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HomeMy WebLinkAbout042-590-0111097-89B,P,E,M _ SWEET; Ste +, 631 ,Breanna Lane; cq r s "4contr�: ,.,John Linhart '(new, -single family)- Y 25.2-59.11 i Permi 67,`90B "`• t.- 1 sq� ftg for garage/sf ) i i • i. !1, , I 441h COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroviller California 95965 - Telephone: 916/538-7541; 'APPLICATION AND PERMIT. ASSESSOR PARcFL NUMB R - ZONING 42-59-11 SR -1 - BUILDING PERMIT OWNER TELEPHONE Ste'hen Sweet t' 893-8775 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRF-55 - 4309 Kath Lane Chico 959261 ST RENEWAL CONTRACTOR' SNAME John Linhart ,CONTRACTOR'S TELEPHONE 342-6563 - - MAILING ADDRESS 669 Henshaw Chico 95926 Fireplace CONSTRUCTION LENDER Sacramento Savings UNKNOWN Total Valuation is ' Filing Fee. _ " $ 10.00 LENDER'S MAILING ADDRESS Chico Permit Fee @ 5 Fee $ 227.75 ARCHITECT OR ENGINEER None LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty BUILDING ADDRESS Permit fee !$ $ , 237.75 PLUMBING PERMIT Filing Fee 10.00 631 Breanna Lane Chico Each Trap 2.00 - _ . Solar or heat pump water heater 20.00 LOT NO. 4 SUBDIVISION.NAME PARCEL MAP 97-77 Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ® DuplexMobilehome❑ Other ❑ SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00e TYPE OF WORK New F] Addition E] Remodel❑ Utilities❑ Instal lation❑ Other] Describe work: 1st Renewal of B.P. #1097-89 Permit Fee S Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP' 2.50 ' CONTRACTORS LICENSE LAW ); I declare under petty of perjury (check one ❑NON.RESID I am licensed under provisions of Chapt. 9, Div. 3 of the Business/POWER and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure -is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. ,(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason I NEW CONST. DWELLING OCCUP.a` OR ADONS. ( ACC. BLDGS. 1 yzQsgft NEW CONSTR. MULTI -OUTLET BRANCH CIRC 1T5 2.50 ea APPARATUS nI (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES eA 0 90 FIXED APPLNS. OR Ex. Occup. OUTLETS IRESID.1 EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare and€rrpenalty of perjury (check ones: ❑ The permit is for $100.007va uival'ion) 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. MECHANICAL•PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee ; Contractor .I certify that I have read this application and state that the above information is correct. 1 agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over' 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ cc CONST TYPE TOTAL FEE 237.75 IlEions HAz CUA PARK SCHL FLO I PAR PD HD ISSUE his permit is Hereby issued under the applicable provi• of the Butte County Code and/or resolutions to do work • indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. WHITE-O.P.W.. YELLOW-ASS[SSOR• PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, OroviII — Phont: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Inspector (_'4/ "V Date ' ;2- fw 1 V r a I COUNTY 0 BUTTE R 1 iT a DEPARTMENT OF PUBL"1C WORKS ' 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 g 747 Elliott Road, Paradise —Phone: 872.-6307 t CORRECTION NOTICE ` ' OWNER PERMIT 0. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. ` 4- 425 A Inspector t a. -r3 -q Date_y '�� • COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico - Phone: 891-2751 7 County Center Drive, Orovi Ile - Phone: 538-7541 747 Elliott Road, Paradise - Phone: 872-6307 CORRECTION NOTICE ER PERMIT 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 Y-10 10r need additional explanation, please contact this office immediately. Inspector ubw-Lu—Date 9-15-4-61- Y - Owner JOHN LINHART Permit No.. ENERGY tERTIFICAYION , LOCATION t ' A.P. NO. DESCRIPTION.OF INSULATION ROOF MATERIAL BRAND NAME THICKNESS THERMAL RESISTANCE (R 7ALUE) EXTERIOR WALL MATERIAL Fiberglass BRAND NAME Certainteed THICKNESS THERMAL RESISTANCE (R VALUE) R-14— CEILING BATT OR BLANKET TYPE FTRFRGT,ASS BRAND NAME Certainteed THICKNESS 10tl THERMAL RESISTANCE (R VALUE)�� LOOSE FILL TYPE INSUL—SAFE Ili BRAND NAME Certainteed THICKNESS - T -)IT THERMAL RESI STANCE R MALLEI R 36 FLOOR, ELEVATED MATERIAL THICKNESS FIBERGLASS BRAND NAME CERTAINTEED THERMAL RESISTANCE FLOOR, SLAB SUB FLOOR MATERIAL FTRFR(_TAgs BRAND NAME CERTAINTEED THICKNESS_ r,111 THERMAL RESISTANCE (R VALUE) _lA-- WIDTH FOUNDATION WALL MATERIAL BRAND NAME THICKNESS THERMAL RESISTANCE (R VALUE) I hereby certify that the above insulation r.as installed in the above building in conformance with the State of California Energy Requirements. SHASTA INSULATION #530235 FIRM NAME/OUTTER STATE CONTRACTOR"S LICENSE NO. I hereby certify the above insulation and all required items as shown on the Building Department approved plans and attachments hLve been installed as required by the state of California Energy Requirements. All equipment, devices and materials aro of the quality approved by the State of California. ---------------------- ------------ -- -- i © 3- ----------------------- Fl N I IF/0W' (P A.- "I I` /G_ o SIGNATURE OF GENERAL CONTRACTOR OhNEI, :).".T'. This certificate must be on file ani th the fii'ILDINC DEI'ARTMENI pr ; or t c• � Taal approval and a copy shall he posted within the building. i t _ / /V V /6 V /767-t .OU1� t 9 Ts 42-59-11109,7-89B,P, E M PERI SWEET, Stephen 631 Breanna Lane, Chico PERI Contr: John Linhart own (new single family) CON.... ASSESSOR PARCEL LOCATION w,y t,6 c 1-o ti T T !� GA S , - 5-1(-50 n/1"J� Temp. Power Pole `� x- Called OFFICE COPY Temp. Elec, Address Called GAS Date Temp. Gas Meter By ELECTRICy Celled I Meter By Date JOB FINALEO (Date) Signature =OK - 0 = Not OK ' = Not Readyable MOBILE HOMES , MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Sewer; Location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / P' ft. / /"Nat. or/ /"L"ft./ P'LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -131 Date Card -81 Date i 10. Roof; Shthg-Roofing Card -61 Date Card -131 Date 11. Ext.; Steps -Doors -Landings Date MOSILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -131 Date Card -131 Date 2. Footings; Size -Spacing -Marriage Line Card -81 Date Card -131 Date 3. Gas; MH Test -Demand -Valve -Connector , 4. Electricity; MH Test -Crossovers -Breakers -Clearances k Date POOLS (Plans) OK except #'s 5. Drain; MH Test -Fall -Flex Connector 1. Setbacks -Easements 6. Water; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability 7. Water and Sewer Connected -C/O to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit Card -B1 Date Card -B1 Date Card -131 Date Card -131 Date 9. Health Department Approval • 10. Plumb.; Cir. Test -Water Supply Test Card -61 Date Card -131 Date Card -131 Date Card -Bi Date a=GK' 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) Date UNDE)MOOR (Plans) OK except #'s V FTt' ,1.,oZ'oxg-Setbacks;-Easements-Flood-Slope tg. in; Soils-Steel-Elec. Grnd.- Z /" Ftg. De t_ ., Garage; Soils -Steel-/ Z /" Ftg. Depth V I b- ' tg., Porches & Decks; 5ei1c_SLool-4 Z' /"Ftg. Dei em Is, Main; Steel -Bl ockouts-1d4al�—ped mwalls, Garage; Steel-Blockouts-Wrapped 7. Slab; Steel -Wrapped 8. Pi -Fireplace Ftg.-Steel V.; Fall -Fittings -Test -2 way C/O -Sewer Test V'Gp Pipe; Size -Anchors er Pipe; Test -Anchors -Regulator -Service Test E ric; Underground P s & Ducts; Clearance- Material-Su pprt-Ins. ders-Sills-Anchor Bolts -Joists -Vents -Cripples Card -81 11 • Datey-%-&q Card -B1 ate Card -B1,- J�ate0-/6-" Card-B1R.j� Date Date PLU NG (Permit) OK except #'s a er Ht. Vent -Access -Combustion Air -Baffle jg,VVajgjfPipe; Test & Anchors -Nail Protection V.; Te - ttngs & Anchors -Nail Protection o r Pan; Test, First Floor -Tub Access 52R.Xst jub & Shower, 2nd Floor -Tub Access s Pipe; Size & Anchors Card -B ate ,-r?,qj�Eard-81 Date Card -B1 Date Card -B1 Date Date ELEC AL (Permit) OK except #'s ft.'Tlxtjwe & Transformer Clearance -Ins. Protection e eceptacles Spacing -Lights & Switches at Doors iz oxes & No. of Conductors -Stapled 2be<og?2xInstalled Close to Edge of Studs & C.J. . Ground made up w/Mech. Fasteners -Bond Gas & Water 4ellAp,pliance Circuts in Kitchen & Conductor Size/G.F.I. 8 bfeed Wire Size / 0/ ga. Cu o A A.C. Wire Size / /ga. Cu AI -- ange Circ. / / ga. Cu oAt Oven Circ. / ga. Cu or Al. Igsulated Neral Yes - Ser 'ce-Riser Conductors & Ground -Main Disconnect gip. Clearances Panels-Motors-Mech. Equip._ 3 . Cjothes Closet Light -Shower Light -Spa Light 31AToke Detector Card to Card -B1 Date Card -B1 Date Card -B1 Date Date MECH AL (Permit) OK except #'s 3 .C.