10
0
2
2
4
:
6
6
6
R
10
10
12
14
14
16
18
18
20
26
34
0
2
2
4
4
6
6
6
8
10
10
10
14
14
16
18
13
20
20
26
30
32
0
2
2
2
4
4
6
4
6
8
10
10
12
12
It
14
1C
18
IB
22
26
30
0
0
2
2
2
2
2
4
4
6
6
6
8
8
8
10
10
12
12
16
18
22
I
0
2
2
2
4
4
6
6-
6
8
10
10
12
12
)4
14
l3
I18
IS
22
26
30
32
0
2
i
2
4
4
4
6
6
8
10
10
12
17.
14
14
14
16
18
12
26
30
32
0
2
2
2
2
4
4
4
6
6
8
8
10
10
)2
12
14
14
16
20
24
26
30
0
0
2
2
2
2
2
2
1
4
6
6
6
6
B
8
8
10
10 1
14
16
18
20
0
2
2
2
2
4
4
4
6
8
I 8
to
+ 10
12
It
14
14
14
16
20
24
28
30
32
0
2
2
2
2
t
4
:
6
C
66
8
10
10
12
12
12
14
16
20
24
:6
30
32
00
0
2
2
1
2
t
4
6
6
8
3
10
10
12
11
12
14
18
22.
24
26
30
0
0 2
2 2
2 2
2 2
2 2
2 4
2 t
2 6
4 6
G 8
4 I ?
6 v
6 I10
6 110
8 1,12
6 12
8 14
8 I4
i2 1B
14 22
l6 124
la j 28
20 130
132
p 0
2
2
2
2
2
4
t
5
6
6.
6
8
10
1J
12
12
14
10
18
22
21
28
30
32
D
C
2
2
2
2
-
i
4
6
6
6
8
B
10
10
10
12
12
16
i3
22
24
26
28
0 C
0 2 2
0 2 7
2 2 f
2 I 2 2
7 I 2 2
2 I 4
1 I G 1
4 4
4 I 6 5
e I 6 A
G I1 8 6
! IIII B 8
6 I 8 8
6 11;1 10
E 110 10
6 i12 !0
8 ''. 1'
r 11T 1:
10 ,16 15
'2 i20 20
14 22 27
16 ( 26 24
18 1 73 28
20 j 30 30
0
0
2
2
2
2
t
!
5
6
S
C
8
8
IO
10
i3
t8
20
2T
24
2F
-1--
C
n
OI
2
2I
2
2
2
41
4
0 �
4j
E
6.
LI
t.
G I
G�
1i1
IGS
1;
l E
I
i 0
0
2
2
I :
t
I.6
6
6
.,
7
!:i
11
10
;0
;2
14
19
2'
7a
9
J 6
a 0
i
° 2
2
4 2
a 4
6 4
6 .
5 6
8 6
8 L
e C
In 8
`0
13 1
17 lc
14 12
.3 ib
:3, it
;4 `2J
Zi • "2:
zu�• 7!
7
0 1
0 1
-`
2 i
;
2!
7
! i
4 ;
; !
L ;
u
E. ,
o i
g j
'•�
1t i
14
:
l E I
;E
+14
+IO
+7
+6
+16
+12
+8
+7
+19
+14
+10
1 +9
-�
All others (pe buil.dinf, points)
eu0-899 0 +5 T +10 +14 +19 +2'
+29 1 +34
900-999
1,000 1,199
0
0
+4
+4
+9
+7
+13
+ll
+17
+15
+11
.119
+26 1-+3
+t;,
+22 T26
1,20(-!,499
1,500-1,999
2,')()0---, ,9:9
n
0
0
+;
+2
+2 I
+6
+5
+3
+9
+7
+5
+12
+9
+7
+15 I
+12
+t;
+18 +21
+l4 +16 I
+10 +ll
3,01':0 -:.d uo
0
A) 1. 3's' Concrete Slab: HC�8.93; R•.29; Factor -7.3
2. 3 3/4' Thick Connon Brick: 11c=7.125; R•.13; Factor -7.3
a) 1. SN' Concrete Slab: HC•14.106; R•.4SB; Fctor•7.)
C) 1. 8" Solid Filled Block: HC -20.63; R-1.93; Factor -6.1
2. 8" SOlid Filled Block With Both Sides _Exposed To Conditioned Air.
NOTE: Use all square footage directly exposed to conditioned air
for ThermalMass Area: HC}30.164; R-.96:; Factor -6.1
D) 1' Thick Concrete/Tile: MC-2.SS; R•.083; Factor -3.7
Table 3-19. Zonally Controlled
Electric Reststance
Space Meatinit Points
I Points foe this eieasurc vi11 i
be cooD'leted after the C£C I
i has approved an Alcc�rnative I
I Component Package for Resistance 'I
I Beat.
Table 3-15. Active Solar Space
F:eatln v!th Cas Points
i
Net Solar Fraction I Points
i (%SF), Z I I
I I I
I 0-6 I 0 I
I 1-14 I +2 I
I 15 - 23 j +4 I
I 24 - 30 I +6 I
I 31 - 39 I +8
I 40 - 47 I +10 I
i 48 - 55 I +12 I
56 - 63 ( +14 I
I 64 - 71 I +18 I
I 72 up I +20 I
Table 3-20. Snlar Hater W-rin> With ttna aa.o-- 9.4..1
wood stove #33 points'(no back up)
casablanca fan + 1 point
Nultifaoil (Pier
unit
oinks)
1
I System Type (
I
Points
I
Floor Area
i
Net Solar Fraction (NSF), Z
per un! C,
ft2
I Cas Only I
i
0
i
I
I Heat P,nsp i
I
0
1
(
Solar vith Electric I
I
I Resistanc. Backup I
1
Meering the Require- (
:
I menta 1:s Part 2
0.9
10-19
20-29
30-39
40-49
1 50-59
60-69
70-79
600-799
0
+3
+7
+10
+14
+17
+21
+:
800-999
1,002)-1,499
1,500-1,999
2 t•�:� and up
0
0
0
0
+3
+2
+1
+1
+5
+4
+3
+2
+8
+6
+4
+L 1
+11
+8
+6
+5
+14
+IO
+7
+6
+16
+12
+8
+7
+19
+14
+10
1 +9
All others (pe buil.dinf, points)
eu0-899 0 +5 T +10 +14 +19 +2'
+29 1 +34
900-999
1,000 1,199
0
0
+4
+4
+9
+7
+13
+ll
+17
+15
+11
.119
+26 1-+3
+t;,
+22 T26
1,20(-!,499
1,500-1,999
2,')()0---, ,9:9
n
0
0
+;
+2
+2 I
+6
+5
+3
+9
+7
+5
+12
+9
+7
+15 I
+12
+t;
+18 +21
+l4 +16 I
+10 +ll
3,01':0 -:.d uo
0
+;
rJ _
+4+5
+7_
+S +10
Table 3-21. Other Hater
Heating Pts.
1
I System Type (
I
Points
I
I
i
7
I Cas Only I
i
0
i
I
I Heat P,nsp i
I
0
1
(
Solar vith Electric I
I
I Resistanc. Backup I
1
Meering the Require- (
:
I menta 1:s Part 2
I Eleccrtc Reststance I
I
WoA Nf (c A� oh bu"'A
fees flan account ;t iS yiot -fd be bit;
ld-a-sg
,t
OROVILLE, CALIFORNIA
I
GENERALCLAIM
CLAIMANT: f u G e and M0.r A A Der,
ADDRESS: �i m r .
