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Home My WebLink About042-160-071VA 42-16-71 PETER J. MERLO %r n D 2139 Sacramento Ave, C ico Perm -t#3246-86B P E M new, sin le fmi7 42-16 71 .,.Contr:. Guy.Stacy- /97 Permit#964-87P(lawm-sprinkler ystem) 0 0 NID PERMIT NO. 3246-86B3, P,E5M PERMIT EXPIRES 4 OWNER — PETER MERLO CONTR. owner ASSESSOR PARCEL 42-16-71 LOCATION 2139 W, Sacto Ave, Chico FFIE 613Y Address V GAS Meter By Date— I ELECTRIC , "SI . Meter By Date F Ft I C E'COPY Address GAS Meter By Date�2 t ELECTRIC t Meter By Date Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Ga! Calle JOB FINA Signa f E d= OK 0 = Not OK - = Not Applicable MOBILEHOMES MISCELLANEOUS * = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. IPlans) OK except N'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) 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 4• Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing _ 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 Card -BI Date Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -BI Card -BI Date Date 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 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GF1 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 -Enc losures- Pane Iboards- Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 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 V Lf OK 0 - Not OK = Not Applicable * Not Ready RESIDENTIAL (Single and Duplex) Date UNDE FLOOR Plans OK except #'s Date FRAING (Continued) Z�ning requir-3ments-Setbacks-Ea.e%entLI tea" -3/Ftg. Property Line Firewall &Openings -Main; Soils-Steel-Elec. Grn .- / VI" Ftg. Depth 49/0'E/. Doors -One 3' -Check Garage -3rd story, 2 exits 3,,Prg., Garage; Soils -Steel- / /" Fig. Depth lairs; Width -Headroom -Rise -Run -Landing -Fire Protection Porches & Decks; Soils -Steel- / /" Ftg„Depth lywood on Roof Overhang -Attic Vents -Rafter Outriggers (�q 5j,,i ails, Main; Steel-Blockouts-Wrapped-SI Siding -Nailing -Veneer - 6alls, Garage; Steel-Blockouts-Wrapped- ab 7.Fireplace Ftg.-Steel W.V.: Fall -Fittings -Test -2 way C/0 -Sewer Test . Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access _ ;lazing Area -Glass Protection -Skylights -Plastic Shear Walls; Nailing -Bolts Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums &_D_wts; Clearance -Material -Support -Ins. _ 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples (T �th Card -BI a Date '+ y Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date _ Card -BI Date1� /1, Card -BI Date Card -BI Date -/—` Card -BI Date Date FINlans) OK except H's Date PLJUMBING (Permit) OK except k's Steps -Door & Sidelight Protection -Landings Knoke Detector Card -BI Card -BI 111. Water Ht.: Vent -Access -Combustion Air 11�/y�ater Pipe: -est & Anchors -Nail Protection 1i"/,p W.V.: Test-Fttngs & Anchors -Nail Protection 1T hower Pan: Test, First Floor -Tub Access 1�/ est Tub & Shower, 2nd Floor -Tub Access 1 . Gas Pipe: Size & Anchors F'- Date � - Card -BI _ Date Date t� Card -BI Date Furnace; Vents -Clearance -Comb. Air-Connector- •B arage; Above Floor -Ducts -Meth. Protection . room Exiting 0, G .I. &Bath Fixtures &Tub Access Elec. Trim & Subpanel; Breaker Sizes -Labels irs &Rails ireplace or Stove; Clearances -Hearth lec. Outlets at Wood Panel; Int. & Ext. 5• it. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance lec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL(Permit) OK except q's jQarage Fire Door; Swing -Landing -Closer A.C. Duct in Garage -Damper Gard B -I Card B-1 _ . 20i Fixture & Transformer Clearance - Ins. Protection - 7Y,. Elec. Receptacles Spacing -Lights_& Switches at Doors Size Boxes & No. of Conductors -Stapled , Romex Installed Close to Edge of Studs & C.J. - 21 -Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 2Y/ 2 Appliance Circuits in Kitchen & Conductor Size 2�6,/Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI �j Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI, Insulated Neutral Yes 7 N - _ Service -Riser Conductors & Ground -Main Disconnect -cco; 0,1 Equip. Clearances: Panels-Motors-Mech. Equip. Clothes Closet Light -Shower Light - _ ----.---_-_-_— > 2 Date % Card -Bi Date �. a Date Card -BI Date - 6 tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- Garage; Above Floor-Mech. Protection b., Elec. & Mech. Equip. Listed for Location ec. Receptacles in Garage; (G.F.I.)-Romex Protec. Insulation -Foam -Looked in Attic E] Yes p ` Guard Rails &Deck Construction -Post Caps Fdn. Vents & Crawl !-tole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 75. Following instld.: D i No: Walks Yes [j No: Planters ❑Yes n-Fi ' 7 Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 760.1" Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opn 79. Water Well; Disconnect, Electrical, Plumbing` xterior Elec. Trim; G.F.I. Receptacle -Underground Vntilation throughout House Glass Protection Date MECHANICAL (Permit) OK except N's _ orrecti ns from Previous Inspections est -Meters Tagged; Gas -Electric Caro -BI Catd-BI A.C. Ducts. Insulation & Support Vent Fan: Exhaust above Insulation _ Condensate Drain & Overflow: Size _& Grade 377. Furnace -Vent: Access -Comb. Air -Return Air Vent -115V outlet 35, cceess & Platform if Furnace in Attic 5k Date ?t�Y ✓ Card -BI Date - _ - Date Card -BI Date wat r & Sewer Connected -C/O to Grade -HD Approval g ergy Compliance Certificate -Other Certificates - -- - - - - - - - --- — _ Card -BI Date �7 Card -BI Date Card -BI Oate Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except q's Com; tents at Final: A Sills, Proper Material & Anchors 3 /Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound 338' Bearing Walls over Girders & Floor Nailing 3�D aft Stop to Walls (rat proof) 40 Fire Stops: -Furred Ceilings -Stairs -Chases - Tub 4 ' Header & Beam -Size & Bearing ytangers-Post Caps -Anchors -Connectors 4 Ing. Joist-Rfir. Ties- Purlin -Roof Brac.