• ucts Insulation & Support 5 n n; Exhaust above insulation ndensate Drain & Overflow; Size & Grade 3, ace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 3 . Attic Access & Platform if Furnace in Attic Card-B1� Date 71 17-11CCard-B1 Date Card -B1 Date Card -B1 Date Date FRAMI (Plans) OK except #'s 3 i I Proper Material & Anchors Studs -Nailing, Spacing & Bracing—Plates-Sound ing Walls over Girders & Floor Nailing t Stop in Walls (rat proof) Stops; Furred Ceilings -Stairs -Chases -Tub eader & Beam -Size & Bearing F 2N D 6 Date FRAMI (Continued) 4 gers-Post Caps -Anchors -Connectors 10T. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 7 it place Ties or Type A Flue -Fireplace Throat Clearance tti Access; Size & Romex Protection -Draft Stop -Ins. Baffles drm. Windows or Exiting Doors -Sill Hgt. & Dimensions S e Fire Protection Framing ,&}-Prop ty Line Firewall & Openings oors-One T -Check Garage -3rd stopr, 2 exits Width -Headroom -Rise- g -Fire Protection lywood on Roof Overhan - tY after Outriggers %&.- iling Veneer esh-Drip Screed -Fd. Vents-Underflr. Access lazing Area -Glass Protection -Skylights -Plastic 5 alts; Nailing -Bolts . n ation-Walls-Clg. Infiltration-Walls-Wndws Card-Bl"Wf) Pate0 13-gUCard-B1 Date Card -B A ate 9'79tXCard-B1 Date Date NAL, OK except #'s Ex oor & Sidelight Protection-Landi Aa -Smoke Detector 5turnace; Vents -Clearance -Comb. Air -Connector - Above Floor -Ducts -Mach. Protection ed oom Exiting & Bath Fixtures & Tub Access -Spa 60-Efrim & Subpanel; Breaker Sizes -Labels 8?,."§tq_0<& Rails ir9place or Stove; Clearances -Hearth le Outlets at Wood Panel; Int. & Ext. 7D,,fjixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 70,1bec. Outlets & Receptacles at Kit. Counter 7Q-Bar9ge Fire Door; Swing -Landing -Closer uct in Garage -Damper tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In age; Above Floor-Mech. Protection Elec. & Mech. Equip. Listed for Location 76. q4gr,. Receptacles in Garage; (G.F.I.)-Rom Protec. sulation-Foam-Looked in Attic s uard Rails & Deck Construction s 7V Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Cljo,wance Looked under Floor ❑ s lowing instid.; Drive ❑ Yes o; Walks ❑ Yes No; F)lanters ❑ Yes 00do' o; Brown -Finish .C. . nit; Disconnect, Electrical, Plumbing P�fe-nts Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. 84. WylerWell; Disconnect, Electrical, Plumbing rior Elec. Trim; G.F.I. Receptacle -Underground V elation throughout House Glass Protection ocections from Previous Inpections T -Meters Tagged; Gas -Electric er & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates 92: Roofing Certificate Card -81 Date S-( OCard-Bl Date Card- Dat d Card -B1 Date Card -B1 , Date DCard-B1 Date Comments at Final: 06 COUNTY OF BUTTE - D,&ARTMENT OF PUBLIC WORKS PER o. 7 County Center Driv;? - Orovijle, California 95965 - Telephone: 916/538-7541 D APPLICATION AND PERMIT-� ASS 55 R PARC NU B R ZON BUILDING PERMI owN �-- t T E H SQ. FT. OCC. BUILDING V LUATION i— O E S IL NG A RESS _ ^ io CO C OR'S NA E U0 rfi T L PH E - 6 CO (1(/QTO IL NG ADDRESO • Q _t2 Fireplace ` DEW CON UCTION yk fill UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING A RESS Permit Fee $ ARCHIT CT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ - Q ARCHITECT OR NGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Iq Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT O. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFX Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is G W 0 -- TYPE OF WORK New X Addition ❑ Remodel ❑� Upjli ' s ❑ Installation❑ Other ❑ Describe work: �YdJ I Penult Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 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 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- ontract- ors.(Sec. 7044) ors. ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING O 1/206 OR ADDNS. ACC. BLDG qft NEW CONSTR.U TI -OUT E x2.50 ea NON-RESID .BRANCH CIRCUITS) / POWER APPARATUS e (SINGLE OUTLET CIR. / EX. Occup(OUTLETS OR FIXTURES e0L0530 FIXED APPLNS. OR EX. Occup. OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 7M i Contractor 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. f9 I shall not employ any person in any manner so as to become subject K{ 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 FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Penult Fee $ Contractor I certify that I have read this application and state that the above information 1s correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue agalns said County in consequence of the granting of this per it. %�- ''�—""."�� Date Signature of Applicant — Owner Contractor ❑ Agent kc � ion oofsstuHA cuestover 3is 9storesoin heightions over 5'Q" deep and dexo on t uct- Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ QcC�. fU� c�T.TYPc �'YT.�Ii JSC7 PLoop .V/ PARCC PD N s8u This permit is hereby issued under sions of the Butte County Code and/or work indicated ab ve for which �� CT OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date `- r '2 Receipt No. 2- lS� WNITL-D.P.W., TEL LO!(- AA. PI 8 R, DE11R00-AP1LICAN s ,/ COUNTY OF BUTTE - DEPARTMEjVT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - ORO LE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET• Permit No. t OWNER w P A. P. No. Proposed Building Use Building Inspector Date r At time of permit application, I was advised the following data must be submitted priorto permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Energy Design Compliance and supporting documentation ......... �6. Statement of Intent for Non -Heated and AC Buildings/. r.Cy t Engineered truss details and layout in duplicate (required prCN plaf�) 8. Mobilehome installation data including manufacturer's installation instructions /..................................... _ 9. Fees of $--- ...... ............... U� i/_1 0. Chico Urban Area fees paid$//3`3/,,00..r,{ii 4�. ..Z /3r �7 . 11. Park fee paid ..................................................... 12.T— Sc ool District fees paid ................. 13. Sanitation approval from Ik Z r Health Department ... 14. City of Chico plumbing permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18�1Drybeway permit (construction approval required prior to occupancy) ... 19. Pre -Inspection for required . , , , Pre-lnsjWc. request to p q Building Inspector (Date) 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 23. Recorded copy of Agricultural Acknowledgment Statement ............ 76 rY Z3- 24. Letter of si Batu a aut rizati n .................. �...r ... ... . 26. ' When you issue the permit, rocess as follows: Mail to owner. Mail to contractor. Telephone a hold for pickup at _nj2C2office. Deliver w/inspector. Other 01 Applicant_ �kx��. .l Date Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted pr' to -permit issuance: (Circle new item not checked above). 1. Index permit for above items No. J! / 1l i 2. Additional items required: MI�AeC w�AeFl i N1t Contractor, designer, owner was advised of above required data by Contractor, design, as advised of above required data by Plans checked by Date 4 a ,, -_P_!jans 11 Sets of plans on hold in.,.File cabinet /5J Copy–DPW one____jnai 1 _counter by date 4-Z7 —O one—mail—counter by- e> -,T— ,*Av C, Ie R G -1S-B ved by Date -7-6L49 TO Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance y Owner Location AP# Pi)en Approved for: Sewage Disposal e0o"- Water Supply Hold final for: Water Supply Final clearanc O.K. for: Water Supply Clearance for(_Zbedroom iININIft home. Other NOTE * * * Sanitaria — D t BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per•Building) A.P. Number d'_1 i". 