CITY & STATE: Gh l G0 G2, IMPORTANT:
0 -db- .W y SEE INSTRUCTIONS
DATE OF CLAIM: ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
Owner has decided not to do work. (Bldg Permit Appin. #596-87BPEM,
Receipt #77935, dated 2/25/87 and 77959, dated 2/26/87.
Building permit fees paid ----------------------- $647.50 I
Retain tiling tee-------------------
Retain plan checking fee ------------'207.50
Retain energy plan checking fee----- 15.00
Amount retained ------------------------------- $232.50
Refunddue -------------------------------------------------
Plumbing permit fees paid-----------------------$ 52.00
Retain filing fee------------------------------- 10.00
Refund due ---------- -------------------------------------=--$ 42.00
permitElect ical fees paid--------------------- 98";15
Retain filing fee=------------------------------ 10.00
Refunddue------------------------------------------------- 88.15
-Mechanirnl ptt�rmit fees paid --------------------- 36.00 _
Retain filing fee ------------------------------- $ 10.00
Refunddue --------- =--------------------------------------- $ 26.00
Refund energy inspection fee paid-------=------------------$ 30.00
TOTAL REFUND DUE --------------------------------------------- $601.15
$601.1.5
CORRECTION TAPE USED BY THE BLDG DEPT. TOTAL
$601.15
I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, an that this
claim is true and correct as stated.
Dated this ......11 .................... day of ....LL............... 190.c� t..O—h...�.......• Calif. .... .�1:•vLr•VY �^1� `�.���
Signature of Clalmant i
I, the undersigned, hereby certify that, to the beat of my knowledge, the services or articles specified above have been performed or de-
livered and that there is a Budget Appropriation or Specific Board Approval E] (Check one) for a aam
Dated this 29th day of ..._.December 19 88at Oroville caul. ..........ry........
e artment Head or Authorized u
Dept.
cde 440-002............ e .........42105.0.0..................PAYABLE FROM .............st.Permits
................................... :...................................................... ...........
FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB.
GROSS AMT.
V
COUNTY OF BUTTE,- DEPARTMENT OF PUBLIC WORKS ERMI NO.
7 County Center Drive - Oroville, Califora,ia 9596.$ - Telephone 916/534-4541 �`
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
-909?'-/3
ZONI G
S
BUILDING PERMIT
OWNER
TELEPHONEfigar
SQ. FT. OCC. BUILDING VALUATION
0. 00
OWNER'S MAILING AD RESS
/-c
M
- 4 3.? . U -a
CONTRACTOR'S NAME .
TELEPHONE
379 Co,;
3 7 90 . o
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOW
Total Valuation $
Q
Filing Fee
$ U 10:00)
LENDER'S MAILING ADDRESS
Permit Fee
$ , p4)
ARCHITE•/C�`'TT O ENGINEER
LICENSE NO.
Plan Checking Fee
$ '
Energy Plan Checking Fee
$ '— 66
ARCHITEC O NGINEER'S MAILING ADDRESS
Penalty
$ '
BUILDING ADDRESS
O Via, G+.
Permit fee
$
7'
PLUMBING PERMIT
Filing Fee 10.00'
Each Trap
fl 2.00 , e5c
f
GYM C LJ
Solar or heat pump water heater
20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
�3(5--
Water piping
5.00 , UO
Each qas water heater or vent
5.00 Ot-)
USE OF STRUCTURE
SF EX Duplex❑ Mobilehome❑ Other
• SPECIFY
Gas piping system 1 - 5 outlets
5.00 ,� ; 1JU
Building sewer
5.00
Mobile Home S G IN
0.00ea
TYPE OF WORK
New& Addition[—Remodel((❑ Utilities❑ Installation❑ Other❑
Describe work: �JS+►-� d Owe. _
Permit Fee
$ S" .UCS
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service Q$o AMPOR_ OR
10.00
Main servi a EA. ADD -L too AMP
2.50 �2, j a
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
I, as the owner. Or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
W DWELLING OCCUP.6 ,
ACC. BLOGS. /22sgft (os',&
EW CONSTR.MULTI-OUTLET
2,50 ea NON.RESID BRANCH CIRC ITS
POWER APPARATUS &J
SINGLE OUTLET CIR.
Ex. OCCUp(OUTLETS OR FIXTURES 2ALO 30
eL0
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EAJ 2.00
Temporary service 10.00 fd, qp
Mobile Home Facilities 15.00
g 15.00
Misc. �yirin--:::F
Permit Fee $ S
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 10.0C
Heating
Cooling
g
/. db
Hood
3.00 3�Cn
Ventilation
2 -
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 ' conse ee,.nce of the granting of this permit.
X a t =;i aS_S�
Datesions
Signature of Applicant — Owner � Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5' a demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee 30, 0a>
TOTAL PERMIT FE $(o-3,
occuP.
CONST.77PEJ
1�SO
FLOG
PARC
PD
ND
ssu
This permit is hereby issued under
of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
BY
P IT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date �� 2 J —
�j
�7— T3— ?P
CJ''5 I!
Receipt No. ,
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK-INSPEC R. GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF',PUB'LIC WORKS - BUILDING t
UI ING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFOR'NI-995965 - TELEPHONE: 9116/53,4_-4541
PERMIT APPLICATION DATA SHEET
' Permit No.
OWNER Nlcr.✓+ka,t 6.1e,,r-cos
A. P. No. -VO
Proposed Building Use S/— "3 (39r'` Building Inspector
Date ;Z,Z5 %c2
t
At time of permit application, I was advised the following,data�must be submitted prior to permit processing
andJor issuance:
DATE RECEIVED APPROVED
1. All items have been submitted. . . . . . . . . . .
2. Plot plans in duplicate. /triplicate, signed by preparer of plans. ,
3. Complete plans in duplicate. /triplicate, signed by preparer of plans.
4. Complete engineered plans and calcs, with wet signature on plans.
5. Plans with Energy Design Compliance Statement. . . . . .
6. CUSD "Fee's Paid'' Stamp on Floor Plan . . . . . . . .
7 Statement of Intent for Non -Heated and AC Buildings.
.Fees of $ C031,125 . / . . . . . . . .
, Z 9. Letter of signature authorization; . . . . . . . . .
anitation approval from Gti«- Health Dept.
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance. . . . . .
13. Contractor's License Information (no., name st ey classif.)
wner-Builder Verification (Given to owner, Mail to ownerE]),
3
—15. Improvements may be required. . . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . . . .
Pre-Inspec.request to (Dote)
17: Pre -Inspection for Required. Building Inspector
ecorded copy of Agricultural Acknowledgment Statement.
cLfe /li-� D��,?� hi�r•em�
�i
riveway Permit. .
c�
20. Plot plan approval from city of
21.
22.
When you issue the permit, process as follows: Mail to owner, Mail to contractor.
Telephone 89�- �3�� and hold for pickup a �Ie Doffice, Deliver w/inspector.
Other 1+
Applicant
Copy of plans sent Health Dept., Fire Dept., Other Date
The following data must be submitted ri r t ermi . is ace: (Circle new item not checked above).