-Truss-Shthnq.-Rfng. 4 1replace Ties or Type A Flue -Fireplace Throat .�Kitic Access: Size &Romex Protection -Draft Stop -Ins. Baffles 4�//Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Protection Framing _ -_- - - - ----__ - -- _- — -- -- - (NOTE Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 5344541 i Skyway and Elliott Road, Paradise -- Phone: 872-2961, Ext. 57 ,;.- �✓ CORRECTION NOTICE A11 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 explangAion, please contact this office immediately. I - Inspector_ _ Date Inter-Repartmentul Memorandum To� F ROM: SUBJECT: DATE: 12 - 1-7-8,6 Owner: Perms_ No' LOCATION ENERGY CERTIF ICAT I O N DESCRIPTION OF -INSULATION ROOF Material Thickness(inches) EXTERIOR WALL Material �Ar� Thickness(inches) CEILING Batt or Blanket Type_ Thickness(inches)^ Loose Fill Type Minimum Thicknesi(Inch(Es) Area coVered(ft. ) FLOOR, ELEVATED Material Thickness(inches) FLOOR, SLAB Material- Thickness(inches) Width(inches) FOUNDATION WALL Material Thickness(inches) A.P. No. Brand Name Thermal Resistance (R Value) Brand Name Thermal Resistance(R Value) � Brand Name— 11% Thermal Resist e(R Val Brand Name Number of Bags Wt. per t Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) Brand Name # Thermal Resistanc6(R Value) Brand Name Thermal Resistance(R Value) .I hereby certify that -the above insulation was installed in!the above building in conformance with the State of California Energy Requirements, Hawkins Insulation Co., Inc. 378407 FIRM NAME/OWNER STATE CONTRACTOR'S LICENSE NO. ez'k� k9r SIGNATURE OF I-NSTALLATION APPLICATOR DATE I hereby certify the above insulation and all required items as shown on the Building Department approved plans and attachments have been installed as required by the State of California Energy Requirements.._ All equipment, devices and materials are of the quality prescribed or are specifically approved by the State of California. FIR1� R ease int) STATE CONTRACTOR'S LICENSE NO. SIGNA F t1WRAL �0NTjA1ftVR16W1tEVVDATE n THIS.CERTIFIQATE.,MHST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. January 1984 COUNTY OF BUTTE - DEPARTMEN,T OF PUBLIC WORKS �- 7 County Center Drive - Oroville, California.95965 - Telephone 916/534-4541 7J APPLICATION AND PERMIT .ASSESSOR PARCEL NUMBER - a-- (0 �><-# N s ZONG BUILDIN PERMI OWN p�TELEPHONE o 'y ^y9�y S0. FT. OCC. BUILDING VALUATION SR o+' - OWNER'S -MAILING AD RESS I b �� r�►�' S tx CONTRACTOR' NAME TELEPHONE D ✓ ♦ �® CONTRACTOR'S MAILING ADDRESS Fireplace ' 0 0 0 n o CONST CTION LENDER 0�Filin UNKNOWN //�ll Total Valuation. $ p[ s 9 Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee a $ ARCHITECT OR ENGINEER A 14 LICENSE NO. Plan Checking Fee �D $ Energy Plan Checking Fee $ f,•00 ARCHITECT OR GIN ER'S MAILING ADDRESS b R 14. Penalty $ BUILDING ADDRESS Permit fee PLUMBING PERMIT Filing Fee 10.00 Each Trap /ZI 2,00 211,00 Solar or heat puinp water heater 20.00 LOT NO SUBDIVISION NAME ,//,, �v/ e,Z-- S PARCEL MAP / �� O� �f 1 Water piping 5.00 s,('$ Each qas water heater or vent 5,00 USE OF STRUCTURE SF-� Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5,00 Building sewer 5.00 �o Mobile Home S 10.00ea TYPE OF WORK NewX Addition❑ Remodel❑ Utilities[] Installation❑ Other❑ Describe work: ��ryn _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 `p,v� Main se'cMA 100 AMP 2.50 oi,S'b CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,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 NEAC OR ADDNS. C. B .=U c T. IL tr) '/z¢sgf NEW CONST It NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR, Ex. Occup(OUTLETS OR FIXTURES 2AL@ eLa30 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 Permit Fee Contractor $ en WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating 60 0oO 6 T (_ Cooling 9 b•V� Hood 3.00 ,�tU Ventilation Permit Fee $ 00 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 liabilities, judgments, costs, and expenses which may in any way accrue again s id Cty in consequ nce of the granting of this perm't. X Date —/ U Signature of A Kant — Owner Contractor ❑ Agent ❑ An OSHA permit is required For excavations over Y deep and demol'tion or construct- ion of structures over 3 stories in heig t. Mobile Home Installation Fee $ Energy Inspection Fee $ �� TOTAL PERMIT FEE $ OCCUP. 3 CONST TYPEJ � JF7J_P^7all This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTO"F PUBLIC By PER IZEXPIRES Date the applicable provi- resolutions to do fees have been pai•d:-- WORKS Date Z c� Receipt No. J� cs WHITE-D.P.W., TELLOW-ASSESSOR, PI R-IN9PECT0 OLDENROD-APPL CANT e COUNTY OF BUT - DEPARTMENT OF�PUB IC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, C*L''IFORNIA 95965 -TELEPHONE: 916/534-4541 PERMIT- APPLICATION DATA SHEET OWNER Proposed Building Use `( Building liispector� Permit No. At time of permit application, I was advised the following data must be submitted prior to permit processing and:/or issuance: DATE RECC,EINiEp! 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 "Fees Paid" Stamp on Floor Plan . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . 9. Letter of signature authorization. Oq 0. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (GiveA to owner [I, Mail to owner ❑•), _15."'