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040-630-005
7� W 0 ca W T 0 3 U 040-63-0-005 99-2788 BPal CROSBY, Ed 9444 Van Ness Way, Durham (new single family) TomN' �'Z 0E ,61 13. NOTES �r s 00/ oh ,SC RESIDENTIAL PERMITD� 040-63-0-005 - 99-2788 BPEM' CROSBY, Ed 9444 Van Ness Way, Durham (new sipgle family) Tom Nix il F/Q; fa /eces 11 SPECIAL CONDITIONS 11 CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY -.---- N6L.a per 14 H Q rrl- USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER OFFICE COPY Address GAS Meter By Date ELECTRIC 3�n,Eaip Meter By Date OFFICE COPY Address V � GASar�T- bb yy�� Meter By___&__'1_1t Date ELECTRIC Meter By Date JOB FINALED (Date) Signature - QK ` 0 = ,lot OK Date - = Not Applicable MOBILE HOMES = Not Ready Zoning Requirements -Setbacks -Easements Date MOBILE HOME UTILITIES (Plans) OK except #'s Footings; Soils -Size -Depth -Spacing -Connectors -Steel 1. Zoning Requirements -Setbacks -Easements 3. 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./ /'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. Zonino Rea uirements-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 F. 4- � .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; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Bea Ms- 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 FINAL (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, 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- Enclosure s-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 J = OK 0 = Not OK • = Not Ready Applicable �fv D RESIDENTIAL Date Underfloor (Plans) OK except #'s 47 Zon i ng -Setbacks- Ease ments-Flood-Slope Date t ., Main; Soils-Elec. ornd.-/ r Ftg. Depth 3Wftg., Garage; Soils-Steel-Elec. Grnd.-/ r Ftg. Depth g g., Porches & Decks; Soils•Steel-/ r Ftg. Depth 3-1§1. mwalls, Main; Steel-Blockouts-Wrapped Elec. Receptacles Spacing -Lights & Switches at Doors temwalls, Garage; Steel-Blockouts-Wrapped fp/Aold Downs and Special Anchors 7. 011ab, Steel -Wrapped ePi -Fireplace Ftg.-Steel 27. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. ULG3s Pipe; Sj rs - Yard Gas Piping; Size Test Appliance Circuits in Kitchen & Conductor Size GFI Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & D ts; Clear ce-M rial-Support•Ins. 14. Girders -S Is-Ancho olts-J st ant Cri s 15. Access & Ventilation 16. Insulation Date I I 1(jp Card B-1 Date Card B-1 Dat pp Card B-1 Date Card B-1 DatPLUMBING (Permit) OK except #'s 1 VWaier Htr.; Vent -Access -Combustion Air Baffle 1 r Pipe; Test & Anchor -Nail Protection 1 .V.; Test Fittings & Anchor -Nail Protection Shower Pan; Test, First Floor -Tub Access 9.1t --Test Tub & Shower, Second Floor -Tub Access 22 --Gas Pipe; Sixe & Anchors (Single & Duplex) Date FRAMING (Continued) 46 Date Date 47 and B-1 Date Card B-1 Card B-1 Date Card B-1 Date Fioplace Ties or Type A Flue -Fireplace Throat Clearance ELECTRICA (Permit) OK except #'s Atti "Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5 Fixture & Transformer Clearance -Ins. Protection rage Fire Protection Framing Elec. Receptacles Spacing -Lights & Switches at Doors Line Firewall & Openings 2 ize Boxes & No. of Conductors Stapled 26/Romex Installed Close to Edge of Studs & C.J. 27. Equip. Ground made up w/Mach Fasteners -Bond Gas & Water 28. Appliance Circuits in Kitchen & Conductor Size GFI 9. Subfeed Wire Size/7 / ga. Cu o - .C. Wire Size / / ga Cu or Al 30. Range Circle/ / ga Cu or AI -Oven Circ. / / ga Cu or At Insulated Neutral Q Yes C) No 31AService-Riser Conductors & Ground Main Disconnect 32. quip. Clearances Panels-Motors-Mech. Equip. 3 . lothes Closet Light -Shower Light -Spa Light 3' Smoke Detector Date Date U f_0.P9 Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date NJECHANICAL (Permit) OK except #'s 3 C. Ducts Insulation & Support 3 nt Fan, Exhaust above insulation 3 Condensate Drain & Overflow, Size & Grade 38,4urnace-Vent Access -Comb. Air -Return Air Vent 115 outlet 39. Attic Access & Platform if Furnace in Attic Date Zl G'� Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 4 Proper Materials & Anchors alts Studs -Nailing Spacing & Braces -Plates -Sound 4 aring Walls over Girders & Floor Nailing 4 raft Stop in Walls (rat proof) 44. Fi Stops, Furred Ceilings -Stairs -Chasers -Tubs 45. eaders & Beams -Size & Bearing (Single & Duplex) Date FRAMING (Continued) 46 angers -Post Caps -Anchors -Connectors 47 ling. Joist-Rttr. Ties- Purlin-Roll Brac.-Truss-Shting.