1. Index permit for above items No. —
2. Additional items required: L
Contractor, designer, owner, was advised of above required data byZZ6hone_mail—counter bye�&date
Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date
Plans checked by Date Plans approved by te3
Sets of plans on hold in File cabinet AP folder
Copy—DPW
— Flours: 10:00 a.m. - 3:00 p.m.
TO: Building Department
FROM: Encroachment Permit Section �-
RE: Driveway Clearance
q0 -tI10-13
own7er location AP #
Driveway permit one has been issued for the above property.
110� , v�7`�e ✓ o
signa re date
Return to DPW AGRICULTURAL STATEMENT -OF ACKNOWLEDGMENTRECORDED BUTTE COUNTY
UFFICIAL RECORDS BY
FOR RESIDENTIAL DEVELOPMENT
Section 26-8.1 of the Butte County Code requires this acknowledgement PARRY SH01MI
be rec,_ � rded prior to .issuance of a building permit. 87—S401 � 1981MR.-4 PX 0 03
The property described herein is adjacent to land or included CANDACE J.GRUBBS
within an area zoned for agricultural purposes, and residents of this
property may be subject to inconveniences or discomfort arising from CLERK-RECOM F ,
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:
Lot 13, as shown on that certain map entitled, "SOUIHGATE ACRES SUBDIVISION NO. 2",
which map was filed in the officeof the Recorder of the County of Butte, State of
California, on December 2, 1980 in Book 80 of Maps, at pages 34 and 35.
Date: March 3, 1987o PROPERTY OWNERS:
BRUCE BERG OM MARTHA BERGSTROM
State of CALIFORNIA. ) On this the 3rd day of March19 87 , before
SS. me, the undersigned Notary Public, personally appeared
County of BUTTE )
BRUCE BERGSTROM and MARTHA BERGSTROM
aaaroeaawaaa�caeaaeeetree■■
m
JULIANNE PETERS
NOTARY PUBLIC -CALIFORNIA 1r
Butts county •
AAy Commbtabn Expires Feb.16.199t �
esloaaaaeeeea��I!�lwl!��*�rEl
L/ Personally known to me./ Proved to me on the basis
of satisfactory evidence.
to be the person(s) whose names) are subscribed to
the within instrument and acknowledged that they
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
'Present A.P. No. '</O
0
�J
FORM '
RESIDENTIAL ENERGY -PLAN CHECK/INSPECTION SUMMARY
Owner
,C8k&&S 6A1 Climate Zone Permit No. W46-8;7
Floor Area
Compliance
path:
Package O A ❑ B ❑ C ®.Point System ❑ Budget®Other �61 3
MIN
R -VALUE DESCRIPTION
REQ'D
INSTALLED
ITEMS
(1) INSULATION•
Roof/Ceiling
®
Wall
❑
---�
Slab Floor Perimeter
❑
Raised Floor
(2) INFILTRATION•
13
(A) A vapor barrier is required in climate zones, 1, 14 & 16.
®
(B) All manufactured windows and sliding glass doors shall meet the
1972 ANSI Air Infiltration Standards and shall be certified and
labeled.
(C) All swinging doors and windows leading to unconditioned areas
shall be fully weatherstripped,
Tight - the above standard features plus:
❑
(D) Continuous infiltration barrier
❑
(E) Electrical outlet plate gasket
❑
(F) Air-to-air heat exchanger
(3) GLAZING:
(A) Location
Area Glazing 7.F1oor,Area Single Double Triple
Total Bldg 0755.% /o?•�G
North /30 i �•Si
East • O
.70
South /, yrs
❑
West
�I
Skylights "R0 / O
(B) Shading
Shading
Coefficient Description
®
East 6 W44. wG_
®
South •�
❑
West
❑
Skylights .8� « '•
(C) South Overhang
Length of projection .Z ft. Description
❑
(D) Moveable insulation: Area ftz Description
(E) Thermal mass
❑
Type - Area Ft.2 HC= R=
MC= Location
❑
Type - Area Ft. HC= R=
MC= Location
❑
Type - Area Ft.2 HC= R=
MC= Location
❑
Type - Area Ft. HC= R=
MC= Location
❑
Type - Area Ft. HC= R-
MC= Location
❑
Type - Area Ft. HC= R=
MC= Location
7/83
FORM
❑ (4) MASONRY AND FACTORY-BUILT•FIREP•LACES shall be equipped with tight
fitting closeable metal or glass doors covering the entire opening
of the firebox; a combusion air intake equipped with a -readily
accessible, openable, and tight fitting damper to draw air from the
outside of the building; and a tight fitting flue damper with a
readily accessible control.
*1(5) HEATING, VENTILATING; AIR CONDITIONING SYSTEM
eating
Central Gas Furnace
(brand'and model number)
Btu/hr
(heating capacity)
Heat Pump. _
(brand and model number)
Btu/hr
(heating capacity at 47.°F)
Active Solar
_L'
SE
ACOP
:,type (liquid or air) Collector brand and
ft2
model number solar fraction collector area collector
orientation collector tilt rated y -intercept
rated slope
® Other W Oa 0
(describe)
*1 (B) Cooling
® Electric Air Conditioner gt)
(brand and model number) (seasonal EER)
Btu/hr.
(cooling capacity at 95°F)
❑ Electric Heat Pump
EER
Btu/hr
(cooling capacity at 95°F)
❑ Other
(describe)
❑ (C) A TWO-STAGE THERMOSTAT, which .controls the supplementary heat on.
its second stage, shall be required for heat pumps.
® (D) AN AUTOMATIC SETBACK shall be provided for all thermostats, except
those controlling heat pumps.
® (E) AN INTERMITTENT IGNITION DEVICE shall be provided for all gas-fired
fan type central furnaces, gas-fired fan type wall furnaces and
gas cooking appliances.
® (F) BACKDRAFT DAMPERS shall be provided for all fan systems exhausting
air to the outside.
® (G) DUCT CONSTRUCTION & INSULATION. All transverse duct, plenum, and,
fitting joints shall be sealed with pressure sensitive tape or
mastic to prevent air loss and shall be insulated to conform to
the provisions of Section 1005 of the UMC, 1976 Edition.
7/83 2
At
' AOR to 1
(6) DOMESTIC WATER SYSTEM
B -(A) Gas Only Gallons
(brand and model number) (tank size)
❑ Heat Pump w/Electric Backup
(brand and model number)
Gallons
(tank size)
13 *2 Active Solar
(collector brand and model number)
(rated y -intercept) (rated slope) (solar fraction)
ft
:(backup heater type, brand and model number) (collector area)
(collector orientation) (collector tilt)
❑ Location of Solar Panels
❑ Other
(Describe)
® :(B) TANK INSULATION. Storage type .water heaters and storage and
backup tanks for solar systems shall be externally wrapped with
R-12 insulation or greater.
® (C) PIPE INSULATION. The five feet of pipe closest to the water
heater and outside conditioned.space shall be insulated with a
minimum of R-3. Steam.and steam conditioned space shall be
insulated with a minimum of R-3. Steam and steam condensation
return piping and recirculating hot water piping outside the
building envelope shall be insulated in accordance with
T20 -1408(d),
® (D) FLOW RESTRICTORS shall be provided for showerheads and faucets
as outlined in -the new appliance efficiency standards and shall
be certified to the Energy Commission.
(7) LIGHTING
® (A) Lamps used in luminaries for general lighting in kitchens and
bathrooms shall have an efficacy of not less than 25 lumens per
watt (usually florescent).