°Improvements may be required. . . . . , . , , , , , 16. Mobilehome Installation Data. . . . . . . . . . �,1aPre-Inspec.: Pre -Inspection for Required. Building Insrequest to (Date) pector Recorded copy of Agricultural Acknowledge S to ent. �j�- 9 Driveway Permit. _ I la 61 E to -►-�""' 20. Plot plan approval from city of 21. i. 22. Whenryou issue the permit, process as follows: VMail to owner, Mail to contractor. Telephone and hold for pickup at office, Deliver w/inspector. 111L�.. Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2, Additional items required: fo Contractor, designer, owner, was advised of above required data by_phone--nail—counter by „,,dto Contractor, designer, owner, was advised of above required data by—phone _mall_countor--by Plans checked by PAS Date AW-0lans approved by 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: Environmental Health, Chico SUBJECT: Sanitation Clearance (46 Owner Location APS LDP4 Plan approved for. sewage disposal C/ water supply t,— Hold /Hold final for: water supply Final clearance O.K. for: water supply I1� Clearance forbedroom mobile home. Other - Note*** I Sanitarian /g- 8,6 Date 8 6- 3 8 7 8 7 ;i7Eu sA OF11LA L i'CORDS • OF BUTTE COUNTY, CALIFORNIA AT THE REQUEST OF 1986 OCT 30 PM 1: 18 ELEANOR M. BECKM CLERK -RECORDER FEE - 86 -38787 Pages Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort arising from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: LEGAL DESCRIPTION ATTACHED HEREIN AND MADE A PART HEREOF , Date: October 29, 1986 PR RTY OWNERS: Peter Merlo State of California ) On this the 29th day of October 1986 before SS. me, the undersigned Notary Public, personally appeared County of Butte ) Peter J. Merlo Personally known to me. / Proved to me on the basis of satisfactory evidence. to be the person(s) whose names) is, subscribed to the within instrument and acknowledged that he executed the same for the purposes theiein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. lop Notary ss0 is Present A.P..No. �y Z - /(Q _-5(0 L wy s BARBARA I. REDWAY i NOTARY PUBLIC -CALIFORNIA a ■ Butte County My Commission Expires May 26,1990 ■ ®OHO■ 130 a an0Elaa12aaa®a®®e 0ap 86-38787 LEGAL DESCRIPTION M Being a portion of Lots 27, 28, 29, and 30 according to that certain - Map of,the Second Subdivision of the John Bidwell Rancho, near Chico, filed with the recorder of the County of Butte, on September 17, 1900 in Volume "5" of Maps, at page 27, more particularly described as follows: Parcels 2, 3, and 4, as shown on that certain Parcel Map recorded in the office of the Recorder of.the County of Butte, State of California,. on October 30, 1973, in Book 48 of Maps, at page 27. EXCEPTING THEREFROM 5040' of all minerals and mineral rights as reserved in Deed recorded April 1, 1963, in Book 1236 of Official Records, at page 153. Excepting any portion of the above described property lying within the bed of the Big Chico Creek below the line of natural ordinary high water and also excepting any artificial accretions to said land water - ward of said line of natural high water. END OF DOCUMENT RESIDENTIAL ENERGY PLAN CHECK/INSPECTION SUMMARY FORM � Owner E D Climate Zone Permit No. Floor Area IM T_,,..,,,� Compliance path: Package ❑ A ❑ B 11C 04 oint System ❑ Budget ❑ Other MIN R -VALUE DESCRIPTION REQ'D INSTALLED ITr (1) INSULATION: �// Roof/Ceiling (]' Wall ❑ 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 I ki Lb [J North lig 1.S �— j East 30' (g/ South —V Cf West —T7 ❑ Skylights (B) Shading Shading Coefficient Description East LAP / South, West ❑ Skylights ❑ (C) South Overhang Length of projection ft. Description ❑ (D) Moveable insulation: Area ft2 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.2 HC= R= MC= Location ❑ Type - Area —Ft.z HC= R= MC= Location 7/83 FORM ❑ (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, VENTIIATING, AIR CONDITIONING SYSTEM / (A) Heating ! (g/ Central Gas Furnace �k W (brand and model number) Btu/hr (heating capacity) Heat Pump _ (brand and model number) Btu/hr (heating capacity at 47°F) Active Solar -71 % SE ACOP type (liquid or air) Collector brand and ft2 model number solar fraction collector area , collector T' � f orientation collector tilt rated y -intercept FORM ❑ (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, VENTIIATING, AIR CONDITIONING SYSTEM / (A) Heating ! (g/ Central Gas Furnace �k W (brand and model number) Btu/hr (heating capacity) Heat Pump _ (brand and model number) Btu/hr (heating capacity at 47°F) Active Solar -71 % 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 ';�'(bU (� Other _ _wwn (Z (describe) r 1 (B) Cooling c� C) L7 Electric Air Conditioner (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 *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 12400 ', heating load A U6BTU elevation factor _�_ x heating load = maximum outlet capacity gas furnace BTU Cooling: Summer design temperature 107,1 °, cooling load 114400 BTU (USE ONLY AS A SIZING GUIDE, COOLING MAY BE INADEQUATE) *2 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 SIGNATURE OF BUILDING DESIGNER OR APPLICANT W w ?N^ (6) DOMESTIC WATER SYSTEM ((� (A) Gas Only Gallons (brand and model number) (tank size) ❑ Heat Pump w/Electric Backup (brand and model number) o 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. —/ [� (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 12400 ', heating load A U6BTU elevation factor _�_ x heating load = maximum outlet capacity gas furnace BTU Cooling: Summer design temperature 107,1 °, cooling load 114400 BTU (USE ONLY AS A SIZING GUIDE, COOLING MAY BE INADEQUATE) *2 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 SIGNATURE OF BUILDING DESIGNER OR APPLICANT W ZONE 11 I I Orten- OWNER * ( �� POINTS. PERMIT N0. ASSIGNED ACTUAL I 1 0-3.1 1 to 16.4 up I I 1. SLAB - INSULATION - 0 ( +1 I +2 I 2. P.AISED FLOOR.