1 Building Department No. School District 1P City County Q Jurisdiction Property Owner r`'i i P ()11 P ✓1 ( ) N )f4 P I f / Project Location/Address AN I r Subdivision Lot Number Residential Development: Sq. Footage ey,_1 4 # of Living MHI Addition (Group -R) Units Commercial/Industrial: aSq. Footage New 'Addition (Including Exterior Roofed Areas) Building Department Representative Date ` ******************************************************************* (Floor Plans reviewed by School District Personnel) District Id No. 990sc66 School District certifies that dt A�'t& I (Applicant Name) (Phone Number) .(Street Address) F6 City) (State) (Zip Code has complied with the requirements of Resolution No. by the payment. of $ /. / l,_Sl� representingsquare feet. School District'Representative / Date PAID BY CHECK NO. ' REMARKS: BANK_ NO PAID F BY, CASH white -applicant, yellow -building department, pink. -school district SCHOOL.FEE (8/88) COUNTY OF BUTTE-,Department.of Public Works 7 County Center Drive,-Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention. Property Owner: An "o.wner-builder " building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials.for construction of the proposed property improvement (yes or no) v z 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following .person (firm) to provide the proposed construction: Name Address CityT C 1} Phone 3.`� Contractors License No. 32 O O 4. ,I plan. to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work.: Name ow�..� 04.-- � Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: Property Owner Social Secu ity Number Date /Z `�,F 9 NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. OWNER'S NAME: PERMIT #: I D % / [ A.P. # : When approved, process as follows: Mail to owner (Address) Z,-�Mail to contractor (Name and Address) Call. and hold for pickup at office. Deliver with next inspection. REVISED PLAN CHECK FEES PAID: RECEIVED DATE TIME $15.00 $30.00 Additional Fees Not Required r = Certificate of Compliance: Residential yZ —, S9-%/ Climate Zone 11 ST�pN�►•t Project Title Address Documentation Author Telephone BUILDING DATA Co did ned Floor Area 2: -ZS Sla is, s Floor j1Q Single Family Detached (SFD) [ ] Single Family Attached (SFA) [ ] Muki-Family (MFS BUILDING SHELL INSULATION Build Permit N Checked By / Date Fnforcartent Astencv Use Only Component Insulation Location/Comments Glass Area % Glass R -Value (attic, to garage, typical, etc.) North 41(0 Number of Stories 2 East _Jo 99 414 Number of Units South 93.5 4.2 (] Addition Alone West 130 g [ ] Existing Building Skylight O O [ ] Existing -Plus -Addition Total 423.5 r9• Component Insulation Location/Comments Type R -Value (attic, to garage, typical, etc.) Wall .............. Wall .............. Roof ............. 36 C.Ei L1 ka Roof .............. -- Floor ............. Floor ............. -- Slab Edge..... GLAZING Shading Devices Glazing Area Glass Type Interior Exterior Overhang Framing Type Orientation (Sf) (single, double) (roller blind, etc.) (shadescreen, etc) (yes/no) (metallwood) North (✓) /02 AFF WWrE North ( ) East W) East ( ) South South West West ( ) Skylight....... _JA THERMAL MASS Type/Covering Area Thickness (slab/exposed, tile, etc.) 00 (inches) Location/Description (kitchen. bath, etc.) HVAC SYSTEMS Minimum Type (furnace, air Efficiency —conditioner, heat pump) (SE, SEER.HSPF) �A J .� 2 . ) —$n_ Maximum Furnace Heating Output: _ HOT WATER SYSTEMS Tank stem etc.) or Duct Output Manufacturer / Model # R -Value (Btuh) (or annroved enual) 5. 77 6PO Btuh facturer/Model # SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) SDecial Featu IRA 02 l�ttaiT-th*:P. .4 ;; ? 4. A CER IFICA TE OF�� C0 4 t4 UNDERSIGNED MANUFA C TURER . that the products identified below and on attached sheets Nos' with the Collective mark of the AMERICAN INSTITUTE 6F TIMBENCONST and were manufactured in conformance with applicable proviskWq Of ANSI/AITC A190.1-1983, Structurai'-,diued LaminatedTlmbet�0*4= � been at our plant in sacjinikw, which pUW as a 4W'OF: IMOVI approved by the Inspection Bureau of the AMERICAN - I.NSTITUTZ iropected periodically by sucIV Bur*dW-:, The manufacture of these mambo" complies with the manuf@CW69 iF�A1lMrlied' 4C" Chapter 25 of the Uniform Building Code. 4;.. • '44; P :Mo; ask" (Stock) p 7! M LWAT"i San LeAndro.- -863 0114187wwm 1272 OATI 1 7 y.4� "e.. "j. G.W.Neuman. Agil;AW, I Prg!d* Shf2.Ca2rd6,.mw-" HEREBY CERTIFIES that the said...colnPanY $00 said P vow use tha'AITC 11 Allark. 14 *AMERICAN INSTITUTE OF TIMBER CONSTRUCTION to. of products which comply with applicable provisions'of"Wd. Standard, that.tM"edequacy Ity :Inspected and verified ied by:the In on Bureau id plant is periodically of :.control system In effect at so ION., andnN 16 the U""Wof; AIT.C�* P! -the AMERICAN INSTITUTE OF TIMBER CONSTRUCT. 0" -said facturing-VA UPOW. PrO10". of 'r� said company is capable of complying with appl"ble'RW4 Standard In respect of products, manufactured at said plant. Conroy with, : tu: -particular product of any specific or t is the sole responsibility of ow mRnyfaM my is qualified to'Or6duim a product ineetloj^4410 hereunder being that the said compa period upectiori Bu ally Inspected gpd verified by Ow AITC Ir and that its plant is per I % 0 ..'Cerfificqt6 AITC 155.14. ),o 0 J . t QH U 10.14 SOPS-VMI6EK-� I -INSTITY�- .,,AMERICAN-. 0 VIZ. FOnM 10CA 104 PAKRICAVO l"t" T—VMOF I &-.:A1TC timber construction, standards '`Tabls.1 Design Values for Structural Glued Laminated Timber For normal duration of load and dry conditions of use a,b,c Bwmag AbOIA X -X Axis Bill"Abad Y•Y Axis _ AA* Loaded Loaded PWPWK ulw loaded Parallel ' to Wide Faeee d Y to Wide Fads d a Lsmr4t*ne i LAMWAD" IL -a Y -Y Y e • _ I Extreme Fiber In Compression Pwpen- Nor4dn- Species• Bandng. Fbe d¢ular to 3ran. Fc l; tai Show. Outer cdnpres• Fvy, psi . '.arena- Tension f,.omptes- Extreme von (Fd mornben Compaa• inns/ Zone sen Tons Modulus Fiber Perpon• weh mumple ssoduka TwN10n skin moan ' Cdnbele- Core Strewed Stressed Cor gree• Monson- Of in Lr dicutar Mornon• piece laminations of Per" ParGW at tan lam•n in Tension •srm lel Show. Elastic- Bedding, to Oran IM Sheer, which are not Elaft- to t0 EWM . SynWdn nations a Tension"' Tension Face Fad Fvx ity. Ex Foy Fc ly v Fw edge gkwd)1 dy. EI One". P, Orton• Fo Off. E par 001 Carl psi psi ■ 10' -pa I psi pan psi fh1 it to'psl ON on 14,040 1 1 1 e { 1 1 • j a 10 11 11 1i to to is Wwally Gre&W Wastam SWAT i a I,e foebwng four combelatans we not balanced and are fa either dry or wet use. ' ,0F•Vt OFANW '- bWh-! 5W . ._ paw Lax 950 2y'_ 30 s.w 855.* 11x 07S 97S 1 ix 10F -V2 NF,11F 5001 3751 ,5S 1.1 ,250 37S 133 1.1 11f" s �? I ' lam e0c i 75 i s 9e0 1660 Y 1.5 ISF-V3 OFIDF 560 560 166 to S 1150 -, 16F•Ve DfS+OF 650 500 t6S 11.2 1200 500 t/S 75 t.t e2s 1 t.t The loaawriv iwo cu•nonstions aro iniepded td stralghi o segrwy cambered members lot dry use and industrial appearance" ' ISF-V DFI112YNAI 1e� 660 560^ t101•e•w f ss 900 255 1305•* 668.10 11" 1 060 OW 1.3111 16F -V6 i DnIN3()Fl 660 5601, 90 m is 1000 1 170. 135 70,.S 750-t e76 1 is �. The loaowing two combrns11ans are valanced and we ,niended lot rnembors continuous or cantilevered over supports and provide equal cspecnv in both positive and negalwe be Mid + W-Ve DPIOF ,000 taw500h., 5Wh 106 1 s 1150 Seo 145 75 14 1160 1660 11.916F•V7 MFIMF 3751 3751 155 11 1200 375 135 70 1.3 a50 1360 1 1.3 The Mtbwing set on combnw ons a•e not balanced and are lot either dry or wit use • ' 2OF•VI DFIWW 65C 560^ 1105•* 1 Ix 1 1000 255 130sw s.w 12' l000 12% 2OF-V2 MFIMF 5001 3751 155 1 S 1 1200 375 135 70 14 M 13501 2OF•V3 DF/DF 650 560h 165 16 1150 560 115 75 1 S 100a ING 2OF.V/ DF OF 2000 1000 590^•' 560^ 1165 1 6 1150 560 115 75 to 1000 1560 to 2OF•V IO OF MF 650 560 1155 1 5 1300 375 133 TO 1.1 2OF•VII OFSrOFS 650 500 165 13 1100 500 115 7 I 1 2OF%12 r At;,AC 560 560 190 15 1200 1 170 1 165 90 Irl 900 1500 1 1.1 I The fond" two tome not.ans are intended for susighl M slightly cambered members to dry use and industrial appearance ` 20F•V9 OFIN3WW 1000 650 560^ g -s.w I 5 1000 255 1355•* 705•'"' 13- 750 Its ,.3a 20F•Ve OFIr{3JF 2000 650 1 SWh I 90m 1 16 1000 170 135 70 1.5 715 9W 15 )y The following three combmwa'1s we holanceland 5rentendedla members continuous Or canhleveredbva suppms andprovde equal capacdyn both 00$*"Wtditgetn'e be," 2OF•V7 OFIOF 650 650 165 16 1150 S60. 