*1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing.
charts (form #4) or other approved methods, section 2-5352(8), and fill out the
following;
Heating: Winter design temperature °, elevation Ca ', heating load
elevation factor j, O x heating load = maximum outlet capacity gas furnace
BTU
Coolie Summer design temperature �° g '
g� g p , coolie load BTU
2 (USE ONLY AS A SIZING GUIDE, COOLING MAY BE"(INADEQUATE)
* Submit T.I.P.S.E. chart or other approved system (form #5) to document sizing of
solar; panels.
® DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of
Title 24, Part 2, Chapter 2-53 of the California Administration Code.
7/83
J
SIGNATURE OF BUILDI G DESIGNER OR APPLICANT
3
t
'TO
21
st-�Itnv b •e-lff
--4k�H 4r -"t- :J,o.
1�
-XP9 1
L.A 9.
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965 '.,Phone: 916-534-4541
p
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An 'owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1. I personally plan to provide the major labor and mater i s for construction of
the proposed property improvement (yes aa.*w) �e
I (have/) signed an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
4. I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
Signed:
Property Owner OnWHEME 9
Social Security Number
Date '3 — 3— $ry
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
. 19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
TOTAL POINTS =
-able 3-1. Slab Floor Points
17ncula- I R -Value of Insulation I
I tiwn I I
I Depch,
(.inches 1 0-2 1 3-4 1 5-6 I' 7+ I
I I i l I I
I -- 1 -3 1
11 - IS 1 -3 -3 1 -2 1 -1 1
I 16 - 19 I -5 1 -2 1 -1 1 0 1
I 20 + I -5 1 -1 1 0 1 +1 I
7/7/83
Table 3-2. Raised Floor Points
I R -Value of I
Insulation I Pointe 1
I I
I below 3 I -12 I
I 3-• I -8 1
-6 I
I 12 I -4• I
I -
is I +2 I
19+ I 0 I
Table 3-3a. Ceiling Insulation
R -Value of Insulation I Points
19
ZONAE 11
22
i -2
OWNER /, AC.644 3>
GS i1I POINTS
PERMIT�i/NO.��Zi�%
ASSIGNED
ACTUAL
1.
SLAB - INSULATION
I Floor
_5
2.
PRISED FLOOR - R-19
I 2.j- 2.8 1
0
3.
CEILING - R-30
I Ales
4.
WALL - R-19
I 2.9- 3.6 1
-3
i
5.
NORTH GLAZING -
2.43.6% -S-i
11.10
10.65
I down I
I 3.7- 4.2 I
4.3- 5.0
I I
-5
-6
6.
EAST GLAZING -
2.5-3.6% ,70
I of Floor I
7.
SOUTH GLAZING -
1.6-3.6%
L
S.
WEST GLAZING -
2.9-3.6%
I -4
9.
SKYLIGHT -
0-1.3% AN
I +2 I
10.
SHADING (Exclude Overhang)
I -8
I -6
EAST . % -
.66 , G
-6-
1 +1 I
SOUTH N.S6P -
.19-.42 64
+L_
I -T I
WEST -
.SKYLIGHT -
.13-.36 •�
.37-.57
��
11.
HORIZONTAL SOUTH OVERHANG 2'
-
12..
MOVABLE INSULATION - NONE
4.9. 6.1 I
-7 I
13.
INFILTRATION (Standard=0)(Tight=+12)
STD
B°-
14.
THERMAL MASS
SF
-9 1
15.
GAS FURNACE (SE)
71-76%
-22 I
16.
HEAT PUtiP (EER)
7.5-7.9% ....�
�^-
-8 1
-7 I
I 8.9- 9.5 1
-25 I
17.
DUAL PACK (SE, SEER) 8.0-8.3/71-76%
1 8.3- 9.7 I
-14 1
-10 1
WOOD STOVE
1 9.6 -i0 -i 1
-27
-20
4A5 WATER YHEATER
E�
-17 1
ATTIC f 7g3
-10 1
110.2-11.0 I
-29 I
OTHER(A FRMS
I -17 I
-f Z
TOTAL POINTS =
-able 3-1. Slab Floor Points
17ncula- I R -Value of Insulation I
I tiwn I I
I Depch,
(.inches 1 0-2 1 3-4 1 5-6 I' 7+ I
I I i l I I
I -- 1 -3 1
11 - IS 1 -3 -3 1 -2 1 -1 1
I 16 - 19 I -5 1 -2 1 -1 1 0 1
I 20 + I -5 1 -1 1 0 1 +1 I
7/7/83
Table 3-2. Raised Floor Points
I R -Value of I
Insulation I Pointe 1
I I
I below 3 I -12 I
I 3-• I -8 1
-6 I
I 12 I -4• I
I -
is I +2 I
19+ I 0 I
Table 3-3a. Ceiling Insulation
R -Value of Insulation I Points
19
1 .4
22
i -2
.38
+s5
+3
II tj
+6
1 +4
i +2
49
I +4
Table 3-4a. Wall Insulation Points
R -Value of Insulation I Points I
I 11 1 -7 I
I 19 I 9 I
130 I +3 I
I I I
Table 3-5. North-Facin Glazing Pests
I I Clazin iq I
Table 3-7. South -Facing Clating Pte Table 3-10.Shading Coefficient Points
I I Glazing Type 1
I Total I I
I 2 of I Sngl, I Dbl, Trpl,
I Floor I (U - I (U - I (U - I
I Area 11.10) 1 0.65) 1 0.41)1
I I ointo ( pints I ointsl
0 :V3_
+! • 3
I up to 1.5 1 +2 1 +2 1 +2 1
I 1.6- 3.6 1 -1 1 0 1 0 1
( 3.7- 5.2 1 -4 I 2 1 -2
I TT --T r 1 -6 1 Z" 1 -3 I
6.6- 7.7 1 -9 1 -6 1 =S I
I 7.8- 8.9 1 -11 1 -8 I -7 I
I 9.0-10.0 I -13 I -10 .I -9 1
110.1-11.5 I -17 I -13 I -11 I
111.6-13.0 I -21 I =16 I -14 I
113.1-14.5 I -25 I -19 I -16 1.
1 14.6-16.0 I -28 1 -22 1 -19 I
I I I 1 I
Table 3-8. West-Facine Glazing Pts.