- R-19 0110 I 1t ( .37-.66 1 3. CEILING - R-30 3 b• o 0 1 0 ! -1 4. WALL - R-19 11 • d =� j 5. NORTH GLAZING - 2.413.6% to I to I' to I to I up 6. EAST GLAZING - 2.5-3.6% 0 1 +1 I +2 I +2 1 +3 SOUTH GLAZING - 1.6-3.6% •� v � Z 7. ' V� 4,(v 8. WEST GLAZING - 2.9-3.6% I 9. SKYLIGHT - 0-1.3% WA c 10. SHADING (Exclude Overhang) .13-.36 1 EAST - .66 . LAP � SOUTH - .19-.42 (j .83 up I I WEST - _- .13-.36 .SKYLIGHT - .37-.57 1 11. HORIZONTAL SOUTH OVERHANG 2' ( 7 1_5 ( 3.1 ( 5-x 1 5.2 12. MOVABLE INSULATION - NONE 0 1 +1 I +3 I +6 I +7 13. INFILTRATION (Standard=0)(Tight=+12) 1✓ 14. THERMAL MASS SF .58-.82 .I 15. GAS FURNACE (SE) 71-76% 16. HEAT PU11P (EER) 7.5-7.9% 17. DUAL PACK (SE, SEER) 8.0-8.3/71-76% WOOD STOVE (AS _ WATER HEATER ATTIC lbb . % + 3 OTHER C E l LMA MAI TOTAL POINTS = q Table 3-1. Slab Floor Points Table 3-2. Raised Floor Points I In:•jls- I R -Value of Insulation ! I R -Value of 1 I tiun I I I Insulation I Points I Depth, 1 i Inches 10-2 1 3-4 1 5-6 1' 7+ I I I 1 1 1 I I below 3 I -12 1 3-4 I -8 1 0-1t1-5 1-5 I-3 1-5 1 1 3-7 i -6 1 12 - 15 1 -5 1 -3 1 -2 1 -1 1 I 8 - 12 ( -4' I 16 - 19 1 -5 1 -2 I -1 1 0 I I 13 - 18 ( 4 I 20 + 1 -3 1 -1 1 0 1 +1 I I -19+ I ' 0 7/7/83 Table 3-3a. Ceiling Insulation R -Value of Insulation I Points 19 I -4 30✓I 0 38 I +2 49 I +4 Table 3-4a. Wall Insulation Point I R -Value of Insulation I Pointe . I I 11 �� ✓ i -7 I 19 1 0 I 24 I +2 L 30 i +3 Table 3-S. North -Facing Glazing P1 T __ T I I Glazing Type I Total i I 2 of ST, Dbl, Irpl, I Floor l u- I U- I U- I Area 10.66 ! 0.42- ! 0.41 ( 1 1.10 10.65 ! dovn O ♦1 +1 +1 1 0.1- 1.2 1 +4 ! +4 1 1.3- 2.3 ! +1 I +2 ! +2 i 2.4- 3.6 I -2 I 0 ( +1 3.7- 4.8 I -4 I -2 I -1 1 4.9- 6.1 ( -7 I -4 jr -3 1 6.2- 7.3 I -9 ! -6 J -S 1 7.4- 8.2 I -12 ! -8.-, -7 I 8.3- 9.7 ! -14 ! -10 I -8 I 9.8-10.8 ! -17 ! -12 I -10 - 110.9-12.0 I -19 I -14 I -12 112.1-13.2 1 -22 ! -16 I -13 113.3-14.5 ! -24 ! -18 1 -15 114.6-15.3 I -2i I -20 I -17 ing Cl zine Pte Table 3-10. Shading Coefficient Points I I Glazing Type I I Total 1 I 2 of ( Sngl, I Dbl, Trpl, I Floor I (U - I (U - I (U - I 1 Area 11.10) 10.65) 1 0.41)1 ( (pointe (points Ipointsl I I up to 1.5 I +2 1 +2 I +2 I I I 1.6- 3.6 I -4 1 ,I 2 � I 3.7- 3.2 1 -4 ! -2 2 - I 5.3- 6.5 I -6 1 -4 I -3 1 I 6.6- 7.7 I -9 1 -6 I =S I I 7.8- 8.9 I -11 1 -8 ( -7 I I 9.0-10.0 I -13 1 -10 .I -9 I 1 10.1-11.5 I -17 I -13 I -11 I T 1 11.6-13.0 1 -21 I =16 I -14 I i 113.1-14.5 I -25 I -19 I -16 I. 14.6-16.0 i -28 i -22 1 -19 ( Table 3-8. West -Facing Glazing Pts. I I Glazing Type 1 I Total I I I 2 of I Sngl, I Dbl, rTrpl, I Floor I (U - I (U - I (U - I I Area 1 1.10) 10.65) 1 0.41)1 r I Points i oints I ointsl o +i +6 +46 I up to 1.3 I +5 I +6 I +6 I 1 1.4- 2.2 1 +3 ! +4 1 +5 I I 2.S- 2.8 I 0 1 +2 1 +3 I I 2.9- 3.6 1 -3 I 0 1 +1 1 1 3.7- 4.2 I -5 I -2 I 0 1 I 4.3- 5.0 I -8 ! -4 I -2 I I 5.1- 5.6 1 -10 I -6 I -4 I 5.7- 6.2 1 -13 I -8 I -6 I 1 6.3- 6.9 I -15 I -10 1 -7 I 7.0- 7.6 I -18 1 -12 ! -9 1 ( 7.7- 8.2 ( -20 I -14 i -11 i I 8.3- 8.8 i -22 I -16 I -13 I ( 8.9- 9.5 1 -25 I -18 I -15 I I 9.6-10.1 1 -27 I -20 I -16 1 110.2-11.0 I -29 1 -23 1 -17 1 1 11.1-11.8 I -35 I -26 I -21 I 1 11.9-12.7 1 -38 I -29 I -24' ! 112.8-13.5 I -42 1 -32 1 -27 ! 13.6-14.3 I' -46 I -35 1 -29 I 114.4-15.2 I -50 I -38 I -32 1 I I I I 1 Table 3-9. Skvlleht Points Table 3-6. East -Facing Glazing Pts. I Glazing Type I I ' Glazing Type I ! Total I 1 -1 Total I I 1 2 of Sngl, Dbl, Trpl, I 2 of I sngl, bbl, Trpl, I Floor I U- l U - I U- I I Floor I (U - I (U - I (U - I I Area 10.66- 10.42- 1 0.41 I 1 Area 1 1.10) 1 0.65).1 0.41)1 1 1 1.10 1 0.65 1 down I I I1p ol4 I olnts ! ointsl I D I +1 +1 1 V4 I up to 1-] I -1 1 0 1 0 1 I up to 1.3 1 +3 I +4 +4 1 1 1.4- 2.2 1 -3 1 -2 1 -1 1 I 1.6- 2.4 I +1 1 +2.4 +2 1 I 2.3- 2.8 1 -6 1 -4 I -3 I I 2.5- 3.6 1 -2 I 0 1 0 1 1 2.9- 3.6 1 -9 1 -6 I -5 1 I 3.7- 4.6 I -5 I -2 1 -1 i 1 3.7- 4.2 1 -11 1 -8 I -6 I ( 4.7- 5.6 I -8 ( -4 1 -3 I I 4.3- 5.0 1 -14 1 -10 I -8 1 5.7- 6.7 I -10 I -6•.1 -5 I I 5.1- 5.6 1 -16 I -12 I -10 I I 6.8- 7.7 i -13 I -8 1 -7 I I 5.7- 6.2 1 -19 1 -14 I -12 I 1 7.8- 8.7 I -15 I -10 1 -Q I I 6.3- 6.9 I -21 1 -16 I -13 I I 8.8- 9.7 I -17 I -12 1 -10 1 1 7.0- 7.6 1 -24 ( -13 I -15 I I 9.8-11.2 I -21 I -15 1 -13 1 1 7.7- 8.2 I -26 I -20 I -17 I 111.3-1I.7 I -25 ( -18 •1 -15 1 1 8.3- 8.8 I -28 I -22 I -19 I 1 12.8-14.0 1 -28 _) -21 I -18 i i 8.9- 9.5 I -31 1 -24 1 -21 I 14.1-15.3 1 -32 I -24 I -20 I I 9.6-10.1 I -33 1 -26 1 =22 I ( SC by I I Orten- I 1 Floor Area tation 6 I East I I 3.2 I I 1 0-3.1 1 to 16.4 up I I 6.3 I ' I 0 -.19 1 0 ( +1 I +2 I .20-.36 I 0110 I 1t ( .37-.66 1 Ow -1 0 I 0 I .67-.82 I 0 1 0 ! -1 .83 up i 0 i -1 i -2 I South 1 0 1 3.2 1 6.4 18:0 1 9.6 i I to I to I' to I to I up 13.1 16.3 17.9 19.5 I I 0--18 1 0 1 +1 I +2 I +2 1 +3 I .19-.42 1 0 01 0 1 0 1 0 I .43-.66 1 0 I -� 2 1 T2 -3 I .67 up 1 ' .i 0 1 -2 I -4 1 -4 I -6 West I .1 11.6 1 3.2 16.4 18.0 I to I to I to 1 to I up 1.5 i 3.1 i 6.3 i 7.9 0-.12 1 0 1 +1 1 +3 1 +6 1 +7 .13-.36 1 0 1 0 1 0 1 0 1 0 .37-.57 I 0 I/`1 1 -3 I -6 ! -7 .58-.82 1 -1K -3 ! -6 I -12 I -15 .83 up I I -2 I -4 I -8 I :-16,1 -20 I I I 1 Skylight i .1 1 .8 11.6 13.2 14.6 1 to I to I to 1• to i to ( 7 1_5 ( 3.1 ( 5-x 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 1- .58-.82 .I -1 I -3 I -6 1 -12 1 -a .83 up I -2 I -4 I -8 1 -16 ( -20 I I I I I Table 3-11. Horizontal South Overhane Points South Glazing Length Out i Area, I of Floor I I from Wall I I I ft r 0-6.3 i 6.4 up 0 - 0.5 1 -2 1 - 10.6 - 1.0 I -2 I -3 I 11 2.0 uo9�l 0 I o I Table 3-12. Movable Insulation Moveable Insulatioo'I 1 Area, S of Floor I Points I 1 0- 5.5 I 0 I I 5.6 - 11.5 I +2 I I 