115 1 75 16 t , 2uF-VB DFIDF 2JW 2000 590^' 590^' 165 1 7 11150 SW 1I5 75 16 two 1000 t • 20F•V9 MFIMF 5001 5001 155 1 5 1100 375 135 70 111 911 14 The ronorrnq eve eombinetans aro not bMrlced and aro for ealar dry a wet use r 22F•V1 OFf W 650 1105•* 1 ex 1050 255 1305•* 665.10 1.35 e60 t10O 1.3a ' 221••v2 MFIMF SOOT 5001 155 1 5 1250 375 138 10 1.1 960 1360 1.1 22F -v3 f3FIi3F x.00 "� 650 5fA1 166 t 7 us0 sed IIs 75 ,.e 1050 15170 +.e �'• 22F -V4 OFIDF 890 •i 560^ 165 1.7 1150 560 115 75 t e 10� Iwo t.e 22F -Vas DFIOFa 650 800^ tea 1.0 ,600 Soo 1.6 tS 1.3 1000 1400 _ 1.3 The fdlbwinj two combinations we intended for straight Of slightly cambered memews fix dry use and industrial appearance 5 • I'• 1 2211-V6 I OFIN3WW 660 500^ gof.s.r 1.68 1100 266 136510 75$ 1.15 e0a 72a 1.15 22F -Vit QFRIX* 2200 1tOD 660J 5WI 1 go- 1 1.1 1 1250 1 170 1 135 1 15-A1.e e00 M1 1.6 f The 1W Siong three corrlbinshe, lle balanced and we nialdedic, bonbon, COMnu us oi'CenNNvendo1M 11upoo werov"9l lVNM upaoq n both pn*vaandnaptReban6rlf� 22�•VI OF 650 1 650 1 le6 1 1.0 1.60 sed bas 75 Is 1100 100 1.e 22F•14 OFIDF 2200 2200 S90 ' t ,Bot 1 7 1150 500 115 15 to 1060 1060 t e '2211-V9 MF11,F 5007 5001 156 is 1250 375 U5 70 14 976 1 1400 1.e The following Sx comnnatinn% Ale nd1 n.11ancod and 3•e to adhor div or wet use - 'LAVVt DF!WW 650 650 1105* 17x 1250 25 1 135s.w 1 70 111" 1 luw Ii 11 N412 t41MF War SW1 0 155 15 1250 375 1 135 70 11 950 133 11 24F V3 OFIOF 2400 1200 rho ,,,h 1rV5 111 Ism SFA 115 /S l e 1100 1600 l e �• z/r.w DF 18 1150 650 '66 1 0 1500 _ _560 145 15 to I Iso te60 1 e Retu to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT aL. FOR RESIDENTIAL DI"'VEI.OPMENT n, `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 BUTTE COUNTY RECORDER for agr:icul.Lural purposes, and residents SERIAL NO.cf of this property may be subject to incon- RECORDED THE REQUEST OF veniences or discomfort arising from the MID VALLEY TITLE COMpANy use of agricultural chemicals, including, DATE RECORDED: Mpg 2g 1389 TIME. but not limited to herbicides, pesticides, IF D1gM 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 esLabl.ished ;igricul Lural zones which have as a priority use for productive agricultural purposes, and residcnlr; within sai.d zones and on adjacent property should be prepared to accept such i ncOnvrn i cnc-r or disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, describcd ;ice follows: SEE ATTACHED DESCRIPTION....... Date: April 25, 1989 PROPERTY OWNERS: ep en wee State of Butte ) On this the 25th day of April , 1989 before me, SS. the undersigned Notary Public., personally appeared County ofCalifornl}a Stephen A. Sweet OFFICIAL SEAL personally known to me. QX Proved to me on the basis MARY R. CASEBEER NOTARY PUBLIC •.CALIf0RNIA of .satisfactory evidence. BUTTE COUNTY to be the person(s) whose name(s) is _ C1 OFOR My Comm. Expires Jan.29,1993 subscribed to the within instrument and acknowledged that. executed the same for the purposes therein contained. IN WI'IWTtis WHEREOF, I hereunto set my hand and official seal. ' a Present A.P. No. - ( Notary Public. Mary R. Casebeer DESCRIPTION ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, DESCRIBED AS FOLLOWS: PARCEL I: PARCEL 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, BEING A PORTION OF LOT 12 OF THE FIRST SUBDIVISION OF THE BAY TRACT, WHICH PARCEL MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 29, 1984, IN BOOK 97 OF MAPS, AT PAGE(S) 77 AND 78. PARCEL II• A NON-EXCLUSIVE EASEMENT FOR INGRESS, EGRESS AND PUBLIC UTILITY PURPOSES OVER PARCELS. 1, 2 AND 3, AS SHOWN ON THAT CERTAIN PARCEL MAP, BEING A PORTION OF LOT 12 OF THE FIRST SUBDIVISION OF THE BAY TRACT, WHICH PARCEL MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 29, 1984, IN BOOK 97 OF MAPS, AT PAGE(S) 77 AND 78. EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED ABOVE. PARCEL III• A 12 FOOT DRAINAGE EASEMENT OVER PARCEL 2, AS SHOWN ON THAT CERTAIN PARCEL MAP,_ BEING A PORTION OF LOT 12 OF THE FIRST SUBDIVISION OF THE BAY TRACT, WHICH PARCEL MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 29, 1984, IN BOOK 97 OF MAPS, AT PAGE(S) 77 AND 78. Certificate of Compliance: Residential Climate Zone 11 SITE Nraj Swes'f Project Title I Imo-- �Q Documenta don Author Telephone BUILDING DATA Condlti ned Floor Area ZL7—S Sla.s Floor f� Single Family Detached (SFD) [) Single Family Attached (SFA) [ ] Multi -Family (NM B UELDING SHELL INSULATION Number of Stories Number of .Units [ ] Addition Alone [ ] Existing Building [ ] Existing -Plus -Addition Component Insulation Location/Comments Type R -Value (attic, to garage, typical, etc.) Wall .............. I EKT.Iy14LLS, Wall .............. -- Roof ............. L i Roof ............. Floor ............. Floor ............. Slab Edge ..... GLAZING Shading Devices Buildin Permit M Checked By / Date Enforcement Agency Use Only Mandatory Measures Checklist: Residential MF -1R NOTE: Lowrise residential buildings subject Loft Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (') may be superseded by more. stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION I DESIGNER I ENFORCEMENT Building Envelope Measures Glass ' §2-5352(a): Minimum ceiling insulation R-19 wcightv3 average. 4,(o §2.5352(b): Loose fill insulation manufacturer's labeled R -Value. .�.�. ' §2.5352(c): Minimum wall insulation in framed walls R- I 1 weighted average (does riot apply to 4 2 exterior mass walls). �• 6 2.5352(k): Slab edge insulation - water absorption rate no greater than 03%, water vapor transmission rate no greater than 2.0 perm/inch. Q 62.5311: Insulation specified or installed mats California Energy Commission (CEC) quality standards. Indicate type and forth. §2.5352((): Vapor barriers mandatory in Climate Zones 14 and 16 only. §2.5317: Infiluation/Exfiltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Doors and windows certified. c. Doors and windows we.:uherstripped: all joints and penetrations caulked and sealed. §2.5352(e): Special infiltration barrier installed to comply with §2-5351 meets CEC quality standards. Glazing Area G1assType Interior Exterior Overhang Framing Type Orientation (St) (single, double) (roller blind. etc.) (shedescreen, etc.) (yes/no) (metal/wood) North (✓) 102.-bpi— North D 2�(}Q N North ( ) East (✓) !2G_ East ( ) South 5 _ South ( ) West (�) West ( ) Skylight....... THERMAL MASS Type/Covering Area Thickness (slab/exposed, tile, etc.) Of) (inches) Location/Description (kitchen. bath, etc.) HVAC SYSTEMS Minimum Duct Type (furnace, air Efficiency Location Duct Output Manufacturer/ Model # conditioner, heat pump) (SE, SEER,HSPF) (attic, etc.) R -Value (Btuh) (or approved equal) �uRt.>t�4e rE . 7 2 5. % 60.06 A 15— / _b20 — Maximum Furnace Heating Output: Btuh HOT WATER SYSTEMS Tank MIanufacturer/Model # System Type (storage gas, etc.) Capacity (or approved equal) Special Feature(s) STorOAa � — --- SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) §2.5352(d): Installation of Fireplaces 1. Masonry and factory -built fireplaces have: a Tight fitting, closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. HVAC and Plumbing System Measures §2.5352(8) and 2-5303: Space conditioning equipment siring: attach calculations. §2-5352(h) and 2-5315: Setback thermostat on all applicable heating systems. ' §2-5316(a): Ducts constructed, installed and insulated per Chapter 10, 1976 UMC. §2-5316(b): Exhaust systems have damper controls. §2.5314(c): Gas-fired space heating equipment has intermittent ignition devices. §2-5314: HVAC equipment, water heaters, showerheads and faucets certified by the CEC. §2-5352(1): Water heater insulation blanket (R-12 or greater) orcombined inLe ior/exterior insulation (R-16 or greater): fust 5 feet of pipes closest to tank insulated (R-3 or greater). §2.5312(Exception p: Pipe insulation on steam and steam condensate return & recirculating piping. §2-5318(d): Swimming Pool Heating 1. System has: a On/off switch on heater. b. of Weatherproinstruction plate on heater. C. Plumbed to allow for solar. 2. 