I I ' Glazing Type I
I Total I I
I I of I Sngl, I Dbl, f Trpl,
I Floor I (U - 'I (U - I (U . I
Area 11.10) 1 0.65) 1 0.41)1
I
I I of
I Orten-
e
I
o
I c"C3 II•
I 1.4- 2.2 1
+s5
+3
II tj
+6
1 +4
I1 +i IITotal
+6
1 +5 I
I Sngl,
Dbl,
Trpl,
I Floor
l u-
l U-
l U- I
I 2.j- 2.8 1
0
1 +2
1 +3 I
I Ales
1 0.66
10.42-
10.41 I
I 2.9- 3.6 1
-3
1 0
1 +1 I
I
11.10
10.65
I down I
I 3.7- 4.2 I
4.3- 5.0
I I
-5
-6
I -2
I -4
I 0 1
-2
I 1
0 + •
I of Floor I
I 0.1 1.2
I +4
1 +4
1 4 1
I 5.1- S.6 I
-10
1 -6
I -4
I 1.3- 2.3
I +1
I +2
I +2 I
I 5.7- 6.2 i
-13
I -8
I -6
1 2.4- 3.6
( -2
I 0
1 +1 I
I 6.3- 6.9 I
-15 I
-10
I -T I
I 3.7- 4.8 I
-4
1 -2
I -1 I
I 7.0- 7.6 I
-18 I
-12
I -9 I
4.9. 6.1 I
-7 I
-4
f -3 I
1 7.7- 8.2 I
-23 I
-14
1 -11 I
1 6.2- 7
-9 1
I
I -5 (
( 8.3- 8.8 i
-22 I
-16
I -13 I
I 4- 8.2
-12 1
-8 1
-7 I
I 8.9- 9.5 1
-25 I
-18
I -15 I
1 8.3- 9.7 I
-14 1
-10 1
-8I
1 9.6 -i0 -i 1
-27
-20
1 -16 I
i 9.8-10.8 I
-17 1
-12 I
-10 1
110.2-11.0 I
-29 I
-23
I -17 I
110.9-12.0 1
-19 1
-14 1
-12 1
I. 11.1-11.8 I
-35 I
-26
I -21 I
112.1-13.2 I
-22 1
-16 1
-13 1
1 11.9-12.7 I
-38 I
-29 I
-24' 1
113.3-14.5 I
-24 1
-18 1
-15 1
1 12.8-13.5 I
-42 I
-32 I
-27
14.6-15.3 i
-27 i
-20 1
-17 1
1 13.6-14.3 I
-46 I
-35 (
-29 I
Points
i 3.7- 4.6
1 -5 1
114.4-15.2 1
-50 I
-33 I
32 I
I SC by
I
I Orten-
I 2 Floor Area
tation
I
I East
I I 3.2 I
I
10-3.1 I to i 6.4 up
I
I I 6.3 I
I
1 0 -.19
-
1 0 I +1 I +2
I .20-.36
1 0 I 0 I 1l
i 0
00
-.82
I .�3
0 -1
.83 up
i 0 i -1 i -2
I South
1 0 1 3.2 16.4 18:0 1 9.6
i
I to I to I' to I to I up
13.1 1 6.3 17.9 19.5 I
I 0 -.18
1 0 1 +l I +2 1 +2 1 +3
I .19-.42
1 0 1 0 1 0 1 0( 0
I .43- 0 1 1 1 -2 I -2 -3
. up
•I
l 0 l -=!" I -4 I -4 I -6
West
I -1 11.6 13.2 16.4 1 3.0
I of Floor I
I to I to I to I to I up
11.5 13.1 16.3 .9 I
I I I I
0-.12
I 0 1 1 1 +3 I +6 I +7
.13-.36
I D I 0 1 0.1 0
.37-.57
0 1 -1 I -3 1 -6 1 -7
.58-.82
1 -1 1 -3 1 -6 1 -12 1 -15
.83 up
1 -2 1 -4 1 -8 1 -16 1 -20
1 1 1 1 I
Skylight
i .1 1 .8 1 1.6 1 3.2 14.0
I to I to I to ! to I to
ft
1 7 1`5 13.1 1 3.9 1'5.2
0-.12
1 0 1 +1 I +3 I ,+6 i +7
.13--36
1 0 1 0 1 0 1 0 1 0
.37-.57
1 0 1 -1 I -3 I -6 I -'
5-8 .
I -1 1 3 1 -6 1 -12 I -.
up
I -2 Ike I -6 I -16 I -20
I I
I
I
I
Table 3-11. Horizontal
South
Overhane Points
Table 3-9. Skylight Points
I South
Glazing
Table 3-6.
last -Facing
Glazing Pts.
I Length Out I Area,
I of Floor I
Glazing Type
from Wall
i T-
I
I
I GlazingT
ype
I
I Total I
i
ft
-1 Total
I
I
I I of T Sngl, I
Dbl, I
Trpl,
I I 0-6.3
1 6.4 up I
I I of
I Sngl, I Dbl,
I Trpl,j
Floor I
U- I
U- I
U- I
I I
I ' I
Floor
I (U - I
(U - I
(U - I
I Area 10.66-
10.42-
10.41
I
0 - 0.5 1 -2
1 -
I Area
1 1.10) 1
0.65).1
0.41)1
1 1
1.10 1
0.65 1
down I
1 0.6 - 1.0 1 -2
1 -3 1
I
Ilppints I
oints I
ointsl
11.1 - 1.9 1 -1
1 -2 1'
t7
I•
•.f
r�
I up to 1.3 I
-1 I
�- I
0 I
I 2.0 up I 0'
I up to 1.3
1 +3 1
+4 1
+4 I
I �1
-3 1
-2 I
-1
I
I 1
1 T -'=-r.4
1 +1. 1
Tr 1
+2 1
1 2.3- 2.8 1
-6 1
-4 1
-3 1
Table 3-12. Movable Insulation
1 2.5- 3.6
1 -2 1
O 1
0 1
1 2.9- 3.6 1
-9 1
-6 1
-5 (
Points
i 3.7- 4.6
1 -5 1
-2 I
-1 1
I 3.7- 4.2 1
-11 1
-8 I
-6 I
1 4.7- 5.6
1 -8 1
-4 (
-3 1
1 4.3- 5.0 1
-14 1'
-10 I
-8 I
I Moveable Insulation'
1 5.7- 6.7
1 -10 I
-6. 1
-5 1
I 5.1- 5.6 1
-16 I
-12 i
-10 I
I Area, 2 of_Floor I
Pointe I
6.8- 7.7
1 -13 I
-8 1
-7 I
I 5.7- 6.2 1
-19 I
-14 I
-12 I
I
1 7.8- 8.7
I -15 I
-10 1
-6 1
I 6.3- 6.9 I
-21 1
-16 1
-13 1
I 8.8- 9.7
I -1.7 1
-12 1
-10 I
1 7.0- 7.6 1
-24 1
-18 1
-15 1
1
9.8-11.2
-21 1
-15 1
-13
7.7- 8.2 1
-26
-20 1
-17
+2
11.3-12.7
-25
-18
-15
8.3- 8.8 1
-28
-22 1
-19
/,17.5
+4 1II1
1(1
12.8-14.0
1
-21
+6
14.1-15. 3
-2
1 3
-24
-20 1
1 9.6-10.1 1
-33
-26
=22
I
.0
+8 I
I
1
4---
b.
Table 3-13- Lnfflttation Control
reatvres Points
T-
I Control Features I Points I
T- I 1
I Standard I 0 I
19.9 air changes per hr ( I
I I i
r-
Tight i +12
10.6 air changes per hr I'
i I 1
Table 3-15. Gas Furn4ce Without
Refrigeration Coollng Points
IrSeasonal EfficiencyI P ots I
I (SE), i 1� I
1 1 1
1 71 - 761
0 1
i 77 - 82
I +2 I
3A-
1 44I
I H9 94
I +6
I 5 up
I +8 I
Table 3-16. Heat Pump Points
i Energy Efficiency I Poi s I
I Ratio (EER) i I
I 1'.5 - 1.9
+3
I 8.0 - 8.