11.6 - 17.5 I +4 I I 17.6 -23.5 I +6 ! I `23.6+ i +8 I - Table 3-13. Lnf!lttatlon Control rtAtvres Points ; I Coctrol Features I Points Standard 1 0 0.9 air changes per hr Tight 1 +12 1 0.6 air changes per hr Table 3-15. Cas Furn*ce Without Refrigeration Ccol!n.e Points Seasonal Efficiency I Points (SE), L 1 71 - 76 I 0 77 - 82 I +2 83-88 I +4 89 - 94 I +6 95 up 1 +8 Tablel3-16. Heat Pumo Points I Energy Efficiency I Pal -its I I Ratio (EER) I I I I 7.5 - 7.9 I +3 I I 3.0 - 8.3 I +6 I I 8.4 - 3.7 1 +9 1 I 8.8 - 9.1 1 +12 1 I 9.2 - 9.6 I +15 1 9.7 - 10.2 1 +18 I I 10.3 - 10.8 1 +21 I I 10.9 - 11.5 I +24 1 11.5 - 12.3 I +27 I 1 12.4 - I 13.2 I +30 I I Table 3-17. Can Furnace With Refrlveration Cooling Points T- IRefrigeracionl Gas Furnace I I Cooling I SE + I 8.0 - 8.3 1 01 +21 +•4I +61 +8 1 8.4 - 8.7 1 +21 +41 +61 +91+10 1 8.8 - 9.2 1 W +61 +81+101+12 1 9.: - 9.7 1 +61 +81+101-121+14 1 9.8 - 10.3 I +31+101+121+141+16 1 10.4 - 10.9 1+1G1+L2i+141+161+19 1 11.0 - 11.6 1+111+141+1614.181+-c0 1 7/7/83 TAELE 3-14 (ADAPTED) 4ASS AREA 1,000 SQ. FT. , A 8 C 1.500 1 2,000 t C D A 8 C ZONE 11 INTEND OR THERRAL MASS POINTS 2,500 3,000 . I 3,500 1 B C D A a C 01 A B C 1,000 I I,SGO S,000 _ 1 I C 0 1 A 6 C 0 a t -C-- SO 50 2 2 2 2 2 2 2 0 j 2 2 2 0 1 0 0 0 0 0 0 O 0 0 0 0• 0 0 0 0 0 0 0 0 01 0, a 0 0 1 !00. 4 4 4 2 2 2 2 2 2 2 2 2 2 2 2 0 2 2 2- 0 2 2 0 0 2 2 0 0 2 2 0 0. 0 0 0 0 1 ISO 6 L 6 4 4 4 4 2 2 •2 2 2 2 2 2 2 2 t 2 +2 2 2 -2 2 2 2 2 t 2 -t 2 0 Z 2 2 0 200 8 8 6 4 6 6 4 2 4 4 4 2 4 4 2 2 2 2 .2 2 2 .2 2 •Z 2 2 2 t 2 t 2 2 2 7 •, 250 10 10 8 6 6 6 6 4 6 6 4 2 4 4 4 2 4 4 2 2 2 2r 2 '2 r2 2 2 2 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 2 2 2 2 t. 2 2 2 t 2. t 2 2 350 14 14 12 8 10 10 8 6 6 6 6 4 6 6 6 2 6 4 1 2 4 4 4 2 4 4 2 2 4 4 2 7 2 2 1 2 400 14 14 12 8 10 10 8 6 8 8 6 4 6 6 4 4 6• 6 4� 2 4 4 t 2 4 1 1 2 4 4 2 2 4 4 t 2 $03 IS 18 16 10 12 12 10 6 10 10 a 6 R 8 6 4 6 6 6 4 6 6 6 2 6 6 1 2 4 4 4 2 600 22 20 18 12 14 14 12 8 12 12 10 6 10 10 8 6 8 8 6 +4 8 C 6 4 6 6 6 4 6 6 4 2I 6 6 4 2 1 790 1 24 24 20 14 18 16 19 10 14 14 12, 8 10 10 10 6 10 10 8 6 a e 6 4 a 6. 6 4 6 A 6 41 6 6 a ). 270 26 24 22 16 70 16 16 10 14 14 12 8 12 10 10 6 10 10 0 6 10 R a 4 I! 6 6 4 a t 6 1 6 6 6 a 1 900 <-8 28 74 16 22 20 18 12 16 16 14 10 14 14 12 8 12 12 10 6 10 10 3 6 I a a '8 4 a 6 6 11 E a 6 t i 1.000 30 JO 26 16 '2 20 20 14 18 18 16 10 14 11 12 8 12 12 10 6 12 10 10 6 10 t0 0 6 8 8 0 4I ^ a E 4 i I,;OU .1± 3T. 28 20 tt 2! 22 14 20 20 18 10 16 16 14 8 1/ 14 12 _ i8. It 12 10 6 10 10 10 6 10 10 a F lJ a es 1,200 34 32 30 22 26 26 22 16 22 20 18 12 18 18 14 10 14 14 12 .8 14 12 12 a 112 •12 12 10 6 10 10 a 6 10 10 a 61,300 34 34 32 22 28 26 24 16 22 22 20 12 18 18 lE 10 1u l4 14 8 14 12 li 8 12 10 6 12 10 10 6� 10 10 F. 6 1,400 34 34 32 24 28 28 26 18 21 24 20 11 20 18 12 18 16 14 10 14 14 12 8 14 14 12 8 12 1± :G EI ,0 10 17 1,500 •2.000 36 34 31 24 30 30 26 18 21 24 22 14 22 20 18 12 18 18 16 '10 16 16 14 b 14 14 12 0 11 1: 10 1.1 12 12 1: 1 1 34 34 32 22 30 30 26 1211 18 26 26 22 16 22 22 20 14 120 20 18 12 18 18 16 10 16 16 i4 LI 14 14 12 6 8 1 2,500 34 34 30 22 30 30 26 18 26 26 24 16 24 24 22. 14 22 22 19 :2 20 20 18 1:• 19 15 16 'e J.000 34 32 30 22 30 30 26 48 28 Z6 24 .16 I24 24 22 14 22 21 20 14, :7 .3 1_ 12 3,500 32 32 30 20 30 3026 id �26 28 14 li 26 24 It t< ! '4 ;4 20 la 4.000 -�_ � - .. 32 32 30 20 30 26 IB 18 2tl 24 li 5 2S 2: if 1,500 I30 32 32 2a 20 30 3J 26 It j it, ±= :E S. m L.T2--t? ti 23 1J :v 76 1- A) 1. 3's' Concrete Slab: NC -8.93; R-.29; Factor -7.3 2. 3 3/4• Thick Common Brick: IIC-7.125; R..13; Factor -7.3 a) 1. 8: Concrete Slab: HC•14.106; R -.45B; Factor -7.1 C 1. B' 5011d 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 Thermal'Mass Area: HC -10.161; R -.96S; Factor -6.1 01 1' Thick Concrete/Tile: KC-2.SS; R-.083; Factor�-3.7 Table 3-19. Zonally Controlled Electric Res,tstence Space Heating Points - I Points for thio eKaaurc will I Table 3-2n. Solar Water Heatinz With Cas Backup Points I be completed after the CEC I I has approved an Alternative I I Component Package for Resistance 'I I Beet. I Table 3-19. Active Solar Space Heating witn C;as Points I Het Solar Fraction I Points I I (NSF), z I I 1 I 1 wood stove #33 poinfs(no back up) Casablanca fan + 1.pointl0'-- -.s t".ultlfamil (per unitpoints) I 0-6 l 0 l I 7 - 14 I +2 I I 15 - 23 I +4 I I 24 - 30 I +6 I I 31 - 39 I +8 I I 40 - 47 I : +10 I 48-55 I +12 I I 56 - 63 I +14 I 1 64 - 71 I +18 I I 72 up I +20 I wood stove #33 poinfs(no back up) Casablanca fan + 1.pointl0'-- -.s t".ultlfamil (per unitpoints) Table 3-21. Other Water Hearing Pts'. Floor Area Points I I I Net Solar Fraction (NSF). i perunit, 0 I I Beat Prep I I I 1 0 I 1 I Solar with Electric I I ( Re+!stance Backup I 1C2. I lseering the Require- i I I mend iu Part 2 I 1 0 I I I Electric 'Resistance I I I I Only ; I I -40 I I 0.9 iv -i9 2C-29 3"--39 40-49 50-59 60-69 70-79 600-799 0 +3 +7 +10 +14 +17 +21 +24 800-999 0 +3 +5 +8 +11 +14 +16 +19 1,000-1,499, 0 +2 +4 +6 +8 +10 +12 +14 1,500-1,999 0 +1 +3 +4 +6 +7 +8 +10 2X00 and up 0 +1 +2 +4 1 +5 +6 1 +7 +9 All pothers (pe building, points) _ 8UO-899 0 +5 +10 +14 +19 +24 +19 +34 900-999 0 +4 +9 +13 +17 +il +26 +30 1,000-•1,199 0 +4 •1.7 +11 +15 +-19+22 +26 1,20r,i.499 n +3 +6 +9 +12 +15 +18 +21 1,500-1,999 0 +2 +5 +7 +9 +12 +14 +16 2,1)1)0-'2,999 0 +2 +3 +5 +7 +8 +10 +11 3,06.0 nr.d u1) 0 +1 +3 +4 +5 +7 +8 +in Table 3-21. Other Water Hearing Pts'. I System Type I Points I I I ) 1 1 can only I I I 0 I I Beat Prep I I I 1 0 I 1 I Solar with Electric I I ( Re+!stance Backup I I I lseering the Require- i I I mend iu Part 2 I 1 0 I I I Electric 'Resistance I I I I Only ; I I -40 I I S RESTDF'4TIAL. PLAN' CNECKIUG GUIDE 7185 (S.F., DUPLEX 6 MISC. ONLY) p / n Bldg. Per_ it b 32 4& - �6 OWNER _ K.IZS . _ A. 0 4.