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet. Lighting and Appliance Measures §2-53520): Lighting - 25 lumens/watt or greater for general lighting in kitchens and bathrooms. §2-5314(c): Gas fired appliances equipped with intermittent ignition devices. §2-5314(a): Refrigerators, refrigerator -freezers, freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Chapter 2-53 and Title 20. Chapter 2. Subchapter4. Article 1 of the California Administrative code. This certificate has been signed by the individual with overall design responsibility and the building owner, who shall retain a copy of it and transmit the certificate to any subsequent purchaser of the building. Designer Name: Titwl-um: Address: Telephone: tic. 0: (signature) (datc) Documentation Author Name: rldc/Fum: Address: Building Owner Nana: Mdc/Fum Address: Telephone: (si6natwe) (dart) Enforcement Agency Name: Agency. Tekptano: Glass Area North I e) 2 East 9_ South West q�v Skylight O Total .423.5 Mandatory Measures Checklist: Residential MF -1R NOTE: Lowrise residential buildings subject Loft Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (') may be superseded by more. stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION I DESIGNER I ENFORCEMENT Building Envelope Measures Glass ' §2-5352(a): Minimum ceiling insulation R-19 wcightv3 average. 4,(o §2.5352(b): Loose fill insulation manufacturer's labeled R -Value. .�.�. ' §2.5352(c): Minimum wall insulation in framed walls R- I 1 weighted average (does riot apply to 4 2 exterior mass walls). �• 6 2.5352(k): Slab edge insulation - water absorption rate no greater than 03%, water vapor transmission rate no greater than 2.0 perm/inch. Q 62.5311: Insulation specified or installed mats California Energy Commission (CEC) quality standards. Indicate type and forth. §2.5352((): Vapor barriers mandatory in Climate Zones 14 and 16 only. §2.5317: Infiluation/Exfiltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Doors and windows certified. c. Doors and windows we.:uherstripped: all joints and penetrations caulked and sealed. §2.5352(e): Special infiltration barrier installed to comply with §2-5351 meets CEC quality standards. Glazing Area G1assType Interior Exterior Overhang Framing Type Orientation (St) (single, double) (roller blind. etc.) (shedescreen, etc.) (yes/no) (metal/wood) North (✓) 102.-bpi— North D 2�(}Q N North ( ) East (✓) !2G_ East ( ) South 5 _ South ( ) West (�) West ( ) Skylight....... THERMAL MASS Type/Covering Area Thickness (slab/exposed, tile, etc.) Of) (inches) Location/Description (kitchen. bath, etc.) HVAC SYSTEMS Minimum Duct Type (furnace, air Efficiency Location Duct Output Manufacturer/ Model # conditioner, heat pump) (SE, SEER,HSPF) (attic, etc.) R -Value (Btuh) (or approved equal) �uRt.>t�4e rE . 7 2 5. % 60.06 A 15— / _b20 — Maximum Furnace Heating Output: Btuh HOT WATER SYSTEMS Tank MIanufacturer/Model # System Type (storage gas, etc.) Capacity (or approved equal) Special Feature(s) STorOAa � — --- SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) §2.5352(d): Installation of Fireplaces 1. Masonry and factory -built fireplaces have: a Tight fitting, closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. HVAC and Plumbing System Measures §2.5352(8) and 2-5303: Space conditioning equipment siring: attach calculations. §2-5352(h) and 2-5315: Setback thermostat on all applicable heating systems. ' §2-5316(a): Ducts constructed, installed and insulated per Chapter 10, 1976 UMC. §2-5316(b): Exhaust systems have damper controls. §2.5314(c): Gas-fired space heating equipment has intermittent ignition devices. §2-5314: HVAC equipment, water heaters, showerheads and faucets certified by the CEC. §2-5352(1): Water heater insulation blanket (R-12 or greater) orcombined inLe ior/exterior insulation (R-16 or greater): fust 5 feet of pipes closest to tank insulated (R-3 or greater). §2.5312(Exception p: Pipe insulation on steam and steam condensate return & recirculating piping. §2-5318(d): Swimming Pool Heating 1. System has: a On/off switch on heater. b. of Weatherproinstruction plate on heater. C. Plumbed to allow for solar. 2. 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet. Lighting and Appliance Measures §2-53520): Lighting - 25 lumens/watt or greater for general lighting in kitchens and bathrooms. §2-5314(c): Gas fired appliances equipped with intermittent ignition devices. §2-5314(a): Refrigerators, refrigerator -freezers, freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Chapter 2-53 and Title 20. Chapter 2. Subchapter4. Article 1 of the California Administrative code. This certificate has been signed by the individual with overall design responsibility and the building owner, who shall retain a copy of it and transmit the certificate to any subsequent purchaser of the building. Designer Name: Titwl-um: Address: Telephone: tic. 0: (signature) (datc) Documentation Author Name: rldc/Fum: Address: Building Owner Nana: Mdc/Fum Address: Telephone: (si6natwe) (dart) Enforcement Agency Name: Agency. Tekptano: 1. Ceiling Insulation -4 3 -1 Number of stories -1 R -value One Two Three R-0 -103 -49 -32 R-19 -8 -4 -2 R-30 -2 -1 -1 R-38 0 0 0 U -value 4 40 -90 0.50 -176 -84 -54 0.30 -102 -49 -32 0.10 -26 -13 .8 0.08 -18 -9 -6 0.06 -11 -5 -4 0.04 -4 -2 -1 0.02 4 2 1 0.00 11 5 3 2. Wall Insulation 27 -52 -17 Single- Single - 6 13 Family Family Multi - R -value Detached Attached Family R-0 -68 -51 -34 R-11 0 0 0 R-13 2 2 1 R-19 8 6 4 U -value -0 2 8 0.80 -153 -114 -76 0.50 -91 -68 -46 0.30 -47 -36 -24 0.10 0 0 0 0.08 4 3 2 0.06 9 7 5 0.04 14 11 7 0.02 19 14 10 0.00 24 18 12 3. Raised Floor Insulation -23 -1 ' Insulation in Floor 8 12 17 Number of stories -20 R -value One Two Three R-0 -17 -8 -5 R-11 -3 -2 -1 R-19 0 0 0 R-30 3 1 1 U -value 4 8 11 0.60 -144 -70 -46 0.50 -120 -58 -38 0.40 -95 -46 -30 0.30 -69 -34 -22 0.20 -43 -21 .-14 0.10 -17 -8 -5 0.08 -11 -6 -4 0.06 -6 -3 -2 0.04 -1 0 0 0.02 4 2 1 0.00 10 5 3 Controlled Ventilation Crawispace •9 21 Number of stories 2 R -value One Two Three R-0 -11 -7 -5 R-5 -4 -4 3 R-11 -2 -2 -2 R-19 -1 -2 -2 4. Slab Edge Insulation t 2 8 - Number of Stories IG R -value One Two Three R-0 0 0 0 R-5 8 5 2 R-7 8 6 3 F2 factor 0.90 -4 3 -1 0.80 -1 .1 0 0.70 2 2 1 0.60 6 4 2 0.50 9 6 3 0.40 12 8 4 S. Infiltration (Air Leakage) Specification Points standard 0 6. Glass Heat Loss Total -14 -48 -69 %Glass U -value East South West Percent 18 5 .51 to .41 to .31 to 0.30 or Glass Single Double .60 .50 .40 less 50 -121 -53 -39 -24 -10 4 40 -90 -37 -26 -14 -3 8 35 -75 -29 -19 -9 1 10 30 -61 -21 -13 -4 4 12 29 -58 -20 -12 -3 5 12 28 -55 -18 -10 -2 5 13 27 -52 -17 -9 -2 6 13 26 -49 -15 -8 -1 7 14 25 -46 -14 -7 0 7 14 24 -43 -12 -5 1 8 14 ' 23 -40 -11 -0 2 8 15 22 -37 -9 3 3 9 15 21 -34 -7 -2 4 10 15 20 -31 -6 0 5 10 16 19 -29 -4 1 6 11 16 18 -26 -3 2 7 12 16 17 -23 -1 ' 3 8 12 17 16 -20 0 4 9 13 17 15 -17 1 6 10 14 17 ,14 -14 3 7 10 14 18 13 -12 4 8 11 15 18 12 -9 6 9 12 15 19 11 -6 7 10 13 16 19 10 -3 9 11 14 17 19 9 -1 10 13 15 17 20 8 2 12 14 16 18 20 7. Shading (Shade Open) Effective Percent Giza (percent Blast x SC) Effective -14 -48 -69 %Glass North East South West Skylight 18 5 1 4 1 na 16 4 2 5 1 na 14 4 2 5 1 na 12 3 3 5 2 na 11 3 3 5 2 na 10 2 3 5 2 1 9 2 3 5 2 2 8 2 3 5 2 2 7 1 3 4 2 2 6 1 3 4 2 3 5 1 2 4 2 3 4 0 2 3 1 3 3 0 1 2 1 3 2 0 0 1 0 3 1 -1 -1 -1 -1 2 0 -1 -2 -4 -2 0 na = not allowed 0 -4 �B. Shading (Shade Closed) -4 -16 2 Effective Percent Glass -1 -2 -1 (percent t1lassXSQ 1 Effective %Glass North East South West Skylight 18 -14 -48 -69 -64 na 16 -12 -42 -59 -55 na 14 -10 -35 -50 -46 na 12 -8 -29 -40 -37 na 11 -7 -26 -36 -33 na 10 -6 -23 -31 -29 .74 9 -5 -20 -27 -25 -65 8 -5 -17 -23 -21 -56 7 -4 -14 -19 -18 -47 6 -3 -11 -15 -14 -38 5 -2 -9 -11 -10 -30 4 -1 -6 -8 -7 -23 3 0 -4 -5 -4 -16 2 1 -1 -2 -1 -9 1 1 1 1 1 -4 0 2 3 4 3 0 na . not ailowad 1 4 6 8 9. Interior Thermal Mass Interior Single- Family Detached 0 3 5 8 10 13 13 12 10 10 10 Slab Floor Multi Family 0 1 3 4 5 7 8 9 11 - 12 13 Raised Floor Mass SEER Stories 1200 SE or HSPF Stories 2700 /CFA One Two Three One Two Three 0.0 -8 -5 -4 -2 -1 -1 0.1 -8 -5 -3 -1 0 0 0.3 -7 -4 -2 0 1 1 0.5 -6 -3 -i 1 