+6
3A-
I +9
8.6 9.1
+12
9. 9.6
+13
10.2
+18
0. 10.8
+21
10.9 11.5
+24
11.6 12.3
IIII11III
+27
1
I
30 I
I 1
Table 3-11. Cas Furnace With
Refrigeration Cooling Points
1-
:RefelSeracion) Gas Furnace I
I Cooling 1 SE : I
1- 7-183- 89- 95
i 1 761 821 881 941 uI
I 8.0, - 8.3 1 01 +21 +41 +61 +8 t
1 8.4 - 8.7 1 +21 +41 +61 +31+10 1
1 6.8 - 9.2 1 +41 +61 +81+101+12 1
1 9.: - 9.7 1 +61 +61+101-121+14 .1
I 9.8 - 10.3 1 +31+101+121+141+16 Y
110.4 - 10.9 I+1Gi+121+141+161+18 i
1 11.0 - 11.6 1+121+1141+1614.181+20 1
7/1/83
TAELE 3-14 (ADAPTED)
.ASS
DWELLIRG AQCA tnoapr rnaT
ZONE 11
iNTER,IOR THERMAL MASS POINTS
AREA
1,000
I 1- 14
I +2 I
1,500
I +4 I
I 24 - 30
2,000
31 - 39
I +8 1
2,500
I ; +10 1
I
3,000
I 56 - 63
I +14 1
3,500
1 +18 L
1 72 up
I
4,000
60-69
I
I.SGD
0
+3
5,000
I
SA. PT.
1 A
8
C
D
A
8
C
D
A
B
C
D
A
8
C
0
A
B
C
D
A
8
C
0
A
8
C
0
A
N
C
01
A
+2
C L j
+5
1 +6
+7
+9
All others (pe din points)
0-899
0
+5
SIU
+14
+19
+24
+:9
+34
0-9
[;0PI.499
0
+4
+9
+13
+17
+il
+26
+30
,199
0
+4
.1.7
+11
+15
4.19
+22
+26
0
+3
+6
50
2
2
2
2
2
2
2
0 1
2
T
2
0
0
0
0
0
0
0
0
`•0
0
0
0
0
0
0
0
0
00
+8
+10
0
0.
0
0
0
100.
4
4
4
2
2
2
2
2
2
2
2
2
2
2
2
0
2
i
2
0
2
2
0
i0
2
2
0
0
0
01
0
0
0
0
iSO
6
i
6
1
4
4
4
T
2
'2
2
2
2
2
2
2
2?
2`
2
2
2
2
!!
2
2
2
't
2
0
1
2
2
0 1
200
8
8
6
4
6
6
4
2
4
4
4
2
4
4
2
2
2
2
.2
2
2
.2
2
2
2
2
i
2
2
2
2
2
-
7
0 1
253
10
10
8
6
6
6
6
4
6
6
4
2
4
4
4
2
4
4
2
2
2
2
2
2
2
7
2
2
2
2
2
2
2
2
2
300
12
12
10
6
8
8
6
4
6
6
6
4
6
6
4
2
4
4
4
2
4
4
7
2
2
2
2
2
2
2
7'
2.
2
2
7
350
14
14
12
8
10
10
8
6
6
6
6
4
6
6
6
2
6
4
t
2
4
4
2
4
4
2
2
4
4
t
7
2
2
7
400
14
14
12
8
tO
10
8
6
8
8
6
4
6
6
4
4
6•
6
4
2
4
4
2
4
4
4
2
i
4
2
2
3
4
2
t
Soo
18
18
16
10
12
12
10
6
10
10
8
6
R
8
6
4
6
6
6
6
6
2
6
6
4
2
4
/
4
2
4
4
j
600
22
20
18
i2
14
14
12
8
12
12
10
6
10
10
8
6
8
4
8
C
6;
4
6
6
6
4
6
6,
/
2
f 6
6
4
a
2'
700
24
24
20
14
IS
16
It
10
14
14
12
8
10
10
10
6
8
6
8
8'
6 •
4
8
S.
6
4
6
A
6
4 I
6
6
!
7.
230
26
24
22
16
70
16
16
10
1/
1/
12
B
12
10
10
10
8
6
10
8
B
1
( !
6
4
C
6
6
6
II
6
6
v
3
90.1
28
28
74
16
22
20
18
12
16
16
14
10
14
14
12
12
10
6
10
10
3
6
8
a
'8
1
8
8
6
41
E
a
6
t i
1,0.0
)0
70
25
1B
'2
20
20
11
18
18
16
10
11
/
8
12
17.
10
6
12
10
10
6
110
10
8
6
8
8
0
,4�
1.;00
.12
37
28
20
24
2!
22
14
TO
20
18
10
14
8
14
11
12
8
li
12
10
6
10
10
10
6
10
10
:,8
C.
1J
e
e
'•
1,200
34
32
30
22
26
26
22
16
22
20
1B
12
18
14
10
11
14
12
8
14
12
12
8
•12
12
10
6
10
70
B
6R
in
in
a
6 i
1,700
33
34
32
22
28
26
24
16
22
22
20
18
18
lc
10
1�
14
14
8
14
12
12
8
12
12
10
6
12
10
10
CI
10
10
F.
1,300
34
34
32
24
28
28
26
18
24
24
It
20
20
18
12
18
16
14
10
i4
14
li
8
14
14
12
6
12
1?
:G
CI
10
13
13
o
4
1,100
76
34
34
24
30
30
26
18
24
22
14
22
20
16
12
18
18
16
10
16
16
14
8
14
14
12
B
17
12
10
6i
IZ
l2
1:
i
u i
2,COJ
34
14
12
22
30
26
18
26
26
22
16
22
22
20
14 120
20
18
12
18
16
16
10
16
lE
i3
CI
1/
11
12
3 i
2,500
34
34
30
22
30
30
26
18
26
26
24
16
24
24
22.
14
22
22
18
:2
20
20
18
I:•
19
IS
16
!0
J,C-00
-
34
32
30
22
30
30
26
18
28
26
24
16 I24
24
22
14
22
22
20
14
!
•�
2J
1_
li i
3,500
32
32
30
20
30
30
26
ld
28
7/
16
26
t4
22
14!
�4
;a
20
14 '
4,000
_
32
32
30
I26
20 `30
30
26
18 '
28
:8
71
1f
26
25
2Z
IF
4,500
132
32
26
20
30
30
i6
It j
ib
.n
±s
;C ;
5.002
---'-
7217
tr
23
IJ
;J
76
1 i
A) 1. 3y` Concrete Slab: HC -8.93; R-.29; Factor•7.3
2. 3 7/4` thick Common Brick: IIC-7.125; R -.I3; Factor -7.3
8) 1. SVConcrete Slab: HC -11.106; 1-.451; Factor•7.1
C' 1. 8` Solid Filled Block: X0.20.63; R-1.9); Faro
r•6.1
2. 8` Solid Filled block With Both Sides Exposed To Conditioned Air.
NOTE: Use all square footage directly exposed to conditioned air
for Thernai'Mass Area: NC -10.164; R-.96;; Factor -6.1
0) 1` Thick Concrete/Tile: KC-2.SS; R-,083; Factor?3.7
Table 3-19. Zonally Controlled
Elcctrtc Resistance
Space Heating Points
I Points forthis reasurc w!li^j Table 3-20. Solar Water Heatinz With Cas Backus Points
( be completed after the CEC I
I has approved an Alternative I
Component Package for Resistance
I Beat.