-Ring. 48. Fioplace Ties or Type A Flue -Fireplace Throat Clearance 4 Atti "Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5 dr . Windows or Exiting Doors -Sill Ht. & Dimensions rage Fire Protection Framing 921"Property Line Firewall & Openings Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits c�►t3+r�1eic5; Width -Headroom -Rise -Run -Landing -Fire Protection 6� I od on Roof Overhang -Attic Vents -Rafter Outriggers iding-Nailing Veneer tucco Mesh -Drip Screed -Fd. Vents-Underflr. Access aaino Area -Glass Protection-Skvliahts-Plastic .y Lh /1040 W. Brace Interior/Exterior Wall Panels Cry r ' 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date it • Card B-1 Date Card B•1 Date Card B,1 Date Card B-1 Date / FINAL (Plans) OK except #'s Vents -clearance -Comb, Air -Connector - 9: Above Floor -Ducts -Mach. Protection F . & Bath Fixtures & Tub Access -Spa Elec. Trim & Subpanel, Breaker Sizes & Labels 7 irepla r Stove, Clearance -Hearth 71. EjOd'Out[pts at Wood Panel, Int. & Ext. Appliance; Ground -Air Gap -Cooking Clearance le utlets & Receptacles at Kit. Counter arage Fire Door; Swing -Landing -Closure Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. Above Floor -Mach. Protection A PI lec. & Mech. Equip. Listed for Location 7 . I eceptacles in Garage (F.F.I.)-Romex Protection 7 n ion -Foam -Looked in Attic Gu ails & Deck Construction -Post Caps dn. VBents & Crawl Hole Door Drainggr& Wood -Earth C ince Looked undo oorQf'Yesol— &--."'Fojmg Instld./Drive es J NoMalks Yes J No/Planters Q Yes logo St rown-Finish A. nit Disconnect, Electrical -Plumbing . ents Above Roof, Plbq-Appliance-Fireplace-Clearance to Openings Electrical, Plumbing xterior Elec. Trim, G.F.I. Receptacle -Underground i&4enfilation Throughout House G ss Protection Corr cti s from Previous Inspections V29 Ap. 91. st-Meters Tagged, Gas -Electric (711VIA & Sewer Connseted-C/O to Grade D o /Address Posted Date f p D Card B-1pig Date Card B-1 D tp IOd Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: INTER -DEPARTMENTAL MEMORANDUM TO: BUILDING DIVISION, OROVILLE FROM: C/ //L,- , ENVIR. HEALTH, CHICO DATE: RELEASE ENV. HEALTH HOLD ON BUILDING FINAL FOR: OWNER NAME: SEPTIC: l/ WELL: AP#: Q ADDRESS/LOCATION: Co 7-5 IJ44) /i/CS Comments: GL/memos/releaseho ld r +�kitCOUNTY 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 614 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 ontact this ffice immediately. r� ItIh0 fe u -✓ , r is � G .✓ � A ,e/ r/ A,g 1 ,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 ZIJ 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 he any questions pertaining to this matter, or need additional explanation, please contact this office immediately. 1 s f I -/ 0 Date i Inspector REV 10/92 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION r ' ' 7 County Center Drive Oroville, California 95965 • Telephone (530) 538-754 PERMIT o• (Rev. 12/96) APPLICATION AND PERMIT L q_ ASSESSOR PARCEL NUMBER 4--D—(�a - 0�—� ZONING BUILDING PERMIT ,,TU CROSBY TELEPMO �g 6 �a SO. FT. OCC. BUILDING VALUATION 2556 R 138 024.00 •OWNERS MAILING ADDRESS 53 7( U 13 554.00 CONTRACTOR'S NAME TOM NIX TELEPHONE 345-6178 277 COV�7 3.861.00 CONTRACTORS MAILING ADDRESS 720 CHURCHILL DR, CHICO, CA 95973 CONSTRUCTION LENDER Fireplace 0 1,500.00 LENDER'S MAILING ADDRESS Total valuation 1$156,934.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 839.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 545-35 BUILDING ADDRESS 9444 VAN NESS WAY, DUREAM Energy Plan Checking Fee $ 23.00 $ PERMIT FEE $ 1,427.35 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF SIX Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 15 7.00 105.00 Solar or heat pump water heater 23.00 Water piping 15.00 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New JR Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: 4 BEDROOM Gas piping system 1 - 5 outlets 15.00 15-00 Building sewer 15.00 119-0 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 0LE Main Service . ,g2.:: OR LESS 23.00 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 I force and effect. j Q License Class k5 Lic. NO. ✓ 'f'� V I 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. f3 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' cgm�ensation insurance carrier and policy number are: Carrier Policy Number Itoo (The above sections need not be completed 'rf 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 (2A�it �� Date 12/� Signature of Applican Owner Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. If Main Service 200A To 1000A 46.00NEW CONST. DWELLING OCCUP. O OR ADDNS. ( a ACC. BLDS. 3.50s�. NOµROe to MULTI.OUTLET 97.50 PSOr APPARATUS d SINGLE OUTLET CIR. 20 @ 100 EX. Occup. OUTLET OR FDCTURES BAIL @ .50 Ex. Occup. .FIX Ts g6lp ° 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 158.82 MECHANICAL PERMIT Fling Fee 20.00 Heating " O.00 Cooling ST 25.00 Hood 6.50 Ventilation , PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HAZ. IMP OD CDF I PARCEL PD D 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 ate EXPIRES ON , 2[ Ds Receipt No. 280664/b48PERMIT WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK- NSPECTO GOLD NROD-APPLICANT a'1-'COr%NTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 A,, PE"IT APPLICATION DATA SHEET OWNER: o S 4,4 . ASSESSOR PARCEL NUMBER: Proposed Building Use: 41el, j WkBuilding Inspector: &Z3, Date: yZ? gg At time of permit application, I wa advised the following data moat be submitted 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. ------ 03. Complete plans, 3/4 sets, signed by the preparer of plans. ❑4. 