1 2 0.7 -5 -2 -1 1 2 2 0.9 -5 -1 0 2 3 3 1.1 -4 -1 1 3 4 4 1.3 -3 0 2 3 4 5 1.5 -3 1 2 4 5 5 2.0 -1 2 4 5 6 7 2.5 0 3 5 7 7 8 3.0 1 4 6 8 8 9 3:5 2 5 7 9 9 10 4.0 3 6 8 9 10 10 4.5 3 7 8 10 11 11 5.0 4 7 9 11 12 12 5.5 5 8 9 11 12 12 6.0 5 8 10 12 13 13 6.5 6 9 10 12 13 13 7.0 6 9 11 13 13 14 7.5 6 10 11 13 14 14 8.0 7 10 11 13 14 14 8.5 7 10 12 13 14 15 10. Exterior Wall Thermal Mass Exterior Wall Mass 0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 1.60 1.80 2-00 Single- Family Detached 0 3 5 8 10 13 13 12 10 10 10 Single- - Family Attached 0 2 4 6 8 10 12 13 13 12 11 Multi Family 0 1 3 4 5 7 8 9 11 - 12 13 11. Heating System . SEER 1199 1200 SE or HSPF 2200 2700 (assumes duds (assumes ducts In attic) or b to Sum of 1.6 or Type Type _ -25 or -24 to -14 to -4 to +6 to 16 or SE HSPF less -15 -5 +5 ' +15 more 0.72 6.60 0 0 0 0 0 0 0.75 6.88 3 3 3 2 2 1 0.80 7.33 8 7 6 5 4 3 0.85 7.79 13 11 10 8 7 5 0.90 8.25 17 15 13 11 9 7 0.95 8.71 20 18 15 13 11 8 0 Effective SE or HSPF 10.0 (SE or HSPF x duct efficiency) 3 3 Effective -25 or -2410 -1410 -4 to +6 b 16 or SE HSPF less -15 -5 +5 +15 more 0.30 2.75 -73 -64 -56 -47 -38 -30 na 3.41 -45 -39 -34 -29 -24 -18 0.40 3.67 -34 -30 -26 -22 -18 -14 0.50 4.58 -10 -9 -8 -7 -5 -4 0.56 5.13 0 0 0 0 0 0 0.60 5.50 5 5 4 3 3 2 0.70 6.42 17 15 13 11 9 7 0.80 7.33 25 22 19 16 13 10 0.90 8.25 32 28 24 20 17 13 1.00 9.17 137 32 28 24 19 15 -12 Zonal Control Adjustment -6 System Type 6.6 -5 -4 -4 Resistance 10 9 7 6 4 3 Other 6 5 4 3 2 2 12. Cooling Syst.:m SCORE CARD Unit Size (sQ Eff. % Glass Water SEER 1199 1200 1700 2200 2700 (assumes duds In attic) or b to Sum of 7-10 or Type Type ' less -25 or -24 to -14 to -4 b +6 to 16 or SEER less -15 -6 +5 +15 more 8.0 -14 -12 -10 -8 -6 -4 8.5 -9 -7 -6 -5 -4 -3 8.9 -5 -4 -4 -3 -2 -2 9.0 -4 -3 -3 -2 -2 -1 9.5 0 0 0 0 0 0 10.0 4 3 3 . 2 2 1 10.5 7 6 5 4 3 2 11.0 10 9 7 6 4 3 12.0 15 13 11 9 7 5 13.0 20 17 14 12 9 6 _ -12 -9 Effective SEER -6 IG None (SEER xdud efficiency) -3 -2 -2 Sum of 7-10 1.4 Solar Effective -25 or -24 to -14 to -410 +610 16 or SEER less =15 S +5 +15 more 5.0 -30 •25 -21 -17 -13 -9 6.0 -12 -11. -9 -7 -6 4 6.6 -5 -4 -4 -3 -2 -2 7.0 0 0 0 0 0 0 8.0 9 8 6 5 4 3 9.0 16 14 12 9 7 5 10.0 22 19 16 13 10 7 11.0 26 23 19 15 12 8 12.0 30 26 22 18 14 9 13.0 33 29 24 20 15 10 0 Zonal Control Adjustment Solar 14 7 10 8 7 6 4 3 9 No Cooling System Installed 2 Stories One -5 -4 -4 -3 -2 -2 III Two+ 3 3 2 2 2 1 Single -Family Detached and Attached Interior Mass/CFA Trve 2 MASS SCORE CARD Unit Size (sQ Eff. % Glass Water . 1199 1200 1700 2200 2700 Heater Credit or b to to or Type Type ' less 1699 2199 2699 more SG None 0 0 0 0 0 or Solar 12 8 6 5 4 HP HWR 8 5 4 3 3 ' WSB 5 3 3 2 2 30Y. POU 8. _ 5 4 _ 3 3 SE None 37 -24 -18 -15 -12 100% 105% 110Y. 115% 120% 125• Solar -1 -1 -1 0 0 1.1 HWR -18 -12 -9 -7 -6 2.S WSB -25 -16 -12 -10' -8 4 POU -18 _ -12 -9 -7 -6 IG None -5 -3 -2 -2 -2 1.4 Solar 7 5 4 3 2 2.9 POU 3 2 1 1 1 IE None -28 -19 -14 -11 .9 0.3 Solar 8 5 4 3 3 1.8 POU -10 -6 -5 -4 -3 3.3 Multi -Family (Individual units) 4.1 4.3 4.5 4.8 , Unit Size (sQ 5.2 Water 56 699 700 1200 1700 2200 Heater Credit or b to to or Type Type less 1199 1699 2199 more SG None 0 0 0 0 0 or Solar 14 7 . 5 4 3 HP HWR 9 5 3 2 2 3.2 WSB' 9 4 3 2 2 4.7 POU 9 5 3 2 2 SE None -45 -23 -15 -11 •9 21 Solar 2 1 1 0 0 3.6 HWR -23 -12 -8 -6 -5 5.1 WSB -25 -13 -8 -6 -5 0.9 _ EOU _23 t 2 8 b 5 IG None -8 -4 -3 -2 ( -2 3.9 Solar 6 3 2 1 - 1 5.3 POU 1 _0 0 0 0 IE None 30 -15 -10 -8 -6 2.7 Solar 18 9 6 4 4 4.2 POU -8 -4 -3 -2 -2 Interior Mass/CFA Trve 2 MASS SCORE CARD SC Eff. % Glass Measures . 1. Ceiling Insulation- .� or 3,t5�4 b. East R -value [381 U -value [0.030] 2. Wall Insulation _ lot, or c. South +,z R -value [ 11) U -value [0.098] 3. Raised Floor Insulation -- 5.6 x R -value [ 19] U -value [0.037] 4. Slab Edge Insulation ""' or �a'7e1dst'71 rc�etw .t.er R-value [0] F2 factor [0.771 5 Infiltration Standard •'� TYPE 1 MA55 WIMC a 4.2, Se: ex oscd slab) �_ _ Eff. % Glass a. North - - 4,L x '(00 = 3 , 93 b. East 4,4 ' 0% 5% 109'. 15% 20% 25% 30Y. 35% 40% 45% 50% 55% 60% 65Y. 70% 7S% 80% 85% 90% 95% 100% 105% 110Y. 115% 120% 125• OY. '0 0.2 0.4 0.6 0.8 1.1 1.3 1.S 1.7 1.9 2.1 2.3 2.S 2.7 2.9 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.8 5 53 10% 0.2 0.4 0.6 0.8 1 1.2. 1.4 I.S. 1.9 2.1 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.7 4 4.2 4.4 4.6 4.8 5 5.2 5.4 20% 0.3 0.6 0.8 1 1.2 1.4 1.6 1.8 2 2.2 24 27 29 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.8 5 5.2 5.4 56 30% 0.5 0.7 0.9 1.1 1.4 1.6 1.8 2 2.2 2.4 2.6 2.8 3 3.2 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 58 40Y. 0.7 0.9 1.1 1.3 1.5 1.7 1.9 2.2 24 2.6 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 5.5 5.7 5.9 50% 0.9 1.1 1.3 1.5 1.7 1.9 21 23 25 27 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 55% 0.9 1.1 1.4 1.6 1.8 2 2.2 2.4 2.6 28 3 3.2 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 5.8 6 62 60% 1 1.2 1.4 1.7 1.9 21 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.8 4 4.2 4.4 4.6 4.8 ' 5 5.2 5.4 5.6 5.9 6.1 63 65% 1.1 1.3 1.5 1.7 1.9 2.2 2.4 2.6 2.8 3 3.2 3.4 38 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 55 5.7 5.9 6.1 6.4 70Y. 1.2 1.4 1.6 1.8 2 2.2 2.5 27 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 52 5.4 5.6 58 6 62 64 75% 1.3 y1.5 1.7 1.9 21 2.3 25 2.7 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 80% 1.4 1.6 1.8 2 2.2 2.4 26 2.8 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 56 5.8 6 62 64 66 85% 1.4 1.7 1.9 2.1 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.8 4 4.2 4.4 4.6 4.8 5 52 54 56 59 6.1 63 65 67 909: 1.5 1.7 2 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 5.1 53 5.5 5.7 5.9 6.2 6.4 66 68 95% 1.6 1.8 2 2.2 2.5 27 2.9 3.1 33 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 5.2 5.4 5.6 5.8 6 6.2 6.4 6.7 69 100% 1.7 1.9 21 2.3 2.5 28 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 6.7 7 105% 1.8 2 2.2 2.4 2.6 2.8 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 56 5.8 6 6.2 6.4 66 68 7 110% 1.9 2.1 2.3 2.5 2.7 2.9 3.1 3.3 3.6 3.8 4 4.2 4.4 4.6 4.8 5 5.2 5.4 5.7 5.9 6.1 6.3 6.5 6.7 69 7.1 115% 2 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.5 5.7 5.9 6.2 6.4 6.6 6.8 7 72 120% 2 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.4 4.6 4.8 5 5.2 5.4 5.6 58 6 62 6.5 6.7 6.9 7.1 73 125% 2.1 2.3 2.5 2.8 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 6.7 7 7.2 7.4 Point System Summary: Climate Zone 11 SCORE CARD SC Eff. % Glass Measures . 1. Ceiling Insulation- .� or 3,t5�4 b. East R -value [381 U -value [0.030] 2. Wall Insulation _ lot, or c. South +,z R -value [ 11) U -value [0.098] 3. Raised Floor Insulation Q=IC)_ or 5.6 x R -value [ 19] U -value [0.037] 4. Slab Edge Insulation ""' or -'- R-value [0] F2 factor [0.771 5 Infiltration Standard •'� 6. Glass Heat Loss Type double U -value 0.65 %% Total Glass 1161 7. Shading (Shade Open) Point Scores a 0 0 -f-4- Sum 4Sum 1-6 WE t U 4 ,) A Sum 7-10 -Y -�2- J Point Total: % Glass SC Eff. % Glass a. North q-, 6 x .77 = 3,t5�4 b. East 444 x = 3✓�A3$ c. South +,z x d. West 5.6 x 4 _ 4.46 e. Skylight 0 x-- 8. Shading (Shade Closed) % Glass SC Eff. % Glass a. North - - 4,L x '(00 = 3 , 93 b. East 4,4 x c. South 42 x d. West 5,e x _ e. Skylight e2 x _ = 0 9. Interior Thermal Mass TYPE 1 MASS AREA = -% Interior Miss/CFA COND. FLOOR AREA 10. Exterior Wall Mass TYPE 2MASS AREA = V% _ Exterior Wall Mass ND. L OR AREA 11. Heating System ;72- x .00:5 Zonal Control? ( Y / N) SE or HSPF Duct Efficiency 10.781 • Effective SE or [0.72/6.6] HSPF [0.56/5.15] 12. Cooling System S : x .gig = 7,Z9 Zonal Control? ( Y / N) SEER [9.51 Duct Efficiency [0.74] Effective SEER [7.03] 13. Water Heating s Type [SG] Credit [none] Point Scores a 0 0 -f-4- Sum 4Sum 1-6 WE t U 4 ,) A Sum 7-10 -Y -�2- J Point Total: Rett -;Ii l;;� DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT 2 Section 26-8.t of the BuLte County, Code requires Lh-is acknowledgement be recorded pri.or to issuance of a building permit. ` 89--15122 The property described herein is adjacent ; to land or included within an area zoned 89-015122 Rec Fee 7.00 for agricultural purposes, and