Table 3-18. Active Solar puce
Heating wi Gas Points
I Net Solar Fra
ct I Points I
I (NSF), z n I I
I
61
0 1
I 1- 14
I +2 I
I is - 23
I +4 I
I 24 - 30
I +6 I
31 - 39
I +8 1
1 40 - 47
I ; +10 1
I 48 - 55
I F12 I
I 56 - 63
I +14 1
1 64 - 71
1 +18 L
1 72 up
I
I +20
1
wood stove $33 poinfsino back up)
casablanca fan + l.point
Multifamil (er unitpoints)
Floor Area
Net Solar Fraction (NSF), Z
per unit,
ft2.
I can only I
0 ;
Beat P.rap I
0
( Solar with Electric I
10,
i
I Meeting the Require- I
I
0.9
IC -i9
2C-29
30-39
2
50-59
60-69
70-79
6007799
0
+3
+7+14
+17
+21
+24
800-999
0
+3
+5
+8
+11
+14
+16
+19
1,000-1,499
0
+2
+6
+8
+10
+12
+14
1,500-1,999
0
+1
+3
+4
+6
+7
+8
+10
2X00 and u
0
+2
+4
+5
1 +6
+7
+9
All others (pe din points)
0-899
0
+5
SIU
+14
+19
+24
+:9
+34
0-9
[;0PI.499
0
+4
+9
+13
+17
+il
+26
+30
,199
0
+4
.1.7
+11
+15
4.19
+22
+26
0
+3
+6
+9
+12
+15
+18
+21
1,500-1,999
0
+2
+5
+7
1
+9
+12
+14
+16
2,000-3,999
0
42
+3
+5
47
+8
+10
+11
3,00.0 ar.d up
-0 1
+1
+3
+S
+5
+7
+8
+10
i
Table 3-21. Other dater Beating Pts.
I System Type 1
Points I
I I
I
I can only I
0 ;
Beat P.rap I
0
( Solar with Electric I
I Resistance 8atkup I
i
I Meeting the Require- I
I
I menti to Part 2 I
I
o t
I
I Eleecrtt Resistance I
I
I
Only
i I
I
RESIDENTIAL PLAN CHECKING GUIDE 7/85
'• (S.F. , DUPLEX & M SC.' GNLY)
/n �'j� &We Bldg. Permit �� - 6f4 --z3 �-007OWNER
id�t/LG S�i�j A.P. # y0' 8- /
GENERAL
a! .Zoning requirements: (sideyards. and number of permitted living units).
e Valuation.
Y�ians signed by designer.
4. Energy Design and Compliance.
Existing violations on property.
PLOT PLAN
Y Complete parcel size and dimensions.
�,Uther
tbacks, sideyards, easements, etc.
buildings or structures.
Grading, fills, drainage.
g! Flood hazard.
6.�Special conditions on creation map or compliance document.
FLOOR PLAN
I��Complete to scale plan with dimensions.
Required windows for light and ventilation (Sec. 1205).
Required windows for second exit (Sec. 1204).
&w" -Skylights (Chapter 34 & Sec;. 5207).
eHuman impact glass (Sec. 5406).'
&-JRroom sizes, ceiling heights (Sec. 1207).
.G F.C.I.'s in baths, garage and exterior outlets (Article 210-8).
Light fixtures, switches, receptacles, and exterior receptacles for maintenance of
echanical equipment..
Locations of water heater, heating and cooling equipment, other electrical or gas
-,,equipment, and plumbing fixtures.
1�rage firewall, door size, and closer (Sec. 503(d)(3)).
��L-- 3'0" exterior exit door (Sec. 3304(e)).
12! i'�nd wood stove location.
180" Smoke detectors (Sec. 1210).
STRUCTURAL DETAILS
Foundation plan complete enough -;':to construct building.
"2--TToor construction details complete enough::to construct building.
levations and wall construction details complete enough to construct building.
r.�Ro.o-f
construction details complete enough to construct building.
A-r,Xj place construction details and calcs if necessary.
Sufficient data and details to satisfy energy requirements (State Law) (Form 1).
MISCELLANEOUS ITEMS TO LOOK OUT FOR
t��i*
xrsure I plywood on exposed locations and overhangs.
�-airway details: landings, rise and run, head clearance, handrails (Sec. 3306).
t�G ardrail details (Sec. 1711 & 3306(j))..
ick or stone veneer (Chapter 30).
/Exterior plaster - weep screeds (Sec. 4706).
e! Proper roof pitch for roof covering (Chapter"32).
Rafter ties or bearing ridge beam.
RESIDENTIAL.PLAN CHECKING GUIDE (CONT'D) 7/85
MISCELLANEOUS ITEMS TO LOOK OUT FOR (CONT'D)
®! Garage door or porch header sizes. r
9-0""Adequate bracing.
10. Living area over garage - complete 1 -hour separation required on garage side •
including supporting walls and -posts, etc.
o exits on three-story dwellings (Sec. 3303 & see Mezannines 1716).
11 Attic access and ventilation (Sec. 3205).
i5. !U!Li%A!=rfloor access and ventilation (Sec. 2516).
ood stoves, clearances, al-cues-&-1-hou-rstrafts
l;—?'Combustion air for fuel burning appliances.
16-r—Noise requirements on duplexes.
1-?-.--Mbe soils - special foundation design.
1&-.--T�ef�aining walls requiring design.
usual shape, size or split level house requiring lateral design.
4
•
e
`
e
1 .
i
596-87B,P,E,M
f PERMIT NO.
7 � •
PERMIT EXPIRES
OWNER MARTHA &'BRUC E BERGSTROM
CONTR.
owner
7 /��
�• ASSESSOR PARCEL
40-48-13 _
i
LOCATION
10 Laguna Ct, CIriCo
Temp. Power Pole
{` Called PG&E
Temp. Elec. Service
Called PG&E
Temp. Gas Service
Cal led PG&E
JOB FINALE[
Signature
J- = OK' '
O = Not OK
- = Not Applicable MOBILEHOMES
* = Not Ready
_ MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
_
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/0 -Concrete
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; Location -Test -Easement Needed (Sketch)
_
4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG
6. Carports; Windows -Doors
7. Utility Clearance
_
7. Elec.
Card -BI
Date Card -BI Date
Card -B1
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except N's
1. Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
2. Soils; Compaction -Structure Stability
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining
4, Elec.; Receptacles and Lighting; Distances-GFI -
5. Drain; MH Test -Fall -Flex Connector.
5. Elec.; Pool Lighting; 15 volts-GFI _
6. Water; MH Test -Regulator -Connector
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Water and Sewer Connected -C/0 to Grade -HD Approval
7, Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater
8. Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
9. Health Department Approval
9. Exits; Insp.-Sketch.
10. Cert. of Occupancy
10. Plumb; Cir. Test -Water Supply Test
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
J = OK
0 = Not OK
- = Not Applicable
* = Not Ready
Date UNDERFLOOR (Plans) OK except #'s
t. Zoning requirements -Setbacks -Easements
2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
_ 3 Ftg., Garage; Soils -Steel- / /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