�L4,, GENERAL Zoning requirements: (sideyards and number of permitted living units). i% Valuation. 3 '�_ Plans signed by designer. i,,Eaergy Design and Compliance. . Existing violations on property. PLOT PIAN ,l! Complete parcel size and dimensions. Setbacks, sideyarde, casements, etc. Other buildings or structures. fl Grading, fills, drainage. 5! Flood hazard. �✓. Special conditions on creation map or compliance document. FWOR PIAN Complete to scale plan with dimensions. ;2` -Required windows for light and ventilation (Sec. 1205). ,a Required windows for second exit (Sec. 1204). Skylights (Chapter 34 6 Sec. 5207). Human impact glass (Sec. 5406). Req+jired room sizes, ceiling heights (Sec. 1207). �7 G.F.C.I.'a in baths, garage and exterior outlets (Article 210-8). Light fixturee. switches, receptacles, and exterior receptacles for maintenance of mechanical equipment. Locations of water heater, heating and cooling equipment, other electrical or gas / equipment, and plumbing fixtures. Gara&c firewall, door size, and closer (Sec. 503(d)(3)). 1 - 3'0" exterior exit duor (Sec. 3304(c)). Fireplace and wood stove location. Smoke detectors (Sec. 1210). STRUCTURAL DETAILS ,? Foundation plan cociplete enough to con;truet building. ,Z. Floor construction details complete enough to construct building. Elevations and wall construction details complete enough to construct building. k. Roof ronstruc_ion derails coeplete enough to construct building. A" Fireplace. tonstruction details and c:+lcs if necessary. ,6: Sufficient data and delail6 Lo c:atinfy energy requirements (State Law) (Form 1). HISCELIANEOUS ITEMS TO LOOK. OUT FOR Exposure 11r15•wood on exposed location.^, and overhangs. /Z. Stairway details: landings, rise and run, head clearance, handrails (Sec. 3306). Guardrail details (Sec. 1711 6 3.306(j)). Brick or stone veneer (Chapter 30). /�/ Exterior plaster - weep screeds (Sec. 4706). �6.' Proper roof pitch for roof covering (Chapter 32). Rafter ties or bearing ridge beam. 4— Garage door or porch header sizes. Adequate bracing. Living area over garage - complete 1 -hour separation required on garage side including supporting walls and posts, etc. jd✓ Two exits on three-story dwellinga (Sec. 3303 6 see Mezannines'1716). Attic access and ventilation (Sec. 3205). C7� Underfloor access and ventilation (Sec. 2516). Wood stoves, clearances, alcoves 6 1 -hour shafts. 1,5". Combustion air for fuel b++rning appliances. Y6 Noise requirements on driplerce. Adobe soils - special foundation design. VRetaining walls requiring design. V Unusual shape, size or split level house requiring lateral design. �'S4 E , .f� l}t}I .., LJ i . ,� yI\ Jnr,; fir, t � •.. i f / U'y 'J r. s r+: c� ti }r V.. t � St r ., . '_i.. i � .. , .1•,' fi ,+✓ :•'LYS. , .. f Order No. 111601 mist. Escrow No. Loan No. WHEN RECORDED MAIL TO' Leone Merlo Rt. 2 Box 92 Chico, CA 95926 4EC"C1 "F AL6 uca E0cs OF 6UTIE CotnfTCC.Il40RNIR ATTMEREQUEtTOF NOy -S PN e. 47 ELEANOR M. DECKER 1-11, CLERK -RECORDER FEE y 5 r,E row 396675E 'Pa. i MAIL TAX STATEMENTS TO: • TT t DOCIMNTARY TRANSFER TAX &---D— Same i. � t Same as above comwt.d - n+. c(n.rdaration or aqua of Draparty cMvayad: os f:omwr,eo.n.,canidwatlon a.yua 4u tiwa or aravmbrMcw Ptn. API 42-16-0-029 1 EASEMENT GRANT DEED FOR A VALUABLE CONSIDERATION• receipt of which is hereby acirowledped, . i PETER J. MERLO, a married man, as his sole and separate property 3 hereby GRANT(S) to r LEONE M. MERLO, a married woman, as her sole and separate property the real property in the)OE*fXdtx unincorporated area County of Butte State of California. described as A non-exclusive easement for well and water line purposes more particularly described as follows: A portion of Lot 30, as shown on that certain Map of the Second Subdivision of the John Bidwell Rancho, filed in Book 5 of Maps, at Page 27, on Septem- ber 17, 1900, in the Office of the Recorder of the County of Butte, State of California, more particularly described as follows: COMMENCING at the Northeast corner of said Lot 30, said point being on the centerline of West Sacramento Avenue; thence West along said centerline, a distance of 330 feet to the Northwest corner of the East half of said Lot 30; thence South along the North-South centerline of said Lot 30, a distance of 130.00 feet to the true point of beginning for the easement description; thence Fest, a distance of 30.00 feet; thence South, a distance of 30.00 feet; thence East, a distance of 30.00 feet, to a point on said North-South centerline of said Lot 30; thence North along said North-South centerline, a distance of 30.00 feet, to the point of beginning. Said easement is appurtenant to and for the benefit of Lot 4, as shown on that certain Map entitled, 'MERLO SUBDIVISION', which Map was filed in the Office of the Recorder of the County of Butte, State of California, on June 21, 1985, in Book 100 of Maps, at Pages 45 and 46. i 4 O,ted November 4, 1986 I PETER J. &ERLO STATE OF CAUWR/GQ I a coutm OF "y. J"' :?