residents Total 7.00 of Lhis property may be subject to incon- Recorded veniences or discomfort arising from the use of agricultural chemicals, including, official Records but not limited to herbicides, pesticides, County of MIDVALLEY TITLE C9 and fertilizers; and from the pursuit Butte Candace J. Grubbs of agricultural operations including, Recorder but not limited to cultivation, plowing, g ; OOam 26 -Apr -89 spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has esLabLished ngric[II Lural zones which have as a priority use for productive agricultural purposes, and rvsidew rc within said zones and on adjacent property should be prepared to accept such i nc (niven i enc e or disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described ,1.1; follows: SEE ATTACHED DESCRIPTION....... Date: April 25, 1989 PROPERTY OWNERS: ep en A. sweet State of Butte ) On this the 25th day of April , 19 89 herore mcg, ) SS. the undersigned Notary Public, personally appeared County ofCaliforn�a Stephen A. Sweet Fti OFFICIAL SEALE] Personally known to me. QX Proved to me on the basis MARY R. CASEBEER ® NOTARYPUBLIC- CALIFORNIA of satisfactory evidence. r ® BUTTE COUNTY to be the person(s) whose name(s) is ,Foa,r WComm.ExpiresJan.29,1993 subscribed to the within instrument and acknowledged Lhal. __ executed the same for the purposes therein contained. I.N WI'I'NI;Ss WHEREOF, I hereunto set my hand and official seal.. Present A.P. No. - Z ' / Notary Public Mary R. Casebeer .9. 89 15.22`. :. DESCRIPTION ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, DESCRIBED AS FOLLOWS: PARCEL 1: PARCEL 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, BEING A PORTION OF LOT 12 OF THE FIRST SUBDIVISION OF THE BAY TRACT, WHICH PARCEL MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 29, 1984, IN BOOK 97 OF MAPS, AT PAGE (S) 77 A?dD 78. PARCEL II• A NON—EXCLUSIVE EASEMENT FOR INGRESS, EGRESS AND PUBLIC UTILITY PURPOSES OVER PARCELS. 1, 2 AND 3, AS SHOWN ON THAT CERTAIN PARCEL MAP, BEING A PORTION OF LOT 12 OF THE FIRST SUBDIVISION OF THE BAY TRACT, WHICH PARCEL MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 29, 1984, IN BOOK 97 OF MAPS, AT PAGE(S) 77 AND 78. EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED ABOVE. PARCEL III• A 12 FOOT DRAINAGE EASEMENT OVER PARCEL 2, AS SHOWN ON THAT CERTAIN PARCEL MAP,— BEING A PORTION OF LOT 12 OF THE FIRST SUBDIVISION OF THE BAY TRACT, WHICH PARCEL MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 29, 1984, IN BOOK 97 OF MAPS, AT PAGE(S) 77 AND 78. END 0F.D000MENT t RESIDENTIAL PLAN CHECKING GUIDE (CONT'D) MISCELLANEOUS ITEMS TO LOOK OUT FOR (CONTS'D) Garage door or porch header sizes. V Adequate bracing. 10", Living area over garage - complete 1 -hour separation required on garage side / including supporting walls and posts, etc. lk.- Two exits on three-story dwellings (Sec. 3303 & see Mezannines 1716). id lAttic access and ventilation (Sec. 3205). l� Underfloor access and ventilation (Sec. 2516). 1!"" Wood stoves, clearances, alcoves & 1 -hour shafts. l� Combustion air for fuel burning appliances. 1;., Noise requirements on duplexes. 1!' Adobe soils - special foundation design. 1_� Retaining walls requiring design. l�T/. Unusual shape, size or split level house requiring lateral design. . av-• , - - --i --- . - . 5. (TlU 4 -AM @ �JALcoN�y i "T��o S�^'►�� r'►��Srr A6t� 4v CARRY 4 ZS PLP W//(o LCF1� . EN�iNEEfi�� lK . Preto OK "V-44MS //�� ' OX M 7/85 Ac K w/Ow�l�lZ /�/�j9 _Lb -6A-V" D€T��cS r4�E �-l.l.Tti�A' Sw.ee7iF - RESIDENTIAL PLAN CHECKING GUIDE (S.F., DUPLEX & MISC. ONLY) Bldg. Permit # /OQ%—D/ OWNER STEPHEN W A.P. # 42.-59-11 GENERAL **.00'Zoning requirements: (sideyards and number of permitted living units). Valuation. Plans signed by designer. Energy Design and Compliance. M Existing violations on property. PLOT PLAN Complete parcel size and dimensions. -4 Setbacks, sideyards, easements, etc. /� Other buildings or structures. Grading, fills, drainage. VV Flood hazard. Special conditions o.n creation map or compliance document. 7/85 FLOOR PLAN V/' Complete to scale plan with dimensions. t� Required windows for light and ventilation (Sec. 1205). Required windows for second exit (Sec. 1204). Skylights (Chapter 34 & Sec. 5207). Human impact glass (Sec. 5406). 6/. Required room sizes, ceiling heights (Sec. 1207). G.F.C.I.'s in baths, garage and exterior outlets (Article 210-8). 8� Light fixtures, switches, receptacles, and exterior receptacles for maintenance of mechanical equipment. Locations of water heater, heating and cooling equipment, other electrical or gas equipment, and plumbing fixtures. 1t*'O' Garage firewall, door size, and closer (Sec. 503(d)(3)). 1*e 1 - 3'0" exterior exit door (Sec. 3304(e)). le Fireplace and wood stove location. li*. Smoke detectors (Sec. 1210). STRUCTURAL DETAILS V Foundation plan complete enough:to construct building. 2*. loor construction details complete enough:to construct building. Elevations and wall construction details complete enough to construct building. oof construction details complete enough to construct building. f! Fireplace construction details and calcs if necessary. 6� Sufficient data and details to satisfy energy requirements (State Law) (Form 1). MISCELLANEOUS ITEMS TO LOOK OUT FOR r000"Exposure I plywood on exposed locations and overhangs. Stairway details: landings, rise and run, head clearance, handrails (Sec. 3306). Guardrail details (Sec. 1711 & 3306(j)). Brick or stone veneer (Chapter 30). Exterior plaster - weep screeds (Sec. 4706). Proper roof pitch for roof covering (Chapter 32)H Rafter ties or bearing ridge beam. O-4 -,L,91- 3 MS ,L,9G3MS ti COUNTY OF BUTTE -"DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPMATION• ASVD PERMIT r PERMIT NO. � :7 &:7, — ASSESSOR PAR IA:NU BER 1,42=59-11 ZONING SR1 BUILDING PERMIT OWNER Ste hen Sweet TELEPHONE 89 775, SQ. FT. OCC. BUILDING VALUATION 420 M 5880 OWNER'S MAILING ADDRESS 4309 Rath Ln is CONTRACTOR' NAME John Linhart TELEPHONE , CONTRACTOR'S MAILING ADDRESS r Fireplace Henshaw Chico CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAIL NG ADDRESS Permit Fee $ 5fj 0 ARCHITECT OR ENGINEER LICENSE NO. i Plan Checking Fee $ 28.25 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 94.75 PLUMBING PERMIT Filing Fee 10.00 631 Breanna Ln. Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. 4 SUBDIVISION NAME PARCEL MAP 97-77 Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 SF'.® Duplex❑ Mobilehome❑ Other Mobile Home Is G W 10.00e SPECIFY TYPE OF WORK New ❑ Additiong Remodel ❑ Utilities ❑ Installation[] Other ❑ Permit Fee $ Describe work: add sq. ftg. garage BPO1097- 89 _ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 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 1, as the owner, or my employees with wages as their sole compen- NEW CONST. DWELLING OCCUR.& OR ADDNS. ( ACC. BLDGS. NEW CONSTR. ULTI.OUTLET NO N.RESID BRANCH CIRC ITS POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EAJ I 2/2Qsgft 2,50 ea 20@50t SAL@3o 2.00 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- ontract- ors.(Sec. 7044) ors. Temporary service Mobile Home Facilities Misc. Wiring g 10.00 15.00 15.00 ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 10.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ 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. Cooling g I shall not employ any person in any manner so as to become subject Hood 3.00 to the W. C. taws 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. Ventilation Permit Fee Contractor $ I certify that I have read this application and state that the above information Mobile Home Installation Fee $ is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue Energy Inspection Fee occ CONST TYPE TOTAL FEE $ HAZ CUA PARK SCHL FLD $ PAR HD ISSUE against said County in consequence oft nting of this permit.J_PD 1, I I I -under X Date ` Signature of Applicant — Owner,K Contractor ❑ Agent ❑ This permit is nereby issued the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. DIR O F P BLIC WORKS Receipt No. 4 6 & 3�9 4*)1 -14r 75 5�3i �90 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT BY "� PERMIT E PIRES Date c Dat�� 7� �I/ COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541' 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE ` v L3 7F 7- OWNER a, PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Date 6- — 5 ^ & Inspector COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE L OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. ow Wel �Ohtw -() Cgn4 e cfe., 7 't o Re-pmed D/-) Date -5 l U Inspector _ 'COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 ^ APPLItOON ANDYERMIT .