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. --------------------------------- 09. anufactured Home data and installation instructions including Tie Down Specifications.------------------ eesoi$----�-==3-��---------------------------------------------------------------- j s Impact fees as shown on the attached schedule. ----------------------------------------------------------------- California Department of Forestry plan approval/fees. --------------------------------------------------------- lood elevation certificate. ---A =-- �--a ------------------------------------------------------------------------ � g - Sanitation and plot plan approval eh c. 6L- Health Department. ------------------------------------------- :_7Z12_161 ❑ 15. City of Chico plumbing permit.----------------------------------------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. --------------------------------=------------- . Planning approval for (A) Use: O {�. (B) Parking: -------------------------- `2- ) - 718. Contact Land Development about Imprgvements; 11 Drainage, Legal Parcel. ----------------------- 1319. Encroachment Permit for driveway (construction approval prior to occupancy). ---------------------------- i 020. Pre -inspection for required Request to Building Inspector on (Date) a Contractor's license information.,(Number, Name Style, Classification). ------------------------------------ Workers' Compensation carrier and policy number. ----------------------------------------------------------- 023 - Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------------- ❑ er of signature authorization. -------------------------------------------------------------------------------- ecbrded copy of Agricultural Acknowledgment Statement. -------------------------------------------------- 26. Letter of intent on building use. ----------------------------------------------------------------------------------- ❑27. Manufactured Home utility clearance.---------------------------------------------------------- ------,____------ ' 028. Existing violations and/or expired permits.---------------------------------------------------------------------- s 9. 33 A, ❑Grant Deed, ❑ M.H. Title, 11 Check to H.C.D $ - --------------- Other: 'd 't,ut g f-o0a-20-91i---- � R£t�v � When you issue the permit, process as follows ❑ Mail to owner, ❑Mail to contractor. � � a Telephone and hold for pickup at i G D offr"ce �1 Deliv� with inspector. 898-08E7 k4r1E Applicant: Date:/ -3A� Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution D By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By; 1. Index permit application for the above items numbered: ;N Plan Check List 2. Additional items required: ontractor esi a wrier, was advised of the above required data by ❑ phone,)i�jnail, ❑ Building Division counter, by Date: ontrac esi wrier, was advised of the above required data byXphone V mail, ❑ Building Division counter, by Date: 1-1,1- Contractor,V!IIED owner, was advised of the above required data byWhone, ❑ mail, ❑ Building Division counter, by Date: -1-1(-- Contractor, designer,�erw advised of the above required data by ❑ phone, ❑ mail, ;kBuilding Division counter, by Date: j_- f 9 _0o Plans reviewed by: Date: Plans approved by: Date: 3 Sets of plans on hol ' 731?lan Cabinet, ❑ A.P. folder. Note transfer by: Date: f vo11-1 E.H. USE,ONLY Not Plan Attached 'V Z Floor Plan Attached Sent to TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance 30-0/K— OVO-,6 Owner Locati& AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well Clearance for dwelling Other 4 X/A�� 19 - Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist 'Date 8/96 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE CA 95965 TELEPHONE (916) 538-7541 SCHEDULE OF FEES DUE OWNER PROPOSED BUILDING USE GuJ S L( 1. &DING PERMIT FEES �r Balance Due ................ $� -- Additional Fees Due ........... $ -- Additional Fees Due ........... $ -- Revised Plan Checking Fee ....... $ • SCHOOL DISTRICT FEES, / `j 14?v I, (paid at District Office) SHERIFF FEES (paid at Building Division) _��6 Residential ........ x $360.00 = $ Units Commercial (sq.ft.)... x $0.03 = $ Sq. Ft. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit) . x = $ #Units Amt. Commercial (sq.ft.) .. x =$, Sq. Ft. Amt. RECREATION DISTRICT FEES (paid at District Office) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIItE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8WATER TENDER FEES (Battalion # ) 200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500:00 (paid at Building Division) 10. OTHER A.P. # DATE /,y9 /c' RECEIPT DATE REC I o� F I 'r W7, /. IffZ&A At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. t APPLICANT i { DATE I2 A r Pursuant to Government Code Section 66020, you are hereby notified that items 2,3,4,5,6,8,9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Div. 2nd Copy - Applicant 3rd Copy - Owner (Rev. 2/97) 4 «w4, BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District b LA (WA/\f\ Building Department No. A.P. Number Q 0 ' W t��p j' jurisdiction: = City County Property Owner � � C , o S e-1 A � / C Property Location/Address 9 5 y 4 VA AJ t4fss WAY Subdivision Residential Development No of Living Mobile Home Units _ Installation I Commercial/Industrial New Addition Building Department Representative Lot No. .................................................... :............................................................. Addition/ *Supplemental to Conversion Permit # ................................................................................................................. *(No foundation inspection) clans reviewea Dv scnooi uistnct rersonnerl District Identification No. CP O 9 Sq. Footage G'Sjrlp (Group R) •� Sq. Footage f (Including Exterior Roofed Areas) Date 3)V /?447" UNf r/ /� D School District certifies that {Applicant) 94�L 4 V nes uAtly (Street Address) (Phone Number) �>vle41-1Vm CA 9593 S (City) (State) (Zip Code) (/ has complied with the requirements of Resolution No. 9tp — by payment of $ 93 3• D b representing o� .`Jr6 square feet. AB 2926 $ FULL_MITIGATIORI _,{ School District Representative Paid by Check rr Remarks: TOM NO( C &5T)m �� r6s 01410-o Date Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act ICEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xis (10/98)dmm *5BUTTE COUNTY PARK FACILITY FEE PAYMENT CERTIFICATION FORM 01 DURHAM RECREATION AND,PARK DISTRICT Assessor Parcel Number (s): q0 - go- 06 t Property Owner (s):: P roject Locati6ri/Address:VA4 ("I WAY qqq Subdivison Name: `btA214Am GfZf_£d Type of Residential New Development Comments:- Y-- pment (check one): Assessable Square Footage: Z5 -5w Afteratioh/Addition Mobile Home (s) Building Division Representative U Non -Residential to Residential 12-21- 99 Date 6 Durham Recreation'and Park District (DRPD) certifies that Applicant Name. Applicant' one Number -7ZD C v,C 6111 LL D& Street Address co C4 9 � -973 Y. City State Zip Code has complied with the requirements of the Butte`County Board of Sbpervisors Resolution No. ! t 93 - 114 by payment for square feet at $ 1.04 per square foot for a total payment of $ DRPD 'Repregen'tativ-Dafb-' PAID' BY CHECK No.:. - Remarks - BANK No.: PAID,BYI'CASH: RECEIP,T'No.: DISTRIBUTION: WHITP_`- APPLICANT PINK-DRPD YELLOW - BUTTE CO. BUILDING DIVISION I • CJ GREGORY A. PEITZ ARCHITECT 383 RIO LINDO AVE., CHICO CA 95926 (530) 894-5719 1-11-00 Plan Check Response Plan no. 99-2788 L. Detail 6/5 shows A35's at 4' o.c. Revised calcs call for SSTB 16's. 2. See below. 3. See the attached report from Applied Testing. Per this report, the soil on site is native undisturbed soil • which meets the design requirements of the UBC for the use of conventional footing sizes. 4. See note on sheet 3 near site plan. STRUCTURAL COMMENTS Z Engineering has been provided. Note for certification is note 11 on sht. 3. Z' Detail 6/5 notes standard spacing. Detail 1/3 specifies spacing at line 3. Roof plan shows spacing at line B. Calcs revised to say SSTB 16. d Added on sheet 1. Noted on foundation plan. See p. 6 of calcs. and roof plan for strapping. 1 January 10, 2000 Tom Nix 720 Churchill Drive Chico, CA. 95973 I • Department of Development Ed Crosby Assessor Parcel Number: 040-180-061 pt. Building Permit Number: 99-2788 Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX Services This office reviewed the above referenced revised building plans. Please respond in writing to each comment by creating a response letter. Indicate which detail, specification, or calculation shows the requested information. Please be sure to include on the resubmittal the architect or engineer's "wet" stamp, signature, registration number and expiration date on all sheets of plans depicting the designed elements and cover sheets of calculations. Your complete and clear responses will expedite the re -check and approval of this project. Provide additional information and/or make revisions to plans, specifications and calculations as follows: 1. Structural calculations do not agree with the building plans in the following areas: y�. A-35 @ 4' o.c. on line 1 and line A are not shown on the building plans. SSTB20 are required on line A and line B and are shown as SSTB 16 are shown on the building plans. The Butte County engineer of record reviewed the building plans and listed six items on the following page. y Parcel Map requirements for the foundation design does not