_ , on Il- Y -gam baton ma M rMrWw6 • Rabn iNauc inaMA Wd Stara OW t array amwr�e_e�+fir S f I t paraonaay arrow b e far I to ar M Ta bis a sam4amy • ROGER A. BUTTON • aroaroal b ba she e-0) Mgr namaW la.'ara arbcribae b tna • • • atoTARr R BLCCAt1+OgM • s.a.. • Nun, msq • within inNrrrttrara No actror.tadpad b are bW haAM/IMy a,.fnAad : Wy Caaarraaar Ezra M¢rtl IM1 � WITNESS wr hard wddacif asst = ITIrY N far a"kio —I w rayl 1 fiyYatrs _ •loos (eAetl MAIL TAX STATEMENTS AS DIRECTED ABOVE B'ID. CIE DOCUMENT B GRANT DEED FOR A VALUABLE CONS-DERATION, receipt of •hktl is Ant>a adnow4d0ed, PETER J. MERLO and LEONE M. MERLO, husband and rife hereby GRANT(S) to PETER J. MERLO, a carried man, is his sole and separate property tIv real property in eve 9AXX< unincorporated area County of Butte Stine of California, dscnbed as s The hest one-half of Lot 29 and the Kest one-half of Lot 30, according to that certain Map of the Second Subdivision of the John Bidwell Rancho, near Chico, filed with the Recorder of the County of Butte, on September 17, 1900, in volu=e '5' of Maps, at Page 27. 441 Dead November 4, 1986 SlArE f� 1 ' fJWFtlRrM COUNTYK Yra oouwlyoy I— '•1-$ � Woe era. the a Nam" gaca ane to ra Stiftapersonar ,,,,y t'F t*j- r —aT, M4 f- to .t � e_ r f/1_ er ID ej7C.L. .E PETER J. LEONE M. kmLO pwtlMr V,Oen b e• M Vrtaa b r P M �a d aaaahOo► `'� {IT. r� • A. 5UI'T'E%M a,nOr�Ca! b be Vo owaatea -W— ate." ale eWauEW to M � f' � _ 5.-r C-4 walr, e,abNa•e ane adnor•IasyaO O a• ti tWalWary aaoaaa • C V� _,Y 1 Naa•a Ll•a a a a]ZCL L 70 9r7Ca1•flOEi vinwas.yw,a.nede.lMd. w ._j(5►�'.� — L` /T,r w 4 Md/ weuY �1) s�yw 1002 18/52/ MAIL TAX STATEMENTS AS DIRECTED ABOVE END OE GOCUTANT 86-39665 Order NO. 111601 misc. kLCO A Sit ut J rflu AL RE COR)s ' E.aowNo. Of6UTItCCLAT[CsllfORaM Loan No. AT INE REQUESTOf ' WHEN RECORDED MAIL TO ISS NOi -5 PN Ir. Peter Merlo Rt. 2, Box 92 ELEAN'a,l K EECKER An Chico, CA 95926 CLERK -RECORDER FEE s6-3961'IS : YACI Aao•, —IS Luh, row wtcowotw•s vsf a Pachm MAIL TAX STATEMENTS TO 6 ETl 000.�TARY lAAr6FEA TAX i Same a5 above _... Casc_ue o+ co•eaw.to� o •aM d t>•oaot► ca+paa: OR —. C_'W on V..—owan_ orae,.,., Ionsorwn nbn,rc. M w APi 12-16-0-029 V GRANT DEED FOR A VALUABLE CONS-DERATION, receipt of •hktl is Ant>a adnow4d0ed, PETER J. MERLO and LEONE M. MERLO, husband and rife hereby GRANT(S) to PETER J. MERLO, a carried man, is his sole and separate property tIv real property in eve 9AXX< unincorporated area County of Butte Stine of California, dscnbed as s The hest one-half of Lot 29 and the Kest one-half of Lot 30, according to that certain Map of the Second Subdivision of the John Bidwell Rancho, near Chico, filed with the Recorder of the County of Butte, on September 17, 1900, in volu=e '5' of Maps, at Page 27. 441 Dead November 4, 1986 SlArE f� 1 ' fJWFtlRrM COUNTYK Yra oouwlyoy I— '•1-$ � Woe era. the a Nam" gaca ane to ra Stiftapersonar ,,,,y t'F t*j- r —aT, M4 f- to .t � e_ r f/1_ er ID ej7C.L. .E PETER J. LEONE M. kmLO pwtlMr V,Oen b e• M Vrtaa b r P M �a d aaaahOo► `'� {IT. r� • A. 5UI'T'E%M a,nOr�Ca! b be Vo owaatea -W— ate." ale eWauEW to M � f' � _ 5.-r C-4 walr, e,abNa•e ane adnor•IasyaO O a• ti tWalWary aaoaaa • C V� _,Y 1 Naa•a Ll•a a a a]ZCL L 70 9r7Ca1•flOEi vinwas.yw,a.nede.lMd. w ._j(5►�'.� — L` /T,r w 4 Md/ weuY �1) s�yw 1002 18/52/ MAIL TAX STATEMENTS AS DIRECTED ABOVE END OE GOCUTANT Order No. 111601 mist. Esnow No. Lan No. WHEN RECORDED MAIL T0: Leone Merlo Rt. 2 Box 92 Chico, CA 95926 MAIL TAX STATEMENTS TO: Same as above AP! 42-16-0-071 e6-31666 4ECO 0101" 01 F ICTAL I:LLCGRCi Of OUTfE COURTT,LALI/ORM AT I�NIE REQUEST 01 V j�" ) k"s-, . W6 NN -S PN I .4T Mum K BECK,ER CLERK -RECORDER FEE 4' 86_3961:6 a SrACt ABOVE TMrS LINE 10. .ECO.ot.'S USE Pepo� DOCUMENTARY TRANSFER TAX f1 d ...... Crq.no an me cons4wetion w .awe of property oorreyed; OR ...... Coq. Md ow me _4w.hon w r.1ue Wea live or erewmWerc� /i to-e.ne Nwer GRANT DEED FOR A VALUABLE CONSIDERATION, receipt of whkh is hereby sanowledoed, PETER J. MERLO and LEONE M. MERLO, husband and wife hereby GRANTISI to LEONE M. MERLO, a married woman, as her sole and separate property the rev! property in the 6Z%KN t unincorporated area County of Butte • State of California, dewribed as Lot 4, as shown on that certain Map entitled, 'MERLO SUBDIVISION', which Map was filed in the Officio rf the Recorder of- the County of Butte, State of California, on June 21, 1985, in Book 100 of Maps, at Pages 45 and 46. A i Dated November 4, 1986 Q PETER J. HERLO r STATE OF CAIIFORNu jae . COUNTY Of Oe/ore ma the E Nolsry qdc w ar4ly aero St �. tAtr DONE M.'MERLO EwM►aoouw 1 Leo�u� M. Qr- o pweorWly E,w.n to m. 1e vp.ed n .» an the tarsi. a aatieraewy ROGER A. BUrrom i e.l0wroa) to be the perepnly .hoes rrrrr(.) Y/M WbcMW To the _ • �+. -� aDTARV q/t� �a • r e,tCrin eWn,rtrerd oral aWwMdptl to me the he/YWprey a.eOned MCaewer =;r 31 t9p ■ Ore canes. • E{f. ••.••••.••./•.••••..•••EIA WITNESS my1//hhancl Y d%dat ad -rd R' -� ETr. w ft. MFW .� W mel/ Nlyral� 1004 l6/821 I MAIL TAX STATEMENTS As DIRECTED ABOVE M OF DOCUMDff 11 Ord -No. 411601 nisc. Etcrow No. Loan No. WHEN RECORDED MAIL TO: Peter J. Mer lo Leone M'. Merlo Rt. 2 Box 92 Chico, CA 95926 12Ab- l - V►1 J�a-/� 2j 86-39668 �EC"DED PI U1 I l., A Lh(Cop 1 CIBUTfECoull r,tru►MIB1. AT THE AEOYEftp/ Cl /+� 1986 NOV S PW e. 4 � ! ELEANOR R BECKER' CLERK -RECORDER FEF 11 86-39668a +ACt ae t Iw,S L,NL IUR RLCORDEN'S U5t P•o•i MAIL TAX STATEMENTS TC - DOCUMENTARY TRANSFER TAX . Conw:lad orI the c""w Won a value of prop" conveyed, opt Same as above C. ted on o+e cond•Ialwn avehl•I— 1W.or «.vinbr•nco `.'�rater • .Jolt trjr.