6. Ste_mwalls, Garage; Steel-Blockouts-Wrapped-Slab
7. Piers -Fireplace Fig. -Steel
8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
9. Gas Pipe; Size -Anchors
10. Water Pipe: Test -Anchors -Regulator -Service Test
11. Electric; Underground
12. Plenums & Ducts; Clearance -Material -Support -Ins.
13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card-BIDate Card -BI Date
Card -BI _ Date Card -BI Date
Date PLUMBING (Permit) OK except q's
14. Water Ht.: Vent -Access -Combustion Air
15. Water Pipe: Test & Anchors -Nail Protection
16. D.W.V.: Test-Fttngs & Anchors -Nail Protection
17. Shower Pan: Test, First Floor -Tub Access
18, Test Tub -& Shower, 2nd Floor -Tub Access
19. Gas Pipe: Size & Anchors
Card -BI Date Card -BI Date
Card -BI Date Card -BI Date
Date ELECTRICAL (Permit) OK except q's
20. Fixture & Transformer Clearance -Ins. Protection
21. Elec. Receptacles Spacing -Lights & Switches at Doors
22. Size Boxes & No. of Conductors -_Stapled _
23. Romex Installed Close to Edge of Studs& C.J.
24. Equip. Ground made up w/Mech. Fasteners_ -Bond Gas & Water
25. 2 Appliance Circuits in Kitchen &_Conductor Size
26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or A
27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral Yes ]No
28. Service -Riser Conductors & Ground -Main Disconnect _
29. Equip. Clearances: Panels-Motors-Mech. Equip.
30. Clothes Closet Light -Shower Light
Card B -I Date Card -Bi Date
Card B-1 Date Card -BI Date
RESIDENTIAL (Single and Duplex)
11 Date FRAMING (Contim
Date
MECHANICAL (Permit) OK except N's
Property Line Firewall & Openings
31.
A.C. Ducts. Insulation & Support
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
32.
Vent Fan: Exhaust above Insulation
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
33.
Condensate Drain & Overflow. Size Grade
_
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
34.
-&
Furnace -Vent, Access -Comb. Air -Return Air Vent -115V outlet
Siding -Nailing -Veneer
35.
_
Attic Access & Platform if Furnace in Attic
Card -Bl
Date Card -BI Date
Card -61
Date Card -BI Date
Date
FRAMING(Plans) OK except N's
36.
Sills, Proper Material & Anchors
37.
Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound
38.
Bearing Walls over Girders & Floor Nailing
39.
Draft Stop in Walls (rat proof)
40.
Fire Stops Furred Ceilings -Stairs -Chases -Tub -
FINAL (Plans) OK except q's
56. Ext. Steps -Door & Sidelight Protection -Landings
41
Header & Beam -Size & Bearing
Smoke Detector
42.
Hangers -Post Caps -Anchors -Connectors
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
43.
Ging. Joist-Rfir. Ties-Purlin-Roof Brac.-Truss-Shthnq.-Rfnq.
Bedroom Exiting
44.
Fireplace Ties or Type A Flue -Fireplace Throat
67. Garage Fire Door; Swing -Landing -Closer
68. A.C. Duct in Garage -Damper
69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
70, Plb., Elec. & Mech. Equip. Listed for Location
71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
72. Insulation -Foam -Looked in Attic ❑Yes
73. Guard Rails & Deck Construction -Post Caps
74. Fdn. Vents & Crawl !-tole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
75. Following instld.: Drive C Yes [I No: Walks [ Yes C No;
Planters El Yes 0 N
76. Stucco; Brown -Finish
_ 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
_ 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79. Water Well; Disconnect, Electrical, Plumbing
80. Exterior Elec. Trim; G.F.I. Receptacle -Underground
81. Ventilation throughout House
_ 82. Glass Protection _
83. Corrections from Previous Inspections
84. Gas Test -Meters Tagged; Gas -Electric
85. Water & Sewer Connected -C/O to Grade -HD Approval
86. Energy Compliance Certificate -Other Certificates
Card -BI Date Card -BI Date _
Card -BI Date Card -BI Date
Card -BI Date Card -BI Date
Com tents at Final:
45. Attic Access. Size & Romex Protection -Draft Stop -Ins. Baffles
46. Bdrm. Windows or Exiling Doors -Sill Hgl. & Dimensions
47. Garage Fire Protection Framing
(NOTE Anentrymust be made each time youvisit jobsite)
48.
Property Line Firewall & Openings
49.
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
50.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
51.
_
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
52.
Siding -Nailing -Veneer
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access_
54.
_
Glazing Area -Glass Protection -Skylights -Plastic
55.
Shear Walls; Nailing -Bolts
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FINAL (Plans) OK except q's
56. Ext. Steps -Door & Sidelight Protection -Landings
57.
Smoke Detector
58.
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
59.
Bedroom Exiting
60.
G.F.I. & Bath Fixtures & Tub Access
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
66.
Elec. Outlets & Receptacles at Kit. Counter
67. Garage Fire Door; Swing -Landing -Closer
68. A.C. Duct in Garage -Damper
69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
70, Plb., Elec. & Mech. Equip. Listed for Location
71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
72. Insulation -Foam -Looked in Attic ❑Yes
73. Guard Rails & Deck Construction -Post Caps
74. Fdn. Vents & Crawl !-tole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
75. Following instld.: Drive C Yes [I No: Walks [ Yes C No;
Planters El Yes 0 N
76. Stucco; Brown -Finish
_ 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
_ 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79. Water Well; Disconnect, Electrical, Plumbing
80. Exterior Elec. Trim; G.F.I. Receptacle -Underground
81. Ventilation throughout House
_ 82. Glass Protection _
83. Corrections from Previous Inspections
84. Gas Test -Meters Tagged; Gas -Electric
85. Water & Sewer Connected -C/O to Grade -HD Approval
86. Energy Compliance Certificate -Other Certificates
Card -BI Date Card -BI Date _
Card -BI Date Card -BI Date
Card -BI Date Card -BI Date
Com tents at Final:
45. Attic Access. Size & Romex Protection -Draft Stop -Ins. Baffles
46. Bdrm. Windows or Exiling Doors -Sill Hgl. & Dimensions
47. Garage Fire Protection Framing
(NOTE Anentrymust be made each time youvisit jobsite)
'BU
OROVILLE, CALIFORNIA
GENERAL CLAIM
CLAIMANT: "I I Aa llpE
ADDRESS: 10 La A u 11 a rt,
CITY & STATE: Lit 'G0 ". 9Sa6 IMPORTANT:
1p p
DATE OF CLAIM: 1 o $ SEE INSTRUCTIONSON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
die u u ` 'n e( M eeS AR '10-U-0
A�
y
TOTAL
1 I; the undersigned, declare under 8n penalty of perjury that the services or articles claimed have been performed or delivere ,end that this
claim is true and correct as stated. FF
Dated this � day of 19 0 etCali[.
................................
Signetur�f Claimant
I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de-
livered and that there is a Budget Appropriation or Specific Board Approval O (Check one) for the same.
t
• Dated this .... day of 19 at Calif.
} Department Head or Authorized Deputy
;Dept. Exp.
ICode............................................ Code ................................................PAYABLE FROM FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO.
INV. NO. INV. DATE
ENCUMB. GROSS AMT.
i�l
INSTRUCTIONS to CLAIMANTS
All claims against the county must be itemized, giving dates and
character of service rendered or work performed, quantities, de-
scription and unit prices of articles furnished or delivered.
Claims must be certified by the claimant and submitted to the De-
partment head for approval. Upon approval the Department head
will forward claim to County Auditor for payment procedure.. Do
not file with the County Auditor first.
Claims should be presented to officials for approval immediately
upon completion of services requested or material ordered.
Claims are paid every Tuesday; however, same must be approved by
officials and in Auditor's office before preceeding Wednesday noon.
Compliance with above will expedite payment of claim, failure to do
so may delay payment considerably.
I
AG
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