appear to be addressed in the structural calculations. Building plans must show how the structure will be built with flood resistant construction to the height shown on the flood elevation certificate. Plan review will continue upon receipt of the above items. Additional items may be required when plan review is resumed. Q)6.Sanitation and plot plan approval is required from the Butte County Environmental Health Department. -7'.""Provide Workers' Compensation policy number. -8' Durham Recreation and Park District approval is required for this project. Complete and return the enclosed Butte County Park Facility certification form. Complete and return the enclosed Butte County School Impact fee certification form. VSheriff fees = $360.00. 1 of 2 Jf. Balance of Building Ait fees = $1,258.32. 0 If you wish to discuss any requirements, you may contact me at (530) 538-7541 between the hours of 1:00 p.m. and 4:00 p.m., Monday through Friday. Sincerely, Glenn Gibbons Plans Examiner C.C. Gregory A. Peitz 2 of 2 .APN: 040-180-061-Ancheck Comments Crosby Residence The above referenced building plans were reviewed by this office. Please respond in writing to each comment by creating a response letter. Indicate which detail, specification, or calculations shows the requested information. Your complete and clear response will expedite the re -check and approval of this project. Please be sure to include on the re -submittal the engineer's "wet" stamp, signature, registration number and expiration date on all Sheets of the plans depicting the designed elements and cover Sheets of the calculations. Provide additional information and/or make revisions on plans, specifications and calculations as follows: 1. Provide engineering for any glue -laminated beams on this project. Also provide note stating that the glued -laminated fabrication shall be performed in an approved fabricator's shop in accordance with UBC 1701.7. Note should also indicate that glued -laminated beam inspection certificates shall be submitted to the field inspector prior to completion of the framing inspection in accordance with section 1704.6.2 of the 1997 UBC. 2. Provide note specifying the spacing of the A35 clips per the calculations. 3. Plans call for Simpson SSTB16's and calculations call for SSTB20's, please clarify. 4. Show shear wall and braced wall schedule on plan. 5. Specify anchor bolt spacing on the foundation plan. 6. Please clarify how 5'0" and 7'2" shear walls in wall line A work as one wall line. Add calculations for drag forces and details to tie the two walls together. December 21, 1999 Tom Nix 720 Churchill Drive Chico, CA. 95973 Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX Ed Crosby Assessor Parcel Number: 040-180-061 pt. Building Permit Number: 99-2788 This office reviewed the above referenced revised building plans. Please respond in writing to each comment by creating a response letter. Indicate which detail, specification, or calculation shows the requested information. Please be sure to include on the resubmittal the architect or engineer's "wet" stamp, signature, registration number and expiration date on all sheets of plans depicting the designed elements and cover sheets of calculations. Your complete and clear responses will expedite the re -check and approval of this project. Provide additional information and/or make revisions to plans, specifications and calculations as follows: 1. Provide shear wall and braced wall schedule on the building plans. 2. Parcel Map requirements for the foundation design does not appear to be addressed in the structural calculations. 3. Flood elevation certificate required. 4. Plan review will continue upon receipt of the above items. Additional items may be required when plan review is resumed. 5. Sanitation and plot plan approval is required from the Butte County Environmental Health Department. 6. Recorded copy of the Agricultural Acknowledgement Statement. 7. Provide Workers' Compensation policy number. 8. Durham Recreation and Park District approval is required for this project. Complete and return the enclosed Butte County Park Facility certification form. 9. Complete and return the enclosed Butte County School Impact fee certification form. 10. Sheriff fees = $360.00. 11. Balance of Building Permit fees = $1,258.32. 1 of 2 If you wish to discuss ar►oquirements, you may contact me at A 538-7541 between the hours of 1:00 p.m. and 4:00 p.m., Monday through Friday. Sincerely, Glenn Gibbons Plans Examiner C.C. Gregory A. Peitz 2 of 2 0 RESIDENTIAL PLAN REVIEW GUIDE SINGLE FAMILY, DUPLEX AND MISCELLANEOUS ONLY Owner: '(Lo 513 Building Permit Number: q — -7cg8 Plans Examiner: a A. P. Number: 0 y0 GENERAL: 1. Zoning requirements — (number of permitted living units). 