(/��` �L�fi•�w ,E..niamrinpnih u. - si,.w N.,R� — APIs 42-16-0-029 L 071 GRANT DEED FOR A VALUABLE CONSIDERATION, receipt of which is hereby adno.vledped, PETER J. MERLO, a married man, as his sole and separate property and LEONE M. MERLO, a married woman, as her sole and separate property , hereby GRANTIS) to PETER J. MERLO and LEONE M. MERLO, husband and wife, as Joint Tenants i the real property in the eigrcak unincorporated area iCounty of Butte State of California, described as PARCEL I• The West one-half of Lot 29and the West one-half of Lot 30, according to that certain Map of the Second Subdivision of the John Bidwell Rancho, near Chico, filed with the Recorder of the County of Butte, on September 17, 1900, in Volume "5' of Maps, at Page 27. PARCEL IIt Lot 4, as shown on that certain Map entitled, "MERLO SUBDIVISION", which Map was filed in the Office of the Recorder of the County of Butte, State of California, on June 21, 1985, in Book 100 of Maps, at Pages 45 and 46. i Dated November 4 1996 I I STATE OF GLIF001NIA lea Coufm OF bale. na V V �a1Ncl try Public N W to saw Stale, W�.aoe.rsdlTe 4 Le 6A)4? Ni e r - l o personalty lu— to ne to proved to me W the ba- Of rndatoly i ROGE n A. surTlo 1 • • en+eel..l to be au o«aolu Mu Ware nam.r. ewwbad to the • NOTARY Pumic-cALSOpMA • co ... elite Ower • .Ven nam-wd end arA veoedped to ar put hwahant" eaeodd • �' yCoI•wovbr Eap•aahmaM .1W • w neeft 6•a•••••a••�•••••••••••••/ WITNESS Itry aM dlttlep wt lTI.M f✓r� ear oMrsy pry •x111 59-t-01 A— ir Tool laetl MAIL TAX STATEMENTS AS DIRECTED ABOVE EM OF DOCUMENT �j � 3� COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville,.Califorigia 95965 - Telephone 916/534-4541;.1 1 APPLICATION AND PERMIT / ASSESSOR PARCEL NUMBER y _ „ _ -7� ZONING BUILDING PERMIT OWNER.. �z� Mme_.!,, r" TELEPHONE _;y"; ti ►, SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS i r } Fireplace CONSTRUCTION LENDER A, 1A UNKNOWN Total Valuation $ FilingFee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECTOR ENGINEER n" i} LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS �I Permit fee $ PLUMBING PERMIT FiIingFee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF E Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00 ea TYPE OF WORK New F-1AdditionElRemodel E:1 Utilities [:1Installation❑ Other E] Describe work: > >� ' ti4 %ri fw. t r h <�r - (r " rtn,"1 /4,L; Permit Fee $ C p,� Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1000V OR 0 AMP ORLESS10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Buslnes$ 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) Q I, as the owner, am exclusively contracting with licensed contract- ontract- ors. ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.EI ,/zQsgft OR ACDNS. (ACC. BLDGS. NEW CONSTRESID, U TI.OUTLET 2,50 ea NO N•R RES BRANCH CIRC ITS /POWER APPARATUS 61 (SINGLE OUTLET CIR. Ex. OCcup(OUTLETS OR FIXTURES 20950t eAL030 FIXED APPNS. EX. Occup. OUTLETS ((RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate Of Consent to Self -Insure. I :hall not employ any person in any manner so as to become subject to *he W. C. laws of California. Notice to Alplicant: 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 orthis permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that (have read this application and state that the above information is correct. I agee to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter uton the above-mentioned property for inspection purposes. I also agree to Mve, indemnify and keep harmless the County of Butte against all liabilities, jidgments, costs, and expenses which may in any way accrue against "said Couay in consequence of the granting of this permit. %� Y 'e"- ` / /'r��'(,-� Date �� ( _ Signature of/Applicat _ Owner Q Contractor ❑ Agent ❑ An OSHA permit is iquired for excavations over 5'0" deep and demolition or construct- ion of structures overt stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCUP. CONST.TYPE I JFLOOOJPARCFLJ PD 7 ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date 7 / 2 - Receipt No. /.>Z .�I �' WHITE-O.P.W.. YELLOW-ASESSOR. PINK -INSPECTOR. COLDENROO-APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Californ'lar95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ERMIT NO. ASSESSOR PARCEL NUMBER _ _ / ZONING BUILDING PERMIT OWNER TELEPHONE SQ. FT. OCC, BUILDING VAL ATION OWNE 'S MAILING ADDRESS o w S, n..� CONTRACTOR'S NAME TELEPHONE s 34 -facts CONTRACT R'S MAILING fDDRESS v _ ,- A Fireplace CONSTRUCTION END R UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S M LING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OENGINEER'S MAILING ADDRESS 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. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFJ29- Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities [:1Installation ❑ Other El Describe work: S�f� NC_ I�ewly.,,, _ Ste, ,,. (` IC, A-1 t; ,W Permit Fee $ S G� Contractor ELECTRICAL PERMIT Filing Fee 10.00 500V OR LESS Main service 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification El 1, as the owner, or my employees with wages as their sole compen- sat ion, will do the work, and the structure -is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ i am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.61 , A =2sgft New CONsrR( MULTIOUTLET NON.R ESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. .20050t Ex. Occup(OUTLETS OR FIXTURES 20050! ALM FIXED APPLINISR EX. Occup. OUTLETS (RESID.)EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. lyirin g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also %e to save, indemnify and keep harmless the County of Butte against ally bil1. )es,� dgments, costs, and expenses which may in any way accrue a ou in consequenc f the granting of this p rmit. X Date &T Signature of Ap licont — Owner Contractor ❑ Agent ❑ An OSHA er it is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCUP. C0.ST.TYPEJ FLOOD PARCEL PD ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which RE PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been aid. P WORKS to �Y Receipt No. /-,9 1 iv WHITE-D.P.W., YELLOW-ASSC990R, PINK -INSPECTOR, GOLDENROD -APPLICANT