� tO W ASSESSOR PARCEL NUMBER 42-59-11 ZONING SRI BUILDING PERMIT ] OWNER Ste hen Sweet TELEPHONE 893-8775 SQ. FT. OCC. BUILDING VALUATION 420 5880 O WNE 'S MAILING ADDRESS 4309 Kath A. co 95926 CONTRACTOR' NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS 669 Henshaw Chico — Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10,00 LENDER'S MAIL G ADDRESS Permit Fee $ 56 50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $28.25 J Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ .7 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. 4 SUBDIVISION NAME 1 PARCEL MAP 97-77 Water piping 5.00 Each Qas water heater or vent 5.00 USE OF STRUCTURE SFJ2 Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00e TYPE OF WORK New ❑ Addition XX Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: add sq. ft�g. garage BP#1097-89 _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR1 OR LESS10.00 Main service EA. ADD'L 100 AMP 2,50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BUS Ines$ 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) ElI, as the owner, am exclusively contracting with licensed contract - ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST./ DWELLING OCCUP.& OR ACDNS. C ACC. BLDGS. 2/zQsgft NEW CONSTR. M ULTI.OUTLET NON•RESID BRANCH CIRCITS 2,50 ea POWER APPARATUS &) SINGLE OUTLET CIR. Ex. Occu Occup(OUTLETS OR FIXTURES 20050e 5AL@30 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Coolin 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. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of t e anting of this permit Date � � X_,�_� ' Signature of Applicant — Owner& Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE HAZ CUA J__PARK SCHL FLo PAR PD HD ISSUE Th.$ permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIR T F P LIC BY ""� PERMIT E PIRES Date the applicable provi- resolutions to do have been paid. WORKS Date-�`�0 �., Receipt No. �nro3�9 n�gg:75 531 19,6 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT ,� ;',;^ `'"its:--'.� V'�p'�`�[ "•s:`ti.�9''�c4"+..-•�=:nP ���iy-r�'3-v^'-=,r,:� -; ^�Z %,;.+;1. .a�;'�, lf.,''"'��,,r� -.. S.' ! .... _ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE-.O�VILLX, CALIF,6RNIA 95965 - TELEPHONE: 916/538-7541 r f+a� PERMIT APPLICATION DATA SHEET - x p�^ Permit No. OWNER T �� S w&C j_ A. P. No. 4i-2 Proposed Building Use 1:)%2/4 Co Buri Iding Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ..................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions . 44- 10. Fees of qcJ• `?5"'�.....�gC�l* . (�(0�79 ............... 5 31 90 43GI 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) A 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, rocess s follows: Mai ^t own Mail to contractor. Telephone 3 7 and hold for pickup E Mail-to ice. Deliver w/inspector. Other Applicant__-/ t. -1._ At& Date Copy of Haz-Mat form sent Health Dept. Fire Dept. _Air Pollution Date Copy of plans sent ___HealthDept. Fire Dept. Other Date By. The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2, Additional items required: Contractor, designer, owner, was advised of above required data by_phone_mail—counter b..date Contractor, designer, owner, was advised of above required data by—phone —Mai I—co nter by date Plans checked by Date Plans approved by 4�4Date / Sets of plans on,hold in File cabinet AP folder f Copy—DPW - .53 E330 O wNER c O' -4R �1 C i N 'R 1 CON 7 R A COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telepnone: 916 '533-75-41 �PRUbTIQN' AND PERMIT ARCcL :vur+9 Ea Illb.-r* •A 00 LING A OR 33 CON 3 T�cl.0 • I O ret . C N O L N O E R\,i1S•/,M AA'' IN V;► V // v ��i LING ADDRESS ARCi-rI EC7 OR ENGINEER ARC7-rrTEG' JR ENGINE ER'S MsI GJRE55 L:Ny LOT NJ. I3U901VISION NAME PERMIT No. L-�/�-- I BUILDING PERMIT NE S0. FT. CC j 6UILDING VALUATION ' I I Other 2-b��3 5 .00 I Fireolace sewer Mobile Horne I S G I I UNr(Np WN Total valuation I S New Addition i Remodel II _' r - Utilities L•, InstallationL Other Filing Fee I Permit Fee 10.C40 LICE NSE vO, ?Ian Checxing Fee I S _ _ De / �01 5 Z I r =••- Pla,c ye_:<Ir ,- 'enaii•: ELECTRICAL PERMIT I FiiingFee I 10.00 iS • _ Permit fee I S PLUMBING PEB(411T j=,nngF�,q Main service Ei. AoO•; loo AMp �Ew coNST.pcc,� cacn Trac j 10.00 Solar or heat pump water heater 2.00 I 2'r =saftl Vater pioino I am under provisions of Chaot. 9. Div. 3 of the Business ono Professions Coae Each cas water - 5.co USE OF STRUCTURE S r 1 Duplex Mobilehomel -eater or vent Gas piping system t - 5 outlets 5.CO I I Other Buiidino 5 .00 s?Ec: Fv TYPE OF WORK sewer Mobile Horne I S G I I I I 5.00 1 110.00 ea New Addition i Remodel II _' r - Utilities L•, InstallationL Other I �1 _Fj. Describe work: s-} (� � Pennrt Fee S De / �01 Concrac:or - � ELECTRICAL PERMIT I FiiingFee I 10.00 Main service i?°V 'o _ESSEss I I t0.Q0 I - CONTRACTORS LICENSE LAW I declare under penalty of Main service Ei. AoO•; loo AMp �Ew coNST.pcc,� I I 2.50 I - Perjury I Y (check one): C I licensed oR SOONs. C �cc. 9�ccs. s) E" CJN5-� I 2'r =saftl am under provisions of Chaot. 9. Div. 3 of the Business ono Professions Coae ..� _-;•c -;_E_ `ON.R�SIC, >o A.vCu C:>C:':�5) I 12.SO eai Ana my license is in full force ana effect. License No, (�9WE '� °�' -Q5 S) SING`` =urn-- Z.R. I I C Classification I I, as the owner, or my employees with wages Ez. OCCUb(puE3 "^ •��a=s sAL, 3.,rl as their sol ccmben- cation, will do the work, ana the structure is not intenaea or for safe. 7044) ^ syJR-i) I 2.CO I (Sec. offered I, as Temoorary service I 110.00 the owner, am exclusively contracting with licensed contract- ors. (Sec. 70aa) Plobile Home Facilities I i 15.00 I [i I am exempt under Sec. B Business and Professions Code Misc.'1liring I IS.CO I for this reason I I I Permit Fee WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury Coniractor S I y (check one): `: The cermi( is for SiC0.00 (valuation)or less. MECHANICAL PER,% IT I FiiinbFee I iG.GO (- have �lacec on file witn :ne County of qu:;e a Car-,;ficace of workmen's =u''d'ng rCertif,cate Compensaticn Insurance dr a Certificate of Consent to Self -Insure. I j I snail not employan y person in any manner so Cooling as to become subject to the W. C. laws of California. Hood Notice to Applicant: It after making this statement, should you become subject to the W. C. provisions of the Labor Ventilation I 3.00 j Code, you must forthwith Comoly W1tn Such provisions or this permit shall be deemed revoked. Penult Fee S I certify that I have read this Contractor acolicatfon ana state trial the above information is correct. I agree to comp) to all to building Y County Ortlinanc�s a Installation Fee S and State Laws relating g construction• and hereby authorize reoresentatives of theCounty Butte to enter upon the above-mentionea Energy Ins Ener Inscec:ion Fie 5 of property for inspection purposes. I also agree to save. Indemnify and keep harmless occ CONST ry/£ the County of Butte against all liabilities, judgments, costs• and exbenses wnich TOTAL FEES l may in any way accrue against said'County in consequence of the granting _. 9 got this permit. I "AL I CUA i PARI( I SCNL I FLO I PAR I Po I»o IssuE X -- Date' Signature of Applicant _ • 0 r^ .•... ^•• L Contractor G Agent Th:s permit is Here by issuea urger the aopucaote prove - sions or the Butte Ccunty Coae and/cr resolutions p L_l t OSHA permit i1 required for •acavatlons over j'Q" '.' ion ion of structures aver 3 stones In helgnt, d••o and demolition or construct. work indicatea above for wni to do Ch tees have been paid - - .;'..• DIRECTOR OF PUBLIC WORKS -•- - 1 Receipt No. aoLoc».00-...LIcA.r Y '•,• BY -! 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