2! Building permit valuation. ,2'*' Plans signed by the designer. A e" Proper description of work on the application. Existing violations on the property. Recorded notice of violation. PLOT PLAN: ,Y. Complete parcel size and dimensions. Setbacks, side yard, easements, etc. f Other buildings or structures. �c. Grading, fills and/or drainage. Flood hazard. Special conditions on Parcel Map (Noise, SRA, Fire Sprinklers, Water Tender, Traffic and Drainage fees). a! FAU & FAS road setback. 8� Building or utilities across lot lines (record form). FLOOR PLAN: . X Plans and specifications drawn to scale with dimensions and of sufficient clarity (Uniform Building Code section 106.3.3). 10% of natural light and 5% of ventilation (Uniform Building Code section 1203). �' Egress windows (Uniform Building Code section 310.4). Skylights (Uniform Building Code section 2409 & 2603.7). Glazing in Hazardous locations (Uniform Building Code section 2406). Required room sizes and ceiling heights (Uniform Building Code section 310.6). GFCI in baths, garage, kitchen, wet bar, and exterior receptacles (NEC 210). Prohibited locations of gas water heaters (Uniform Plumbing Code 509& 1213.5). Prohibited locations of gas heating equipment (Uniform Mechanical Code 304.5). 1r Garage firewall separation - required on garage side including supporting walls and posts (Uniform Building Code section 302.4 exception #3). 21. Wood stove location - Alcove clearance (UMC section 205 confined space & 223 unconfined space). 0 Smoke detectors (Uniform Building Code section 310.9.1). i4 -""Water closet clearances (Uniform Plumbing Code 408.5). 1X�Shower compartment minimum 1024 sq. in. & 30" circle (Uniform Plumbing Code 412.7). Page 1 of 2 STRUCTURAL DETAILS: _ Y Conventional construction — Unusually shaped buildings (Uniform Building Code section 2320.5.4). Standard bracing or engineered design (Uniform Building Code se6tion 2320.11.3). 5 cW�.`�44Lf .3! Clerestory requiring balloon framing and/or engineering. Three story building requiring engineered calculations and plans. Foundation plan complete enough to construct building. Aj> KW5 SOIL C OIY if V VIW ¢/ Floor construction details complete enough to construct building. Elevations and wall construction details complete enough to construct building. Y Roof construction details complete enough to construct building. 4'_ Rafter ties or bearing ridge beam. 1CFireplace construction details and calculations if necessary. lof Garage door header size(s). V1. Porch header size(s). 13' Stud heights. (P-'Expansive soil 4 special foun on esi equine J.5- Retaining walls requiring design. W'Special Inspection requirements. KHeader sizes. L. Gypsum wallboard nailing inspection required. SCELLANEOUS ITEMS: AY Stairway details — landings, rise and run, head clearance, handrails (Uniform Building Code section 1006). Guardrails (Uniform Building Code section 509). .3' Brick or stone veneer (Uniform Building Code section 1403). ,of' Exterior plaster — weep screeds (Uniform Building Code section 2506.5). 5- Roof pitch for roof covering (Uniform Building Code Table 15-B-1& 2, 15-D-1 & 2). �V- Roof covering type — (fire hazard). Foam insulation — protection. .8'." 36" halls and stairways (Uniform Building Code section 1004.3.3.2). A" Two exits on three — story dwellings (Uniform Building Code section 1004.2.3.2). ),0'Underfloor access and ventilation (Uniform Building Code section 2306.3 & 2306.7). jd!Attic access and ventilation (Uniform Building Code section 1505). 12! Combustion air for fuel burning appliances — LPG requirements. ]Sound requirements. 14. Energy design compliance and supporting documentation. k.5. Flashing at all exterior openings. 1� CDF responsible area requirements. k'r Building Permit requirements: L7' SRA. ® Flood elevation certificate. Fire Sprinklers required. 1K Special Inspection requirements. L7'S. Use Permit conditions. 17/ Sub-Standard Housing letter. 0 Page 2 of 2 0 JAN -04-00 09:36 AM ATC -APPLIED TESTING•. 530 891 4243 P.02 APPLIED TESTING CONSULTANTS January 03, 2000 Custom Homes P.O. Box 4679 Chico, CA 95927 Dear Tom Nix We have completed compaction testing on Lot #5 of the Durham Greens Subdivision in Durham, CA. Two nuclear density tests were performed within the lot where the proposed foundation will be located. Although neither test result met -the 90% relative compaction requirement, It did appear that the entire lot was within native undisturbed which is consistent with our compaction test results. It should be noted however that our office has no knowledge of the condition of the subdivision prior to our arrival (i.e. abandoned orchard). Attached is our test report indicating test locations, test depths and results. Should you have any further questions, please call. Sincerely yours, Mark Haydon Sr. Engineering Technician 3060 Thomtree Drive, Ste. 10 • Chico, CA 95973 • Telgphone: (530) 891-6625 Facelmlle: (530) 991-4243 JAN -04-00 09:36 AM ATC—APPLIED TESTING 530 891 4243 P.03 -- m APPLIED TESTING CONSULTANTS MATERIALS ENOINEERINO• TESTINO AND INSPEC71ON A^fim AR&T. NUcteer Uertlslly 1 te61111V r%cpwla ryr r%v I... Ilepert Seq• No. cent; Tom J, Nix Custom Homes Page; 1 or 1 ddreee: P.O. Box 4679 oea: 12/29199 Ky. autc Chico, CA 95927 Tech: M. Haydon Net: Tom Nix reject: Durham Greens Subdivision, Lot # 5 soilCesrripllon: Brown Clayey Sandy Silt Gauge a.. CALIBRATION DATA: Density Std.: Moisture gid Deneity xi : Molstur0 xi Compeaion Equipment' Req'd % Compaction Curve No : T-1 Meir Dry Density, 11 8.7 N RW Test M Depth Locet�on• Lot d 5 Elov. Density Density Do M0151. content; 13.E ry moisture Density Content Comp I�'h Reeulte 1 6" West Side of Building Pad FPO 118.2 18.7 100.5 18.6 87% FAIL T 6" o eae o ner o u n Pad FPO 112.4 15.9 96.5 16.5 63% FAIL Arrived at jobsits at 1045 hrs. to perform compaction testing of the Building Pad for Lot 05. Performed 2 nuclear density tests at random locations, as Indicated above. Both test results indicated less than 90% relative compaction. NOTE: Based on the above test results, and a visual inspection of the tested material along with the surrounding terrain, K Is our judgement that this pad lies on undisturbed native soil. Departed jobsite at 1130 hrs. oplee to: Reviewed M 3060Thomtree Drive, Ste. 10 • Chico, CA 95973 • Telephone: (530) 891-8825 Facsimile: (530) 891-4243 �la AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 1 999-0053334 Recorded Official Records County BUTTE f CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 11:29AN 27 -Dec -1999 REC FEE 10.00 COPIES 1.00 Maureen Page 1 of AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. 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 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 purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: PDate PROPERTY OWNERS: State of California ) 0�1 County of 13VT 6 ) '� 1�r1 tri e CY^OSb On g ! before me, ffA1e Y JT. 6iC(w�l� �JOTo9�e j/ �u b�i c personally appeared EDWA- p T, C1205 e y JAN) %fArH�/ZSNP 6, L'62CS13 `_personally known to me (or proved to me on the basis of satisfactory evidence) to be the persons) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature Seal: KARY J. BOWELL Cormwsslon t 1201170 Mfr CPS1 A.P. # Q�� ZW - Notary Public Butte county. Cdltomlo MY Conxn"on Exp. WV. E, 2002 r � � 11 -it ORDER NO. BU -177032 TB DESCRIPTION THE LAND REFERRED TO IN THIS REPORT IS SITUATED IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, AND IS DESCRIBED AS FOLLOWS: PARCEL I: LOT 5, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "DURHAM HOUSE PLANNED UNIT DEVELOPMENT - PHASE 2 AND LOT LINE ADJUSTMENT", WHICH MAP WAS RECORDED IN THE'OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON FEBRUARY 12, 1999, IN•BOOK 146 OF MAPS, AT PAGE(S) 66, 67 AND 68. EXCEPTING THEREFROM ALL OIL, GAS AND OTHER HYDROCARBONS AND MINERALS, AS RESERVED IN DEED RECORDED OCTOBER 27, 1939, IN BOOK 229, PAGE 338, OFFICIAL RECORDS. AP NO. 040-180-061-000 (A PORTION) THIS DEED IS MADE AND ACCEPTED UPON THE COVENANTS, CONDITIONS AND RESTRICTIONS AS SET FORTH IN THAT CERTAIN DECLARATION OF RESTRICTIONS RECORDED FEBRUARY 12, 1999, UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 99-06295, BUTTE COUNTY, CALIFORNIA; ALL OF WHICH ARE INCORPORATED HEREIN BY REFERENCE THERETO WITH THE SAME FORCE AND EFFECT AS THOUGH FULLY SET FORTH HEREIN AT LENGTH AND GRANTEES BY ACCEPTANCE OF THIS DEED APPROVE, ADOPT, RATIFY AND AGREE TO THE TERMS OF SAID DECLARATION. PARCEL II: A NON-EXCLUSIVE RIGHT AND EASEMENT OF ENJOYMENT IN AND TO COMMON AREA, INCLUDING INGRESS AND EGRESS OVER LOT A, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "DURHAM HOUSE PLANNED UNIT DEVELOPMENT - PHASE 2 AND LOT LINE ADJUSTMENT", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON FEBRUARY 12, 1999, IN BOOK 146 OF MAPS, AT PAGE(S) 66, 67 AND 68. PARCEL III- A NON-EXCLUSIVE RIGHT AND EASEMENT OF ENJOYMENT IN AND TO THE COMMON AREA, INCLUDING OPEN SPACE, RECREATIONAL PURPOSES AND DRAINAGE EASEMENTS OVER LOT B, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "DURHAM HOUSE PLANNED UNIT DEVELOPMENT - PHASE 2 AND LOT LINE ADJUSTMENT", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON FEBRUARY 12, 1999, IN BOOK 146 OF MAPS, AT PAGE(S) 66, 67 AND 68. ❑ APPROVED CONDITIONALLY APPROVED ❑ RESOLVE PROBLEMS PRIOR TO APPROVAL PERMIT CLEARANCE Permit #: C1'9 — 2`) (38 Genera/Information Owners Name: C fes' Owners Address: Building Site Address Date: )2= ) 1— 9 7 AP#: 090- 190 - Parcel Acreage: VA N N ESS w y. ]�y •e Ng >^.�. ProAertY Information Permit Type: ❑ Agriculture Building ❑ Commercial ❑ Industrial ❑ Mobile Home ® SFD ❑ Residential Accessory ❑ 2nd Dwelling ❑ Multi -Family >2 units per parcel ❑ Septic ❑ Well ❑ Other Zone District: General Plan: Use Permit: —P - Aft Date of Zoning Ordinance Development Agreement: Variance: Parcel Is In: Land Conservation Agreement a No ❑ Yes, check use Minimum Acreage: Nitrate Action Plan Iff No ❑ Yes Violation Area ® No ❑ Yes 10 --L& - 9`) Specific Plan ❑ No g� Yes ❑ Chico Iff D2N ❑ Cohasset Enterprise Zone B No ❑ Yes, check use ❑ No 11 Yes E Floodplain Zone: �"� . Watershed Protection Zone No F-1 Yes Proposed Use Complies With: General Plan M Zoning Proposed Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit Commercial/Industrial/Multi-Family Uses: Parking: ❑ Parking Requirements are,OK as Shown ❑ Other Landscaping: ❑ Landscaping Requirements are OK as Shown ❑ Other Road and Drainage Improvements Required:'. E] No ❑. Yes., Applicable Setbacks: Panel Number: D :S20 C--- ❑ Accessory Building use Zoning Code Street & Highways T Fire Prevention Subdivision Ma Front 2© P/L Side Side street Rear Height Environmental Health I .a• Septic Permit Review: Well Permit Review: Land Development Review: Parcel Created by: ❑ Deeds Date of Creation: Deed Reference: Permit clearance Agriculture Affidavit Required ❑ No ❑ Yes Designated Well Site ❑ No ❑ Yes Drainage Plan (Com/Ind/Multi) ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road Complies with County Standards for Deed Creation: Comments: Legal Access Provided: Legal Access Required: ❑ No ❑ Yes, Road Name: ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes Dv����ti--. fir✓ Grr-�1 S v►3 ® Map Date of Recording: Lot:# Book: Page: 5 Block: Conditions That Must be Met Prior to Issuance of Permit: ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Creation Deed ❑ Comply with condition no. of conditions of approval for the ❑ Obtain a Certificate of Compliance (See Planning Division for application). ❑ Construction across propertylines is not permitted (See Land Development for a Merger Application/Lot Line Adjustment). ❑ Comply with Old Subdivision Lot Ordinance (Maps Recorded Prior to Book 17 of Maps Page 23). ❑ Construct road to ❑ Other general Comments: ❑ Meet parcel size required by zone ❑ Meet current EHD requirements. t �( t- Y N th c L+ L-- 7 I "fv 13 E!5�- PF vt:E- L j b �- O M CAI L, oA/ �Ll�d l� Q (Z A C 1 oY4 t /, � � rc 1�7' ENGINEERED WOOD SYSTEMS Certificate -0-f Conformance Certificate 054060 THIS IS TO CERTIFY that the glued laminated timber products identified with a collective mark of Engineered Wood Systems (EWS) were manufactured in accordance with the applicable standards and associated specifications indicated below: ANSI Standard A190.1-1992, For Wood Products – Structural Glued Laminated Timber NER-486 Glued Laminated Timber•Combinations And "GAP" Computer Program For Determining Design Stresses AITC 117-93 – Manufacturing – Standard Specifications For Structural Glued Laminated Timber Of Softwood Species IT IS HEREBY CERTIFIED that the APA EWS trademarked structural glued laminated timber members were produced in a manufacturing facility subject to regular audits in accordance with the Engineered Wood Systems (EWS) Quality Assurance Program. Routine audits include inspection of the manufacturing process and evaluation of the in -plant QA program with adequate sampling to verify conformance to industry standards for lumber grade and glueline bond quality. 31V12- k13 �� �G9 0 0,04*,�, 0 Rq�, =?!` �i rnz L SEA• :Z- 3: so yi 11If �N GA %; by J A&,.T— Thomas G. Williamson Executive Vice President ENGINEERED WOOD SYSTEMS is a related corporation of APA —THE ENGINEERED WOOD ASSOCIATION. 7011 South 191h Street -P.O. Box 11700 -Tacoma, WA 96411-0700 ' Telephone: (253) 565-6600 - Fax Number: (253) 565-7265 CERTIFICATION OF INSULATION ADDRESS OR TRACT SACRAMENTO INSULATION CONTRACTORS _Tom 0 L)I4- LOT « ' ' ` ` {��� �� ��_/� ^ ^ W-\`1^` �I ,'V`V\ ❑ P.O. BOX 854, WEST SACRAMENTO, CA 95691 LIC. #202026 ❑ 1309 MELODY ROAD, MARYSVILLE, CA 95901 LIC. #202026 ❑ P.O. BOX 9651, FRESNO, CA 93793-9651 LIC. #202026 ❑ P.O. BOX 1631, RENO, NV 89505 LIC. #10675 ❑ 3326 A PONDEROSA WAY, LAS VEGAS, NV 89118 LIC. #10675 DATE INSULATION COMPLETED ( SQUARE FEET) ( SQUARF-FEET) ( SQUARE FEET) TYPE OF INSULATION TYPE OF INSULATION TYPE OF INSULATION MATERIAL FIBERGLASS MATERIAL FIBERGLASS MATERIAL FIBERGLASS FORM BATTS FORM BATTS & BLOW FORM BATTS MANUFACTURER'S PRODUCT I.D. MANUFACTURER'S PRODUCT I.D MANUFACTURER'S PRODUCT I.D. MANUFACTURER MANUFACTURER MANUFACTURER OCF OCF OCF BAGS R - VALUE INSTALLED APPLIED THICKNESS ___ R - VALUE INSTALLED APPLIED THICKNESS MIN. INSTALLED WEIGHT PER SQUARE FOOT R - VALUE INSTALLED APPLIED THICKNESS 3 1� k4 3141 Iq C�114 KNEE WALLS IF R -VALUE IS OTHER THAN WALLS ABOVE MATERIAL FIBERGLASS FORM BATTS . R VALUE MANUFACTURER OCF AIR INFILTRATION SEALANT MATERIAL MANUFACTURER W R GRACE THIS IS TO CERTIFY THAT INSULATION AND/OR SEALANT HAS BEEN INSTALLED IN CONFORMANCE WITH APPLICABLE CODES, MATERIAL STANDARDS AND REGULATIONS. • SIGNATURE -INSULATION CONTRACTOR TITLE MANAGER DATE SIGNATURE -GENERAL CONTRACTOR TITLE DATE REMARKS: SIC -303 BUILDER COPY